title: Mental health and psychosocial wellbeing of Syrians affected by armed conflict.
abstract: OBJECTIVE
  This paper is based on a report commissioned by the United Nations High Commissioner for Refugees, which aims to provide information on cultural aspects of mental health and psychosocial wellbeing relevant to care and support for Syrians affected by the crisis. This paper aims to inform mental health and psychosocial support (MHPSS) staff of the mental health and psychosocial wellbeing issues facing Syrians who are internally displaced and Syrian refugees.
  
  
  METHODS
  We conducted a systematic literature search designed to capture clinical, social science and general literature examining the mental health of the Syrian population. The main medical, psychological and social sciences databases (e.g. Medline, PubMed, PsycInfo) were searched (until July 2015) in Arabic, English and French language sources. This search was supplemented with web-based searches in Arabic, English and French media, and in assessment reports and evaluations, by nongovernmental organisations, intergovernmental organisations and agencies of the United Nations. This search strategy should not be taken as a comprehensive review of all issues related to MHPSS of Syrians as some unpublished reports and evaluations were not reviewed.
  
  
  RESULTS
  Conflict affected Syrians may experience a wide range of mental health problems including (1) exacerbations of pre-existing mental disorders; (2) new problems caused by conflict related violence, displacement and multiple losses; as well as (3) issues related to adaptation to the post-emergency context, for example living conditions in the countries of refuge. Some populations are particularly vulnerable such as men and women survivors of sexual or gender based violence, children who have experienced violence and exploitation and Syrians who are lesbian, gay, bisexual, transgender or intersex. Several factors influence access to MHPSS services including language barriers, stigma associated with seeking mental health care and the power dynamics of the helping relationship. Trust and collaboration can be maximised by ensuring a culturally safe environment, respectful of diversity and based on mutual respect, in which the perspectives of clients and their families can be carefully explored.
  
  
  CONCLUSIONS
  Sociocultural knowledge and cultural competency can improve the design and delivery of interventions to promote mental health and psychosocial wellbeing of Syrians affected by armed conflict and displacement, both within Syria and in countries hosting refugees from Syria.
authors.affiliation: Department of Psychology,UQAM University,Montreal,Quebec,Canada.
authors.forename: G
authors.initials: G
authors.lastname: Hassan
authors.affiliation: Public Health Section/DPSM, UNHCR,Geneva,Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Ventevogel
authors.affiliation: Medical School,University of Massachusetts,Boston, MA,USA.
authors.forename: H
authors.initials: H
authors.lastname: Jefee-Bahloul
authors.affiliation: Yale School of Medicine,Yale University,New Haven, CT,USA.
authors.forename: A
authors.initials: A
authors.lastname: Barkil-Oteo
authors.affiliation: Department of Psychiatry,Division of Social and Cultural Psychiatry,McGill University,Montreal,Quebec,Canada.
authors.forename: L J
authors.initials: LJ
authors.lastname: Kirmayer
mesh_terms: D000328:Adult; D000068337:Armed Conflicts; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D012036:Refugees; D000072339:Sexual and Gender Minorities; D017741:Survivors / Q000523:psychology*; D013593:Syria; D014754:Violence
keywords: Mental health; multicultural; other psychosocial techniques/treatments; psychological assessment
references.citation: Br J Psychiatry. 2012 Oct;201(4):276-81
references.pmid: 22844022
references.citation: Community Ment Health J. 2011 Jun;47(3):331-40
references.pmid: 20446036
references.citation: Am J Psychiatry. 2013 Dec;170(12):1396-7
references.pmid: 24306337
references.citation: Lancet. 2008 Apr 5;371(9619):1165-72
references.pmid: 18395577
references.citation: BMJ. 2015 Sep 09;351:h4833
references.pmid: 26354032
references.citation: BMC Womens Health. 2014 Feb 20;14(1):25
references.pmid: 24552142
references.citation: Lancet Psychiatry. 2015 Oct;2(10):870-1
references.pmid: 26462218
references.citation: Psychiatry. 2014 Summer;77(2):130-54
references.pmid: 24865197
references.citation: Transcult Psychiatry. 2012 Apr;49(2):149-64
references.pmid: 22508634
references.citation: Eur J Psychotraumatol. 2015 May 18;6:27414
references.pmid: 25989952
references.citation: Compr Psychiatry. 2004 Nov-Dec;45(6):475-82
references.pmid: 15526259
references.citation: Lancet. 2003 Jun 21;361(9375):2128-30
references.pmid: 12826440
references.citation: Int Rev Psychiatry. 2022 Sep;34(6):604-612
references.pmid: 36502397
references.citation: Br J Psychiatry. 2016 Aug;209(2):99-106
references.pmid: 27103679
references.citation: Eur Psychiatry. 2014 Feb;29(2):107-15
references.pmid: 24503244
references.citation: Bull World Health Organ. 2015 Oct 1;93(10):666-666A
references.pmid: 26600604
references.citation: Confl Health. 2015 Apr 09;9:12
references.pmid: 26056531
references.citation: Glob Ment Health (Camb). 2015 Jun 19;2:e8
references.pmid: 28596856
references.citation: Lancet. 2015 Oct 17;386(10003):1531
references.pmid: 26530614
references.citation: JAMA. 1998 Aug 5;280(5):443-8
references.pmid: 9701080
references.citation: Telemed J E Health. 2014 Oct;20(10):977-9
references.pmid: 25188281
references.citation: Int J Soc Psychiatry. 2004 Jun;50(2):102-14
references.pmid: 15293428
references.citation: Lancet. 2013 Jun 22;381(9884):2165-6
references.pmid: 23768843
references.citation: Soc Sci Med. 2010 Jan;70(1):7-16
references.pmid: 19854552
references.citation: CMAJ. 2011 Sep 6;183(12):E959-67
references.pmid: 20603342
references.citation: J Trauma Stress. 1996 Jul;9(3):595-606
references.pmid: 8827659
references.citation: JAMA. 2009 Aug 5;302(5):537-49
references.pmid: 19654388
references.citation: Br J Psychiatry. 1998 Jan;172:90-4
references.pmid: 9534840
references.citation: Int J Soc Psychiatry. 2007 Sep;53(5):447-63
references.pmid: 18018666
references.citation: Lancet. 2015 Jun 13;385(9985):2341-2
references.pmid: 26088630
references.citation: Int J Drug Policy. 2015 Jan;26(1):116-8
references.pmid: 24947994
references.citation: Lancet. 2004 Dec 4-10;364(9450):2058-67
references.pmid: 15582064