Migration Matters: Mental Health in the Field

Story by Nadia Kalinchuk, National Headquarters, RFL Outreach Coordinator and Caseworker for the Americas, Migration Focal Point

This week, the blog has highlighted migration in the Americas, specifically tapping into my experiences during field visits to El Salvador, Honduras and Guatemala. The stories from the field give context to the work the Red Cross does to provide care for others. However, we often don’t talk about the elephant in the room – our humanity, reactions and need for self-care. The size of the problems, the needs that one faces in the field, and the passion we have to make a difference all have a psychological impact. In this blog, I would like to take the opportunity to bring together migration field work and self-care perspectives and strategies. I would like to humbly admit that I am not a guru and that I, myself, struggle with self-care, but this lack of perfection will grant us the opportunity to discuss the challenges to self-care more frankly.

The context: migration field work in the Americas

Since May 2014, there have been news reports, meetings, press conferences, meetings, teleconferences, meetings, action alerts, meetings, emails upon emails and, oh, did I mention meetings? There were many of all these things – all about migration. But the work didn’t start in May. Rather, the issue of migration is long-standing and transcends many borders. The catalyst for the added attention to migration in the region came to light during the time when unaccompanied children were coming to the US at a rate of over 300 a day. During this time, many stories and reports were launched, each with tragic stories attached. It became impossible to read the news without thinking that there should be a trigger warning attached to each segment.

Similarly, field visits to the border and the Northern Triangle provided exposure to people with great needs, large and complex problems within even more complicated contexts. Even as I grapple with situations within the confines of an office, close to home, it still comes with a unique set of challenges. I bring up the context because context will always impact a worker’s response.

For some humanitarian workers, their context is the frontline of a conflict or international disaster. The mere fact that, often times, there is isolation, lack of familial contact, and an inability to physically separate oneself from the situation, makes these critical incidents for the affected population and the responding worker. Each context is different and cannot be oversimplified into a mechanical, universal, response.

Perspectives

International response has not always been effective in addressing the needs of staff and volunteers. Many reports have found that despite the adventurous disposition of many aid workers, there is a high percentage of depression and substance abuse, yet debriefs can be seen as impractical, out of touch, or retraumatizing.

Similarly, some would argue that self-care is only part of the puzzle, and that international organizations should shoulder some of the responsibility in providing support for workers. Regardless, the narrative of humanitarian work would have us believe that caring for others, including the worker, is fundamental, making the investment of time and effort into a resilient workforce, a moral imperative. This perspective just lays the ground for discussing strategies.

Strategies

In addition to organizational strategies (which is another blog for another time) I have found it important to build my own coping strategies. Here are a few that I came up with. They worked for me. They are not comprehensive. They may work for some, but not others. And feel free to share your own in the comment section.

1. Assess my reality before I deploy. My reality includes leaving a family at home, working with children, having contact with people who look like me, in fact, could be family, experiencing violence, fleeing violence and facing uncertainty. There is obviously much more to this, but just taking a moment to breathe and acknowledge my own challenges and the realities ahead helped.

2. Connect, connect, connect. I reach out to people, mostly my spouse and friends from work, when I am getting ready to visit the field. My spouse knows I need time to talk out my anxieties, but he also holds me accountable to unplugging the computers and cell phone when I am at home. We take time to talk, spend time with the family and friends, go to yoga, laugh. Seriously though, laughter should have its own category.

3. Don’t compare yourself with others or take yourself too seriously. It is easy to come back from a field visit and say things like, “well, yeah…that is bad, but I have no room to complain after what I saw.”  I am allowed to be human and complain about silly things if I see fit. I am not a martyr or a saint. Yes, you gain perspective in all of life’s experiences, but we all have needs even in light of great suffering. And again, laugh, especially at yourself.

4. Process. I just read that the blogosphere has helped in the self-care of humanitarian workers. How about that? It helps to feel connected. One of the biggest risks to depression, anxiety and substance abuse is the feeling of isolation.

5. Have a plan. I like to build a highly unrealistic self-care plan each visit. I know I might not get to all of it while I am in the field, but the intentions and the creation of the plan have put my mind in a place to commit to myself, my care. One of the key things I sort out before I leave is a call schedule for me and my family. Then, I tell my colleagues when I get there that I have a standing appointment at XX hour and I go call my family at that time.

These are a few tips, but I welcome yours! What works for you? What has been a challenge? I want to know and I want to open up discussion on how to build a resilient workforce. Have a great weekend and be sure to unplug!