Syrian refugees coming to Hamilton will carry little with them when they arrive, but one thing many will carry are emotional and mental scars from the war zone they have fled.
Hamilton has the skilled and experienced professionals to provide trauma treatment, but mental health workers warn that more funding and resources are needed to meet any spike in need .
'When the right help is there and regardless of how long it takes, healing is possible.' - Karen Smith, executive director, Thrive Child and Youth Trauma Services
Karen Smith, executive director of Thrive Child and Youth Trauma Services in Hamilton, says it has the skilled clinicians but their space is limited.
"The services are there but they're not currently geared up with a capacity to see a sudden influx of a thousand or more people without some waiting time," she said.
Time spent waiting to address trauma symptoms makes things worse and if unresolved, can cause life-long problems.
- Read more: How Hamiltonians can sponsor a refugee
- Read More: Dundas group is planning a warm welcome for a Syrian family of 14
Many factors affect trauma
The severity of symptoms depends on how long the physiological "fight or flight response" has been triggered following time in war zones or in refugee camps.
The effects of conflict, separation from family members, travel and displacement are varied. It's also true that affects don't always present themselves immediately, experts say.
"The longer you're exposed, the more kinds of traumatic experiences you're exposed to and the age and stage of development of that child, that's going to have different effects on different kids," explained Smith.
She adds: "When the right help is there and regardless of how long it takes, healing is possible after trauma for kids as well as adults."
Refugees are resilient
"There is a huge capacity for resilience to get to Canada," said Mary Jo Land, a registered psychotherapist and program coordinator of the Outreach, Assessment and Specialized Intervention Services (OASIS) program in Hamilton.
Land has done extensive work in the field of trauma, witnessing first hand the effects it can have on daily life. She has spent time working with war-affected families in Afghanistan, co-authoring a 16-part series, 'A Journey of Peace'.
It tells the story of a rural family's struggle to cope with war trauma in Afghanistan.
She has worked on behalf of the 'Children of Afghanistan' to create a school-based curriculum to deal with war trauma and teach peace skills.
Land says, Post Traumatic Stress Disorder or PTSD is a "western concept but is relevant across cultures... PTSD presents itself differently in different cultures."
"Headaches, tummy aches, sleep disturbances, eating disturbances and in adults, high blood pressure, heart problems, asthma, asthma in children, feeling ill, diabetes... bed wetting and nightmares are very common in children.
"We even see seizures," she said.
Government sponsored newcomers to Hamilton will be welcomed at Wesley Urban Ministries. Privately sponsored refugees will meet with their host families. The priority is to ensure everyone begins to feel "safe" before any trauma work can begin.
"Safety, shelter, food, these are the things that are going to be the immediate priorities," says Smith.
Families and children arrive at Thrive Child and Youth Services by referral.
The Oasis program is one of many offered to help newcomers address mental health and acculturation challenges.
The approach is gentle and resilience based, recognizing the strength of the refugee family and ensuring a dedicated "circle of care" is provided.
"We measure symptoms, we measure the severity and frequency of symptoms and we want to see that going down. That's an ongoing indicator that the treatment plan is effective."
"If we can help kids off the bat self-regulate and feel safe, then they're going to have a much quicker start to school," she said.
Even though the work isn't easy, both Smith and Land agree, it is heartwarming.
"I can't think of anyone I've met in this work that I don't feel tremendous compassion, tremendous respect that I wouldn't really do more for them... the effort that people go through, they're so appreciative. They really do appreciate whatever we're trying to do."