Prevalence of mental disorders and torture among Bhutanese refugees in Nepal: a systemic review and its policy implications

Abstract

The mass expulsion and exile of Bhutanese de facto refugees to displaced camps in Nepal represents one of the world's most neglected humanitarian crises. We aimed to summarize the impact of the long-term displacement on refugee mental illness using systematic review techniques, a methodology seldom used in the humanitarian field. In order to examine the impact among the population and the association between tortured refugees over non-tortured refugees, we searched 11 electronic databases from inception to 12 May 2006. We additionally contacted researchers at the United Nations High Commission for Refugees (UNHCR) and at the Centre for Victims of Torture, Kathmandu, and searched the websites of Amnesty International, Human Rights Watch, Relief-Web, and the US State Department. We included any studies that use a pre-defined protocol to determine mental illness within this population. Six studies met our inclusion criteria. All were conducted amongst the Bhutanese populations residing in Nepalese refugee camps, and include a sub-sample of 2,331 torture survivors residing in the camps, identified in 1995. All studies report a dramatically high incidence of mental illness including depression, anxiety and post-traumatic stress disorder. Both tortured and non-tortured participants reported elevated rates of mental illness. Our review indicates that the prevalence of serious mental health disorders within this population is elevated. The reported incidence of torture is a possible contributor to the illnesses. The use of systematic review techniques strengthens the inference that systematic human rights violations were levied upon this population and that they continue to suffer as a result. The international community must resolve this protracted crisis.

Post-traumatic stress disorder, psychiatric comorbidities and associated factors among refugees in Nakivale camp in southwestern Uganda

“…PTSD is highly comorbid with other psychiatric disorders and is associated with perceived psychosocial needs. A higher prevalence of mental health concerns were identified compared to similar studies among refugees in both pre and post-resettlement settings [28][29][30][31][32][33]. Two previous studies conducted in Nakivale found relatively high prevalence of PTSD, 61.7% among Congolese refugees and 48.1% among Somali refugees [17,34].…”

Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States

“…Although the mental health of Bhutanese refugees in Nepal has been studied previously, [2–7] no systematic investigation has focused on the mental health and suicide risks of Bhutanese refugees in the US. Between January 2008 and November 2014, more than 78,541 Bhutanese refugees were resettled to the US.…”

Prevalence of mental disorders in South Asia: An umbrella review of systematic reviews and meta-analyses

“…The full texts of the remaining 140 citations were evaluated, and 117 articles were excluded, which did not fulfill the eligibility criteria. Finally, 23 articles meeting all the criteria were recruited in this umbrella review (see Table 3), including 12 systematic reviews (Aggarwal and Berk, 2015;Arora and Aeri, 2019;Hossain et al, 2017Hossain et al, , 2014Math and Srinivasaraju, 2010;Mills et al, 2008;Mirza and Jenkins, 2004;Nadkarni et al, 2013;Naskar et al, 2017;Newman, 2013;Rajapakse et al, 2013;Thapa et al, 2018) and 11 meta-analyses (Chauhan et al, 2019;Ganguli, 2000;Hendrickson et al, 2019;Hussain et al, 2018;Mahendran et al, 2019;Malhotra and Patra, 2014;Pilania et al, 2019;Prabhu et al, 2019;Ranjan and Asthana, 2017;Reddy and Chandrashekar, 1998;Upadhyay et al, 2017).…”