The nearly 12 million Syrians -- half of them children -- who have fled their homes to protect themselves and their families have seen unspeakable violence, both during the war in Syria and during their escapes.
These experiences are understandably traumatic, but their long-term effect may be even greater than we realized. A new study has found that half of the Syrian refugees who have fled to Germany are experiencing psychological distress and mental illness resulting from trauma, Germany's chamber of psychotherapists announced this week.
The chamber's recent research highlights the devastating legacy of the refugee crisis, including long-term mental health issues for adults and children who have fled their homes.
The researchers evaluated refugees seeking asylum in Germany, and found that more than 70 percent had witnessed violence and that about 50 percent were victims of violence themselves.
"There are three major potentially traumatic backgrounds: being involved in a war in Syria, being a refugee and arriving in a new foreign country," Dr. Peter Henningsen, a professor of psychosomatic medicine at the Technical University of Munich who has been invovled with previous research on refugees, explained in an email to The Huffington Post.
More than half experienced mental illness, including post-traumatic stress disorder and depression, as a result. The findings also revealed that 40 percent of adult refugees experienced nightmares, and 50 percent had vivid flashbacks reliving a tramaumatic event.
Forty percent of the children who were evaluated had witnessed violence, and 26 percent had watched their families being attacked, the new research found. Earlier this year, Henningsen and colleagues studied 100 Syrian children and adolescents at a refugee center in Munich, and found that 1 in 5 suffers from a psychological disorder as a result of trauma.
Dietrich Munz, president of the German chamber of psychotherapists, estimated that while 3,000 to 4,000 psychotherapy sessions are offered in German refugee camps each year, the demand may be 20 times higher.
"Sadly, since the focus in resettlement is on physical injuries and the treatment of infectious diseases the identification, and treatment of mental health problems is often overlooked," Dr. Priscilla Daas-Brailsford, an international psychologist and trauma specialist at Georgetown University, told The Huffington Post in an email.
"Language and cultural barriers and biases frequently come in the way of the refugee and the helper," she added. "Training of culturally competent providers is therefore crucial in overcoming some of these challenges. Much work remains to be done."
There's more that we can be doing to help these people, Henningsen agreed. While ending war isn't realistic, providing better mental health care for people who have been affected by it is.
"Secondary prevention is more realistic -- that is, early recognition of psychological distress through systematic screening, psychoeducation, helping the helpers to cope, low level interventions, offer for specialist treatment where needed," Henningsen said.