KEY TAKEAWAYS
KEY TAKEAWAYS
There is a growing mental health crisis in Myanmar — one fueled by the junta’s violent atrocities against the population and a humanitarian crisis that has displaced an estimated 3.1 million people.
And even though Myanmar’s resistance maintains immense popular support and continues to gain momentum in its fight against the junta, the cumulative impact of sustained conflict and instability — both over the last three years and over the previous seven decades — means the crisis will only grow more dire the longer the struggle continues.
Meanwhile, years of systemic neglect and disinvestment have left resources for mental health scarce. But new USIP research reveals that local leaders are finding innovative ways to support their community’s mental health and emotional wellbeing — including through partnerships with religious actors.
USIP coordinated with The Network for Religious and Traditional Peacebuilders to learn more from these community support networks providing mental health and psychosocial support (MHPSS) to displaced people from Myanmar. Through this research initiative, we discovered that small-scale initiatives led by local community members — in collaboration with religious leaders — and mental health practitioners have proven effective despite limited resources. Integrating scientific knowledge with spiritual beliefs at the local level can significantly assist communities facing high-distress situations. Based on our findings, we have developed six recommendations for international organizations implementing MHPSS initiatives in Myanmar.
Since the COVID pandemic and the 2021 military coup, there is a growing awareness of and interest in MHPSS needs in Myanmar. While much progress is still to be made, non-state actors and community-based providers, including local religious actors, have been pivotal in filling critical service delivery gaps amid the health system’s collapse. International organizations must develop creative mechanisms to support providers and religious leaders who are already implementing MHPSS initiatives and are enthusiastic to improve their technical capacity.
Religion serves as a primary source of strength and resilience in Myanmar — 99 percent of the population is affiliated with a religion — which makes religious leaders and actors uniquely positioned to offer effective MHPSS. Some religious actors and MHPSS providers in Myanmar are already linking MHPSS to religion and spirituality.
This integration is particularly evident among Christian and Buddhist leaders. Between the two, Christian communities appear to have better access to MHPSS systems, in part because pastoral counseling is a component of Christian religious leaders’ training. Buddhist leaders often provide psychosocial support through mindfulness and meditation practice, though it is currently more accessible to men than women.
International organizations should encourage both horizontal learning within and between these religious groups to enhance and build support for their services, share successful practices, and destigmatize MHPSS.
Most community support network participants agreed that there has been less stigma around struggling with and seeking mental health care since COVID and the coup. However, stigma remains — especially in rural communities.
This negative perception is further exacerbated when people seeking MHPSS wish to discuss topics that are considered taboo, such as domestic or sexual violence, discrimination on the basis of ethnic or sexual identity, or displacement due to armed conflict.
The topic of displacement is particularly of note. There is shame and fear associated with IDP (internally displaced person) status in Myanmar, as IDP camps have been a target of the junta’s violence toward civilians. So, although IDPs residing in camps supported by international organizations often have better access to MHPSS, individuals may be reluctant to reside in these camps and label themselves as IDPs.
Addressing these intersecting layers of stigma requires experts from Myanmar who understand cultural and social nuances. Mental health providers in Myanmar recommended utilizing non-clinical language and labeling MHPSS initiatives as resilience trainings, awareness raising or as community well-being meetings.
Community support networks explained that actors who hold influence in Myanmar, such as religious leaders, can also tackle the stigma directly by advocating that it is normal for individuals to struggle with their mental health given the current context. Additionally, community support networks from Myanmar noted it’s important to recognize and formalize practices such as community dialogue, creative activities and engagement in community events as valid methods of MHPSS.
Leveraging existing community practices will help frame interventions as opportunities for communal healing.
Leveraging existing community practices will help frame interventions as opportunities for communal healing, which better aligns with local and cultural perceptions, reduces reliance on external interventions, and ensures that MHPSS initiatives can integrate more seamlessly into the community fabric. Utilizing this localized approach will allow local vocabulary, beliefs rituals and understanding to guide the conversation, fostering a more inclusive and effective MHPSS environment.
