Psychosocial first aid for refugees (an essay in social psychiatry).

Post-war refugee resettlement schemes offer an opportunity for the study of contemporary social phenomena of compulsory mass migration. The process, set in motion by man-made disasters of war, oppression and persecution, deeply affects not only the victims but also the social institutions as they mobilize resources to accommodate the stateless and homeless new populations. The traditional focus on 'culture-change' is inadequate for the development of principles of aid to the refugees. In this paper, an operational definition of the structure and natural history of the social situation of resettlement is outlined, with reference to the working hypotheses of (1) the Social Displacement Syndrome and (2) the Psychosocial First Aid for Refugees Project. This has been derived from clinical and field studies of four successive refugee groups in Canada over the past 27 years, with specific focus on the social dynamics of the situation from immediately upon resettlement to one year after. In this early phase, the coexistence of personal and social disequilibrium in the refugees and among those who represent the institutions responsible for their management creates specific conditions, of which some enhance the disposition for recovery or 'repair' and some might reinforce the disposition for lasting 'social breakdown'. Some generalizations concerning practical and theoretical work in social psychiatry are made.