The number of refugees throughout the world, particularly children, has skyrocketed in the last decade. The trauma they face, both in the home and host country, causes changes in the hippocampus, reward centers, grey matter, and amygdala. The neurology behind these symptoms is complex and not fully understood yet. These changes are linked to significantly higher rates of mental health disorders among refugees, in some cases 30 times higher than the non-displaced population.
As a result of conflict and persecution, 29.4 million people worldwide are refugees or asylum seekers. Over 40% of them are children, a group particularly affected by the trauma in their surroundings . As these statistics increase, countries are struggling to keep up with the influx of migrants and provide them with the support they need. In countries such as the United States, the backlash has caused policies to shift towards keeping migrants out instead of helping them -- at times, even detaining asylum seekers in allegedly inhumane holding centers.
As the number of refugees has increased, there has been more research conducted on refugee welfare. Scientists used tests, such as the Harvard Trauma Questionnaire, to measure mental health over various time periods. The test results showed that mental health concerns persist if treatment is not received or if detention facilities, chronic family separation, unemployment, or social isolation played a role in the trauma .
Cross-sectional studies have found that nearly 15 - 30 % of the refugee population show signs of PTSD and have, on average, two flashbacks per day. In comparison, the rate of PTSD in the general population is around 1.1% . Other disorders, such as depression and schizophrenia, remain prevalent and severe in refugee groups. With the ever-increasing number of migrants, scientists such as epidemiologist James Kirkbride have termed it a “public health epidemic” - one that is invisible but far too dangerous to go unaddressed.
Furthermore, studies report that “prolonged detention, insecure residency status, challenging refugee determination procedures, restricted access to services, and lack of opportunities to work or study, combined in a way that compounded the effects of past traumas in exacerbating symptoms of PTSD and depression”     . Many of the conditions that refugees are subjected to meet these risk factors and show the need for change in our policies.
Scientists have discovered that the hippocampus atrophies, leading to memory and concentration problems, and the amygdala enlarges, increasing anxiety, aggression. The overactive amygdala is usually controlled by the prefrontal cortex; however, trauma causes this pathway to be impaired, leaving the amygdala unchecked   . These structural changes help explain the high prevalence of mental health disorders in the migrant populations.
Further evidence lies in the reward system. Neuroscientists have observed changes in brain structures such as the nucleus accumbens and ventral striatum. The HPA axis, which involves the aforementioned structures, regulates responses to temptations and distractions and is damaged as a result of stress, resulting in the brain needing more stimulation to receive a reward or even anhedonia . Moreover, there is a significant decrease in cortical thickness and surface area, as well as dendrite length. Interestingly, these changes can be reversed if the trauma occurs in adulthood, but not in childhood - confirming children are distinctly vulnerable to the debilitating effects outlined above .
These effects are known as toxic stress, which is caused by stressful events such as separation from parental figures. Even when people are able to escape from their source of trauma, the toxic stress on their body, specifically the brain, does not dissipate. Without proper attention, it can develop into mental health disorders – explaining the high rates of PTSD, depression, and schizophrenia observed in refugees.
As dire as the situation seems, researchers have come up with some solutions.
First, they propose that lawmakers move away from the idea of “quick integration.” Clinical psychologist Thomas Elbert says that “It is illusory to think that people can learn a new language and find work when they can’t function properly mentally. If we want quick integration, we need an immediate plan for mental health.” Moreover, it is essential to reduce the stress that migrants face when entering recipient countries because excess toxic stress can only compound the effects on the brain and body. 
Scientists, recognizing that many countries do not have the time or money to provide the necessary treatment, have come up with innovative, inexpensive ideas.
One is an app known as MeWe – an interactive storytelling program made in collaboration with UNHCR. The creator’s hypothesis is that an arrested story (in which a person feels as though their narrative is written by others) leads to arrested development and mental health issues. These issues, hypothetically, could be alleviated by MeWe, which allows users to take control over their story. Research at Princeton University shows that storytelling can change neuronal coupling and brain structure. Although it would not be as potent as therapy or medication, it can alleviate the negative effects of mental health disorders and improve self-efficacy .
Another solution is to train laypeople to guide refugees through the health system and provide basic counseling. Dr. Elbert has conducted research in Afghanistan and Germany showing that systems, where lay people can carry out Narration Exposure Therapy, can alleviate symptoms and free up time for professional psychologists to deal with patients with severe illnesses. This solution has been implemented throughout the world successfully, showing its viability. Not only is it effective, it requires minimal extra resources on the host country, providing benefits for both parties. 
Irrespective of the receiving of refugees, research shows those escaping turmoil in their home countries are at heightened risk of mental health disorders and current policies are inadequate in providing the help needed. Furthermore, there are viable solutions available that can change the lives of millions of people. –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
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Lasya is a senior at Blue Valley North. She is planning on majoring in neuroscience or biomedical engineering. She first got involved in the IYNA after participating (and placing 7th) at the National Brain Bee. She is now the Director of Chapters and is focusing on helping extend the impact the IYNA has. Lasya also runs a neuroscience blog to help students prepare for the Brain Bee and just learn more about the nervous system. She hopes to help students of all ages and backgrounds learn about the amazing organ that runs our whole lives. In the future, Lasya hopes to be a neurosurgeon and research the molecular mechanisms behind memory. Outside of neuroscience-related activities, she loves to write, read, and play the violin/piano.