Report says mental health crisis surges in refugee camps after cuts to aid and end of resettlement programmes.

An earlier version of this article incorrectly stated that the EU Delegation had not responded to a request for comment. The story has been updated to include their response.

Yangon, Myanmar – Drastic cuts to humanitarian assistance for refugees who fled Myanmar for Thailand have stoked widespread “hopelessness and depression” in camps along the border, deepening a mental health crisis that has seen suicide rates soar, a coalition of civil society groups says.

Major donors including Norway and Sweden have withdrawn funding for the camps in recent years, while the European Union has ended food aid in favour of other projects, leading to cuts in food rations for around 100,000 refugees as aid workers struggle with less than half the money they had in 2012.

Fifteen local groups have urged foreign donors to reinstate funds in a report published on Thursday to mark World Refugee Day. The report, There Is No One Who Does Not Miss Home, is based on interviews with 338 displaced people from various ethnic minority groups living in camps in Myanmar and Thailand.

The report noted cuts to aid have led to concern that refugees are coming under pressure to move out of the 10 camps along the border and back to Myanmar, where negotiations to end decades of conflict between the military and various rebel groups have stalled and violence continues.

The situation has led to “higher rates of depression and suicide” in the camps, the report said.

“There are examples of individuals writing their goodbye note saying that the ration cuts were the last straw,” one NGO worker on the border, who asked not to be named, told Al Jazeera.

But the worker cautioned against viewing cuts to aid as the sole reason for the high suicide rate. “There is little data to make direct correlations … it is often a set of compounded factors.”

Future uncertainty

The suicide rate in Mae La, the largest of the camps and home to about 50,000 people, is more than three times the global average, a 2017 study by the International Organization for Migration found.

Twenty-eight refugees killed themselves at the camp in the two years from 2015, while 66 attempted suicide.

Ta Mla Saw, joint secretary of the Karen Women’s Organization, one of the groups behind Thursday’s report, told Al Jazeera conditions in the camps had reached an all-time low and the termination of resettlement programmes to third countries has also played a role.

“Ten years ago, people still felt like they still had some kind of hope,” she said. “Now people are unsure about their futures, and the reduction in aid is a factor in that.”

Refugees interviewed for the report said domestic violence and drug and alcohol abuse have increased. Meanwhile, ration cuts have forced volunteer teachers and security staff in the camps to quit, undermining basic services. Thailand is not a party to the 1951 Refugee Convention and those in the camps are not allowed to work.

“We are concerned by the possible link between decreased aid and increased mental health problems in the camps,” said Susanne Mikhail, director for humanitarian assistance at the Swedish International Development Cooperation Agency (Sida).

But she added the agency’s decision to withdraw funding was justified because continued support “would risk using never-ending humanitarian aid as a solution to a problem that requires long-term political solutions”.

“Should the humanitarian situation deteriorate significantly, Sida will consider resuming humanitarian aid to avert a disaster.”

‘Strategic move’?

As donors have cut aid at the border, they have increased funding for the formal, government-backed peace process inside Myanmar, arguing this is the best hope of reaching a lasting solution for refugees.

Some critics, though, see the decision to redirect funds as a strategic move by Western powers eager to gain a foothold in a country that came to rely heavily on China during decades of isolation under direct military rule, which ended in 2011 amid a wave of economic and political reforms.

“A cynic might say that there are trade and economic issues at stake and also some geopolitical reasons,” said Rin Fujimatsu, advocacy director for Progressive Voice, a rights group that coordinated the report.

“For example, Norway started to fund the peace process very early on, and started decreasing funding for cross-border aid and refugees. Norwegian companies like Statoil and Telenor won big contracts from the government not long after.”

Norway’s development agency, Norad, did not respond to a request for comment.

An EU Delegation spokesperson said the EU has shifted its focus at the border away from short-term support towards funding long-term projects like education and livelihoods. The EU is providing €6 million from 2018 through to 2020 for such projects, they added, and has spent around €200 million in the camps since 1995

“Donors should strike a balance,” said Ta Mla Saw. “You can give more money to the peace process, but you still need to provide humanitarian aid. The situation on the ground hasn’t changed.”

A girl who fled Myanmar for Thailand pictured when Thai authorities conducted a census at Mae La in 2014 [File: Chaiwat Subprasom/Reuters]

Rumbling conflict

Some of the refugees on the Thai border have lived in the camps for two decades, the report noted, but others have been there for less than a year having fled recent clashes and systematic persecution by the Myanmar military.

The report’s authors stressed even as armed groups – including the Karen National Union (KNU) – have signed ceasefires, the military has violated the terms of some of those agreements and continued to mount attacks.

The military’s attempt to build a strategically important road through a KNU-controlled area led to clashes between the two groups last year, displacing thousands.

These and other outbreaks of violence have “seriously eroded what little trust has been built in the peace process thus far”, and show it’s not yet safe to return, the report said.

While the situation of Rohingya refugees in Bangladesh has attracted global attention, “the systematic persecution and marginalisation that led to the genocide of the Rohingya is present in other ethnic areas”, Fujimatsu said.

The report also accused the United Nations High Commissioner for Refugees (UNHCR) and other aid agencies of misleading displaced people about conditions back home by failing to provide information about recent clashes near potential return sites.

“Instead, they share their assessments that the peace process is going well, stating their assessment as fact. They also provide follow-up information about only those returnees who are doing well, not returnees facing challenges,” the report said.

UNHCR has also come under criticism in Bangladesh for failing to consult Rohingya refugees about plans to repatriate them.

Jennifer Harrison, a UNHCR spokesperson, said the agency “shares impartial and factual information on the situation in the place of return with the refugees” in Thailand.

“But in many cases, they also have their own sources of information on the ground and know more than we do,” she said.

“At the same time, UNHCR informs the refugees that if they have any concerns, they can change their minds at any time before departure, and some have done so.”