Religious leadership across Buddhist, Christian, Hindu and Muslim communities in Myanmar is predominantly male. This gender dynamic creates barriers for women seeking psychosocial support, particularly when it is deemed inappropriate for women to interact privately with male religious figures. Such barriers are even more pronounced for women seeking care after experiencing sexual or gender-based violence, due to heightened fear of judgement.
To address these challenges, international organizations should ensure that women, even those not in leadership positions, are included in trainings. It is essential to involve women not only as training participants, but also to support MHPSS initiatives with women in visible and impactful roles. This requires creating connections with local actors who can facilitate women’s involvement in a manner than respects cultural and religious practices while also empowering women to take on leadership roles in their communities.
Younger people in Myanmar tend to have more knowledge regarding MHPSS and are open to incorporating mental health practices into religious psychosocial support. In comparison, some older generations tend to have stronger stigmas against individuals suffering from mental health disorders.
However, it is important that elder religious leaders are still involved in local-level MHPSS initiatives because they often have longstanding trust and respect within their communities. In some places, it can even be perceived as inappropriate or threatening if an activity is implemented without receiving endorsement from community elders.
Strategies for promoting intergenerational collaboration in MHPSS initiatives that include both youth and elder leaders should be explored. Furthermore, as with gender, there is a need to redefine participation and leadership roles within MHPSS initiatives to allow young people to take active, visible leadership positions while also ensuring that elders have significant, ongoing input into the direction and decisions of the initiatives. Such models could support the bridging of generational divides and leverage the unique strengths of each group.
These actors, especially those already providing MHPSS, have the cultural understanding and social context to combat stigma, navigate ethnic or religious tensions, and meaningfully include marginalized groups.
International providers who do not understand the complexities of the local context risk inadvertently causing harm. For example, there are social hierarchies within ethnic groups that can inhibit an MHPSS provider’s ability to build trust within certain communities. If a religious leader provides psychosocial care to somebody who does not practice the same religion, this could exacerbate ethnic tensions and discrimination or be perceived as proselytizing.
International providers who do not understand the complexities of the local context risk inadvertently causing harm.
This does not mean that involving providers or trainers of different religions and ethnic groups will always exacerbate divisions — these trainings can be opportunities for inter-religious inter-ethnic relationships to form — but it is important for the implementer to be a local actor who has experience and awareness on how to successfully navigate these dynamics.
Community support networks from Myanmar also shared there is a negative perception among people in Myanmar of some international organizations. This stems from the fact some international organizations registered with the junta to maintain an in-country office or receive visas for their international staff to work in the country. By partnering with trusted local leaders and uplifting their initiatives, international programs can overcome this perception, and reach displaced communities in need that are unable to access other forms of MHPSS.
Safety concerns associated with the ongoing armed conflict often impede mental service providers’ travel from urban areas to rural conflict areas, and it is difficult to hold online sessions due to limited electricity, internet access and recent restrictions on VPNs.
As mentioned previously, partnering with local organizations that are already implementing MHPSS in Myanmar is crucial, as they have a better grasp of how to navigate the operational challenges. Local partners understand the risks associated with holding activities better than international organizations and can help make informed decisions.
For example, research participants spoke of trainings that required long, dangerous travel. As one community support network member explained, travel should be organized in collaboration with actors currently residing in Myanmar, to identify routes that are safe from active conflict and natural disasters. It is imperative that MHPSS initiatives are developed with individuals who have recent experience on how to safely travel and conduct activities. Collaborations should emphasize adaptive programming that can swiftly respond to the volatile political and social dynamics within Myanmar, particularly in conflict-prone and border areas.
Religious actors and mental health providers are the best source for localizing MHPSS in Myanmar. With the violent conflict escalating, there are a growing number of areas where the military is no longer present. A reconstruction effort in those areas must include a MHPSS component to effectively address the intergenerational trauma and impact of violent conflict. By setting the MHPSS groundwork now, the future leaders will be better equipped to support a new transition once the military falls.
Yu Yu Htay is a program officer for the Myanmar team at USIP.
Sarah Harper-Johnston is a program specialist for Myanmar at USIP.
Divya Moorjani is the regional programme manager for Asia at the Peacemakers Network.