Meeting the mental-health needs of London's Yazidi refugees

Hundreds of Yazidis from Iraq have resettled in southwestern Ontario. Many are dealing with considerable trauma — are local institutions equipped to support them?
By Mary Baxter - Published on February 28, 2019
a building in London, Ontario
The Cross Cultural Learner Centre, a non-profit settlement organization and support network, delivers the federal resettlement-assistance program in the London area.(Tareq Nasser/google.com)

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LONDON — Ramzya Issa came to Canada seeking a fresh start and a sense of safety. Instead, since leaving a refugee camp in war-torn Iraq, the 22-year-old Yazidi woman’s life has been defined by something else: “Every day, I’m worrying,” she says.

Issa, like thousands of women and children who share her faith, Yazidism, was enslaved by the Islamic State — in her case, for more than two years, from 2014 to 2017. She “slipped away” from her captors, she says. Today, she finds it challenging to adjust to a new culture; she feels concern for her family left behind (two of her sisters are still captives of the Islamic State; her parents, one brother, and a sister-in-law remain in the refugee camp; another brother came with her to Canada). She’s not the only one in London facing such challenges.

Of 1,200 Yazidi refugees brought to Canada in 2017 under a federal-government program, Issa is one of 370 who settled in London. Her near-constant anxiety about family members who remain in Iraq is something shared by many others in her situation, says Rifat Hussain, settlement-services manager at the Cross Cultural Learner Centre, a non-profit settlement organization and support network that delivers the federal resettlement-assistance program in the London area. “Any newcomer that comes in from these war-torn countries, they want to make sure their family is okay,” she says. “The unfortunate thing with this community is that it has an extra concern because there is legitimate torture involved.”

But there’s an unfortunate reality that makes resettling the Yazidis difficult, says Karen Bax, a psychology professor at Western University: Canadian organizations still don’t know how best to help. Health professionals are “not prepared for that,” she says. “We haven't had to, as a society, deal with quite that extent of harm to individuals’ mind and body.”

Largely clustered near Mount Sinjar in northwest Iraq, the Yazidis have been the target of dozens of genocidal efforts over several centuries. The most recent of these, led by the Islamic State in August 2014, resulted in mass killings, the destruction of towns, the flight of thousands of people from their homes, and the abduction of thousands of women and children. Most of the Yazidis who came to London are under the age of 17, according to statistics from the Merrymount Family Support and Crisis Centre, a non-profit facility that provides mental-health services to children and families.  

Their ordeal has given rise to unusual and complex conditions, such as pseudo-seizures, which resemble epileptic seizures but are, doctors believe, the result of post-traumatic stress. The condition is rare, affecting just two to 33 per 100,000 people in Canada a year. According to the Globe and Mail, the rate is much higher in the Canadian Yazidi population: six of the 300 Yazidis who have settled in Calgary have been diagnosed with the condition. Mundane details of daily life can be triggering: a bus trip may return them to their initial kidnapping; a loud noise can resemble a gunshot. “The extent of incredible trauma that the Yazidi population has experienced is beyond what most any other population in Canada has gone through,” says Bax.

The trauma has exacerbated pre-existing medical conditions and created behavioural issues in children, some of whom had been forced by the Islamic State to become child soldiers and turn against their families. “Many families are living with open wounds, current and complex trauma,” according to a six-page submission by the London Cross Culture Centre to the House of Commons Standing Committee on Citizenship and Immigration in 2017. “Therefore, settlement is hard to attain when grieving processes are hard to even entertain, let alone endeavour to start.”

Cross Cultural Learner’s Hussain says settlement workers were aware of the issues and did prepare by taking training in managing mental-health issues. Normally, she adds, the agency researches the community a refugee group comes from in order to identify any potential triggers. But in the case of the Yazidis, it has been difficult to anticipate when something may trigger a reaction. She recalls that one woman fainted during an information session after imagining she’d recognized someone who had harmed her. “This community is so unique in that so much has happened — so much has happened that anything could trigger a reaction.”

Their acute forms of post-traumatic stress haven’t been the only barriers to integration. Sherin Hussien, program director at Merrymount, cites communication as an issue. Many of the refugees are illiterate. Some do speak Arabic, “but we need to be culturally sensitive,” she says, because many were forced to learn the language in captivity. And it’s not just about finding the right words: the Yazidi culture does not include concepts such as mental health or counselling. “I need to explain it,” Hussien says. “I need to explain confidentiality. I need to explain about using an interpreter in the room.”

Karen Bax, who is also the director of the Mary J. Wright Research and Education Centre at Merrymount, says it has found success teaching families to manage emotions and communicate better — describing how the brain works under stress, teaching mindfulness (how to pay attention to in-the-moment thoughts, feelings, and sensations). Data collected over the past two years about 40 families participating in an eight-week program, called Making Mindfulness Matter, show that both parents and children use these skills four to six times a week. “Just like learning to play the piano,” Bax says, “your brain needs to make those connections over and over and over again for you to see results.”

Hoping to build off this success, Merrymount and partners such as Western University and the Canadian Mental Health Association have applied to the Public Health Agency of Canada for funding to expand the program by adding components that address the impact of trauma on the brain. The plan is to develop customized cultural materials and pilot the program locally, then scale it up for regional and national delivery. In addition, the proposal involves adapting the program for Syrian refugees, who are also identified as being at risk of experiencing significant mental-health issues. With a better understanding of how their brains have been affected by the war, the thinking goes, refugees will be able to take control of their own recovery.  

Merrymount is currently facing a $1.5 million budget shortfall, partly because of the rising costs of providing support to Yazidi families: interpreters need training; transportation that avoids public buses can be expensive. The agency appealed to the city for more funding, but council denied the request. Some councillors cited budget constraints and said that it shouldn’t be a municipal responsibility. Council directed city staff to explore other potential sources of funding.

Meanwhile, the federal Liberal government is facing opposition pressure to provide more aid for resettled Yazidis. Doctors and activists are becoming increasingly vocal about the need to tackle physical-health problems, and Conservative immigration critic Michelle Rempel has called on the government to fast-track family reunification.

Until that happens, Issa is left wondering about her family still in Iraq.

She volunteers, studies English, and thinks about pursuing her education. There have been some high points since she arrived in her adopted home, such as spending Christmas with a Canadian friend. But she’s still not comfortable asking for help from people she doesn’t know: in the village where she grew up, everyone knew everyone else. 

Last summer, she begged her mother to let her return to the refugee camp. “My mom said, ‘No, you don't have to come back with us.’ She said, ‘I want you to stay here.’ And now it's hard for me.”

This is one in a series of stories about issues affecting southwestern Ontario. It's brought to you with the assistance of faculty and students from Western University’s Faculty of Information and Media Studies.

Ontario Hubs are made possible by the Barry and Laurie Green Family Charitable Trust & Goldie Feldman.

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