• Anna Pochtarenko | Public Information Assistant
  • Marie Rumlerova | MHPSS Specialist
  • Olga Sydoruk | Case Worker (Psychologist)

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The little fabric bag is emptied, and the colourful stones shine on the table. “People often have a hard time talking about their mental health. It is easier for them to describe their physical and medical condition, financial or accommodation problems,” explains Marie Rumlerová, a Mental Health and Psychosocial Support (MHPSS) specialist with the International Organization for Migration (IOM) in Czechia, as she prepares for a group counselling session with Ukrainian refugees. “These stones help us connect and start a dialogue. Working with symbols and images helps our beneficiaries visualize and express their emotions and internal conflicts.”

IOM has been providing MHPSS support in Czechia as a part of the Ukraine response since October 2022. Individual and group sessions in Ukrainian, Czech and English are complemented by support to local community workers. IOM sees the need to focus on preventing emotional burnout and therefore conducts workshops for community workers and other specialists who are closely working with refugees from Ukraine.

The IOM MHPSS team works closely with implementing partners to improve beneficiaries' well-being and social adaptation. A referral mechanism allows beneficiaries to be referred to specialist services, including psychotherapists, child-specific therapies, hospital appointments, autism services and peer-to-peer support groups.

"Working with symbols and images helps our beneficiaries visualize and express their emotions and internal conflicts.”

Homesickness, grief and guilt

Every form of migration is stressful because people miss their relatives and routine, need to adjust to a new culture and redefine their identities. In addition, people fleeing war often have to cope with the negative psychological reactions resulting from the violence, fear, losses and threats they experienced during hostilities.

“Yet the most common problem I encounter is guilt,” says Olga Sydoruk, a psychologist and caseworker in the IOM MHPSS team in Czechia. Many people, whom we meet feel guilty for leaving. They meet difficulties to stay in touch with their relatives and friends, who are in Ukraine. Living in safer, better conditions, they are afraid to share photos from the country that sheltered them, as this may cause anger among those who remained in Ukraine. Perhaps their anger is just a defence, a way to express their pain,” explains Olga. “Sometimes anger can be managed with simple words: ‘I understand how difficult your situation is now. You have a right to feel frustrated.  Is there a way I can support you?’” she adds.

Single parenting doubles isolation

“Out of all refugees from Ukraine, mothers with small children are in most distress,” explains Marie. “You can’t do your best for your baby if you don’t receive any support,” she adds. Most of these women are lonely, away from their husbands and relatives – men aged 18 to 60 are not allowed to leave Ukraine – deprived of any family support. Since they spend all their time looking after their children, these women cannot work to make a living. As a result, many experience financial problems. Locked in their routine, with no one to talk to, without access to integration opportunities, they face double isolation: as mothers and as migrants.

Women who take part in IOM MHPSS group counselling sessions can leave their children in a nearby playroom with a babysitter. For many of them, these two hours a week are the only time they have for themselves. Even in the most desperate situations, mothers rarely ask for help. They are more likely to ask for help for their children, rather than for themselves.

When listening is the best advice

IOM MHPSS specialists use a variety of tools including therapy cards, art therapy, storytelling, games, colouring books and other self-expression forms, as well as relaxation techniques such as cognitive behaviour therapy, meditation and somatic symptoms discussions. Association cards and worksheets for stress management and anxiety are used in individual counselling.

“In our work, we are dealing with the tip of the iceberg,” says Marie. “Sometimes you get upset that there are too many problems you can’t solve. But you have to be self-aware and understand your limits. Yesterday, I had a consultation with a beneficiary who was going through loss and grief. Basically, I was just nodding and listening. There are situations in our work when giving space whilst listening is more appreciated than for example an elaborate speech.”

When you share, you are not alone anymore

“Some people believe that asking for support is a weakness, but it is not. There is strength in admitting that you can’t do it yourself. When you feel bad, you are isolated, but once you open up, you are no longer alone. You don’t have to take someone else’s advice, but it is important to know that you are not alone in dealing with your problem,” says Marie.

MHPSS counselling participants eventually understand that their problems are not unique and that their experiences are not unusual. Other people’s stories can provide practical solutions to problems. In a group where people don’t know each other, it is easier for them to start talking. Sharing makes them realize that they have more in common than they had thought before.

“Creating a safe space, free of judgement and criticism, takes skill and effort, but it’s worth it,” says Olga. “When you start the group, the first few sessions are difficult. It’s a group dynamic: at first, people express their problems, share their stories, and it is quite overwhelming. But, at a later stage positivity comes in. You feel the progress when you hear laughter in the group sessions.”

Helping the helpers

The IOM MHPSS team provides services not only to beneficiaries but also to community centre staff. Supervision, counselling, stress management and burnout prevention are important for them. “People who help others are supposed to be strong, but the breaking point for them is understanding that they need support as well. Helping others, they often forget about their own lives. Sometimes they need to remind themselves that sleeping enough and eating properly is important,” explains Marie.

“With age, you are either more prone to burnout or better prepared to deal with it. I consider myself lucky enough to be able to keep my distance,” says Marie. “But sometimes, I am overwhelmed and feel like it is too much, and if I can switch off and have a rest, I am ok. My dog gives me excuses to take care of myself – long walks in the park, fresh air, small talks with other dog owners.”

To be able to support other people, helping professionals have to look after themselves. Promoting a culture of well-being and self-care among beneficiaries, implementing partners is an important part of IOM’s MHPSS work.