As wars, persecution and instability force record numbers of people out of their homes, a new study suggests that something as simple as a workbook and a few supportive phone calls could help tackle one of the world's most overlooked public health emergencies: the mental health crisis among refugees.

According to a study led by researchers from UNSW Sydney, the University of Newcastle, and the University of Melbourne, a low-cost mental health programme significantly improved psychological well-being among displaced Afghan refugees living in Indonesia, offering fresh hope for millions trapped in uncertainty.

The findings arrive at a time when forced displacement has reached unprecedented levels. In 2024, one in every 67 people worldwide experienced forced displacement, according to the study. Most have sought safety in low- and middle-income countries where access to mental health services remains limited. For many refugees, the trauma does not end after crossing a border. It simply changes shape.

In Indonesia, around 12,000 refugees live in a prolonged state of waiting. Many people can't work legally, reunite with family members, or secure permanent resettlement. Some have spent more than a decade in this limbo.

"It’s a very, very difficult context," said Professor Angela Nickerson, clinical psychologist and director of the Refugee Trauma and Recovery Program at UNSW Sydney.

"People are often living in prolonged limbo, without stable rights, work or support, sometimes for over a decade."

Scientific studies have consistently shown that refugees experience far higher rates of depression, anxiety and post-traumatic stress disorder (PTSD) compared to the general population. PTSD is a mental illness that develops after experiencing or witnessing frightening, violent, or life-threatening events. Previous international research and World Health Organization estimates suggest that nearly one-third of refugees may suffer from PTSD or depression, making mental illness one of the most common yet least visible consequences of displacement.

To address this challenge, researchers partnered with Refugee Learning Nest, the Indonesian legal aid organisation SUAKA, Universitas Gadjah Mada, and HOST International. Together, they tested the WHO programme "Doing What Matters in Times of Stress" with 303 Farsi-speaking Afghan refugees in Indonesia.

Participants received an illustrated workbook in their language and five brief phone sessions from trained refugee facilitators. The facilitators themselves are from refugee communities, and they were trained by local partnership organisations.

"We were really excited to see that such a brief, light-touch kind of an intervention could have a meaningful impact," said Dr Philippa Specker, a clinical psychologist and UNSW researcher who led the facilitator training.

The programme is based on acceptance and commitment therapy, a practical approach that teaches people how to manage difficult thoughts and emotions rather than constantly fighting them. Participants learned simple skills such as mindfulness, accepting distressing feelings and focusing on actions that reflect their personal values, even when circumstances remain beyond their control.

The results were striking. Refugees who received the intervention reported greater reductions in psychological distress and PTSD symptoms than those in the control group. They also experienced improvements in their well-being, social functioning, and daily activities. One month after the intervention, about half of the participants demonstrated meaningful improvements or recoveries, compared with roughly 30% of those who had not yet received the program.

One unexpected finding stood out. Even members of the control group showed some improvement. Researchers believe regular conversations with trained assessors who practised empathic listening may have contributed.

"This study points out the possible importance of connection and emotional support in fostering refugees’ wellbeing," the study noted.

The finding underscores a powerful truth. In situations where resources are scarce and problems seem impossible to solve, human connection itself can become a form of care.

As global displacement continues to rise, experts say scalable, peer-led mental health programmes could become a crucial tool for governments, humanitarian agencies, and host countries. For refugees living in uncertainty, a workbook may seem small. Yet this study suggests it can help restore something many have lost along the way—a sense of control, resilience, and hope.