Hamza Mohammad Khalid, Hicks Madelyn Hsiao-Rei
Clinical Mental Health, Lamar University-Texas State System, Worcester, USA, and former Board Member & Chairman, SAMS Mental Health Committee, USA (2014-2020).
Department of Psychiatry, University of Massachusetts Medical School, Worcester Recovery Center and Hospital, 309 Belmont St, Worcester, MA, 01604, USA.
Avicenna J Med. 2021 Jan 5;11(1):8-14. doi: 10.4103/ajm.ajm_141_20. eCollection 2021 Jan-Mar.
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.
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.
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.
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.
我们描述了叙利亚战争期间在实施精神卫生保健过程中所面临的挑战及吸取的经验教训，以为受冲突影响的叙利亚民众提供有效的服务。
我们检索了学术文献和灰色文献。我们借鉴了具有九年在战斗环境、围困地区、境内流离失所者营地和难民营提供临床及项目精神卫生保健经验的叙利亚裔美国精神卫生专业人员的经验。
由于叙利亚正规培训的精神卫生保健专业人员短缺，与非专业人员合作至关重要。使用心理和诊断术语会增加污名化，而询问患者确定的问题、“痛苦”或“挑战”有助于建立医患关系。与战争相关的创伤和横向暴力普遍影响叙利亚儿童、青少年和成年人。对患者尊严、宗教接纳和信仰的敏感增强了恢复力和医患关系。
叙利亚战争仍是一场持续的公共卫生和人道主义危机，在这场危机中，精神卫生保健必须迅速适应患者及社区的特定需求和资源。精神科医生可以通过对叙利亚患者的横向暴力经历、尊严丧失、污名化、宗教和信仰可能是恢复力重要来源的世界观以及文化上可接受的沟通方式保持敏感，来提高其护理的可接受性和效果。
