Gaps in mental health care
Nearly 450 patients seek mental health counseling in the Jamtoli and Hakimpara health facilities alone. The prevalence of chronic psychosis—a severe mental disorder that requires psychotropic treatment—is high among MSF patients. When 17-year-old Rohingya twins Abdul Hasim and Abdul Halim first came to the Jamtoli health center, they behaved like small children and were disconnected from reality. Disorganized thinking, seeing or hearing things that are not there, and other behaviors exhibited by the twins are typical signs of psychosis.
Many MSF patients complain of nightmares and flashbacks. Aggressiveness, suicidal tendencies, delusions, and substance addiction are also common. MSF psychologists say these are symptoms of trauma and unresolved grief. Other patients suffer from bipolar disorder, schizophrenia or other psychoses, and psychological difficulties linked to epilepsy.
When the influx of refugees in 2017 began, psychosocial support was essential to helping survivors cope with the trauma of suffering extreme violence. Today, psychiatric care, combined with psychosocial support, is necessary to alleviate the mental health conditions exacerbated by life in the camp.
The need for mental health care remains an unaddressed gap. Increasing long-term comprehensive mental health services requires additional resources and personnel to evaluate the true extent of mental health issues in the refugee camps. The health response needs trained psychiatrists who can diagnose and prescribe medicines to treat severe mental disorders.
Another gap is services for children with developmental, neurological, or learning disabilities or delays.
“We have patients with cerebral palsy, attention deficit disorder, and autism-spectrum disorders who cannot go to a regular school or a learning center, as they get teased and bullied,” said Iyer. “They suffer in silence.”
MSF health facilities across the Cox’s Bazar district—which more than 1,500 square miles—aim to support local health structures in addressing the growing needs of patients. While the majority of MSF’s patients are Rohingya, comprehensive mental health care services are also available for Bangladeshis.