For the displaced Burmese populations living along the Thailand-Burma border the ongoing experiences of socio-economic struggle, physical and psychological trauma, endless human rights abuses, chronic illness, exploitation as migrant workers, and being targeted for human trafficking have resulted in many psychosocial challenges. As the population living along the Thailand-Burma border quickly grew throughout the 1990s, it became evident to Dr. Cynthia and other community leaders that psychosocial support was needed for this population.
In 1999, Mental Health Counselling Training was coordinated through the assistance of international organisations, for 32 participants including MTC medics and schoolteachers, as well as individuals from other local organisations. This was an introduction to the basic concepts and techniques of mental health care. The following year, a Child Psycho-Social Training was conducted, for 32 participants from MTC and other local organisations, focusing on basic principles of childhood behaviour and development, children’s rights, and programme development to enhance children’s mental health. The introduction of these mental health care skills to the organisations working along the border was certainly beneficial, but with the population of displaced Burmese people continuing to grow, and more and more people accessing health care at MTC, more needed to be done to address the increasing psychosocial needs. Both staff and patients of the Clinic needed greater psychosocial support – they needed confidential counselling, in a private space, from counsellors with more advanced skills. In response, preparations began in 2004 for the development of a separate Counselling Centre at MTC.
The MTC Counselling Centre, as it functions today, was established in 2006. A new building was constructed, providing a space for the Counselling Centre as well as the HIV Voluntary Counselling and Testing Program. Further training sessions were conducted, providing basic knowledge and skills in mental health care, as well as tools for specifically addressing the now endemic psychological trauma.
In 2010, the Counselling Centre began looking at the issue of psychosocial health amongst migrant school children. One way that this is being approached is through promoting peer support and peer counselling. The project uses the diversity and experiences of the children as a rich source of strength for developing sustainable unity, individuality, and psychological flexibilities. Enhancing the psychosocial development of these children from pre-primary to pre-university levels lays a foundation for psychologically resilient individuals who would be competent in leading a healthy and harmonious life.
The Counselling Centre’s services include supportive counselling to individuals and their family and friends, relaxation, amputee/injury support and physical therapy group, patient advocacy, psycho-education, intensive case management, and medication management.
Patients of the Counselling Centre are individuals and families severely impacted by psychological trauma, loss and mourning, landmine accidents, domestic violence, substance dependence, gender-based violence, economic struggles, mental illness and daily struggles of life inside Burma and along the Thailand-Burma border. The centre provides counselling services to an average of 60 patients per month. It also offers home visits to patients, as part of the follow-up.
In addition to providing mental health treatment, the Counselling Centre also provides training, supervision, and consultation and advice to MTC interns, staff and affiliated organisations. Dr. Aung, a long term volunteer at the Counselling Centre, recently produced a Slide-Video Combination of Basic Counselling Skills in English and Burmese for the use of internationally resettled Burmese communities. Click the links below to view the slides or video.
The first six months were very slow, as neither patients nor staff had a strong understanding about what counselling services were, who should be accessing them, and the incredible benefits that they could have. Also, there was the challenge of staffing the centre, as the newly trained counselling staff continued their work in other departments of the clinic, which were often busier and seen as a priority.
These challenges instigated the development of the Department Awareness Program, wherein staff members from other clinic departments were invited to the Counselling Centre for one-hour information sessions. The counselling staff explained the services available at the centre, the great benefits of these services, how and when to refer patients, and when staff should visit the centre themselves. The counselling staff continues to run the Department Awareness Program, which has successfully led to the continual increase in the number of patients accessing the Counselling Centre.
The increased number of patients to the centre has affected the available spaces at the Clinic for diverse activities.
Collaboration with other Community Based Organisations
For those requiring psychosocial assistance, the Counselling Centre provides incredible support, but at times, due to insurmountable obstacles, the outcomes sought by both patients and counsellors are not always attainable. Some patients come with social problems related to natural disasters or chronic diseases, or when their community no longer accepts them. As we cannot provide social services such as hep finding work, we work in conjunction with other CBOs, referring patients to them when we can. For example, one patient had been suffering from stress and depression as a result of not being paid by the factory owner he worked for. The main issue with this very common problem is how patients are supposed to address these issues when a complaint to the authorities exposes them to the risk of arrest and deportation back to Burma. In these cases, the counselling staff rely on their community networks, referring patients to other organisations such as the Migrant Assistance Program (MAP) for labour issues, or Social Action for Women (SAW), for women and children escaping abusive environments, who need a safe place to stay and access to income generation and education opportunities.