UNTANGLING THE NEEDS OF REFUGEES IN MALAYSIA: THE WAY FORWARD

Background and Purpose: NGOs have become the most vital actors in meeting refugees’ needs in Malaysia; alas, most of these concerns cover basic needs such as food, health care, and education. In this regard, this study investigates other forms of NGOs assistance that ought to be provided to Malaysia's refugee communities to enhance living standards. Methodology: This study employs a qualitative approach consisting of semi-structured interviews with Somalian, Rohingya, Pakistani and Syrian refugees. Data were collected during observation trips in Penang, Kedah, Selangor, Kuala Lumpur, and Johor to comprehensively understand these diasporic communities, notably regarding the challenges refugees face in Malaysia. Findings: The data indicated that refugee communities are significantly in need of proper and accessible channels through which they might share their grievances, temporary shelters, mental health care, and language classes. The team concluded that these forms of assistance ought to be made available to all refugee communities in Malaysia. Without such forms of assistance from NGOs, refugees' lived realities are made invariably more difficult; this is in addition to their vulnerability to forces that threaten their security. Contributions: This paper provides insights into the needs of refugees in Malaysia based on interviews and observations conducted with them. Based on the findings, this research provides recommendations to NGOs to ameliorate life necessities for refugee communities. Keywords: Humanitarian assistance, Malaysia, NGOs, refugees, UNHCR. Cite as: Nazri, A. S., Talib@Khalid, K. A., Sulaiman, N., & Gidah, M. E. (2022). Untangling the needs of refugees in Malaysia: The way forward. Journal of Nusantara Studies, 7(1), 196-220. http://dx.doi.org/10.24200/jonus.vol7iss1pp196-220

The Experiences and Views of Service Providers on the Mental Health and Well-Being Services for Syrian Refugees in Coventry and Warwickshire

Objectives: Previous literature demonstrated that, even when mental health and psychological support services are available for refugees, there may still be obstacles in accessing services. This is the first known study to explore the experiences of mental-health and well-being services for Syrian refugees in Coventry and Warwickshire, United Kingdom. The research investigates the views and perceptions of service providers on the current mental-health and well-being services provided for this population. Methods: Eight service providers participated in semistructured interviews and focus groups, and the data were analyzed using thematic analysis. Results: Three main themes emerged from an analysis of the data: “positive aspects of service delivery,” “service challenges,” and “recommendations for service improvements and quality.” Conclusion: The findings bring to the fore specific gaps in current provision and interpreting services. Recommendations for proposed improvements in service provision and policy as well as clinical implications are included in this article.

States and Refugee Integration: a Comparative Analysis of France, Germany, and Switzerland

The Syrian civil war led to mass migration and Europe becoming a potential site of refuge. How have Syrians experienced refuge in Europe? Drawing on 58 interviews with Syrian refugees in Germany, France, and Switzerland, we find that refugees continue to experience exclusion in all integration domains including those found as markers and means, social connections, facilitators, and foundations of integration . While our cases demonstrate that Syrian refugees in Europe experience discrimination across all domains, not all conditions are equal. Using narrative analysis, differences were observed within three integration domains. Accessing language programs was more challenging in France, finding housing was more challenging in Germany, and F type residence permits limited refugees’ rights in Switzerland more than in other countries. Discrimination across domains is deepening the socio-cultural-economic divide between autochthonous communities and Syrian refugees, but not all domains are equally divisive across countries. The findings outline that where these states outsourced refugee services, refugees experienced increased barriers to integration.

Prevalence of common mental disorders in adult Syrian refugees resettled in high income Western countries: a systematic review and meta-analysis

Background The immense social upheaval and ongoing humanitarian crisis created by the 2011 war in Syria has forced millions of civilians to flee their homeland, many of whom seek refugee status in Western nations. Whilst it is known that the prevalence of mental illness is higher within refugee populations, this systematic review and meta-analysis aims to pool the prevalence rates of common mental disorders (namely posttraumatic stress disorder, depression and generalized anxiety disorder) in adult Syrian refugees resettled in high income Western countries. Methods Seven electronic databases (Medline, PsychInfo, CINAHL, PTSDpubs, SCOPUS, PubMed and Embase) were searched up to the 31st of December 2020. Using pre-determined inclusion and exclusion criteria, relevant articles were screened by title and abstract, and later by full text. A meta-analysis was used to estimate the prevalence rates for each mental illness. Results Eleven studies met the eligibility criteria for the systematic review. Nine of these studies had a low-moderate risk of bias and were included in the meta-analysis. Of the 4873 refugees included in the meta-analysis, the total pooled prevalence rate of having any of the three mental disorders was 33% (CI 95%, 27-40%), 40% for anxiety (CI 95%, 31-50%), 31% for depression (CI 95%, 20-44%) and 31% for PTSD (CI 95%, 22-41%). A meta-regression revealed that the total pooled prevalence rate for having any of the three mental disorders was not influenced by age, host country, duration in host country, educational or marital status. Conclusions Despite significant study heterogeneity, the prevalence rates of common mental disorders in adult Syrian refugees resettled in high-income Western countries are significantly higher than reported rates in the general population.

Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial

Background Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention. Methods Refugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n = 24) or E-CAU only (n = 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses. Results There were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found. Conclusions gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT. Trial registration ClinicalTrials.gov Identifier NCT03567083; date: 25/06/2018.

An Invitation to Civic Dialogue

Those of us who have benefited from the climate of injustice need an invitation from others to join with them in changing our social climate to a climate of justice. The controversaries over national monuments opens the door to explore the question of who needs an invitation from whom and what white people need to learn in order to respond to the civilian invitation from others. The others include future generations, Syrian refugees, migrants at our Southern border, and personal invitations from People of Color. Personal invitations depend on our aptitude in engaging in dialogue, as is illustrated by an imaginary dialogue involving a white man and a black woman. Such dialogues can create the conditions for good conversations, and these conversation can move us toward a climate of justice—an ethical foundation for developing policies to protect our habitat for future generations.