Abstract
Objective: We describe the challenges confronted and lessons learned in implementing mental
healthcare during the Syrian war to inform effective services for conflict-affected
Syrian populations. Materials and Methods: We searched the academic and gray literature. We draw on the experiences of Syrian-American
mental health professionals with nine years of experience providing clinical and programmatic
mental healthcare in combat settings, siege, internally displaced person camps, and
refugee camps. Results: Collaboration with nonprofessional personnel was essential due to the shortage of
formally trained mental healthcare professionals in Syria. The use of psychological
and diagnostic terms increased stigma, whereas asking about the patient’s identified
problem, “suffering,” or “challenges” supported engagement. War-related trauma and
horizontal violence commonly affect Syrian children, adolescents, and adults. Resilience
and engagement were enhanced by sensitivity to patients’ dignity, religious acceptance,
and faith. Conclusions: The Syrian war remains an ongoing public health and humanitarian crisis in which
mental healthcare must adapt rapidly to specific needs and resources of the patient
and community. Psychiatrists can increase the acceptability and efficacy of their
care by being sensitive to Syrian patients’ experiences of horizontal violence, loss
of dignity, stigma, worldviews in which religion and faith may be important sources
of resilience, and culturally acceptable modes of communication.
Keywords
Conflict - mental health - refugee - Syria - trauma - violence
