Introduction
Contextual background on the situation in northeast Syria and Iraq
When the so-called Islamic State group (IS) rose and spread in Iraq and Syria, people travelled from all over the world to join the group, mostly between 2013 and 2015. Many of the fighters and sympathizers brought along spouses and children, and/or married/re-married in the conflict zone, and thousands of children were born to them in the following years.Footnote 1 The military operations opposing the International Coalition and partner forces on the ground against IS resulted in high numbers of people being killed or becoming unaccounted for, and in mass displacement and capture, between 2017 and 2019, of many of those fleeing the areas formerly controlled by IS, including a majority of children. Thousands of relatives of foreign men, women and children last known to be in IS-controlled areas approached the International Committee of the Red Cross (ICRC), as well as National Red Cross and Red Crescent Societies around the world, seeking news of their loved ones.
Thousands of men, women and children allegedly affiliated with IS have been stuck in places of detention and camps in Iraq and northeast Syria since 2018–19. They comprise Syrian and Iraqi nationals, as well as many third-country nationals, who are collectively perceived as foreign fighters, and their families.Footnote 2
Owing to a lack of safety, access to essential services (including food, health care and education) and exposure to potentially traumatic events, the development of children who have experienced armed conflict and detention over periods of years has often been severely affected, particularly when they have lost family members or have directly undergone, witnessed or been coerced into committing violence. Women have also been particularly vulnerable to violence and exploitation and have suffered gendered harms. The ICRC has called this situation one of the most complex child protection crises of our time.Footnote 3
Repatriations
Starting in 2019, the ICRC raised the alarm about the dire humanitarian situation witnessed in northeast Syria. It called on States to repatriate their nationals stranded in Iraq and Syria, subject to the principle of non-refoulement, with priority given to children accompanied by their mothers as primary caregivers.Footnote 4 It further highlighted that children – whether they were born in the conflict zone, were brought there by family members, or travelled there on their own, and regardless of whether they had been recruited by an armed group designated as “terrorist” – are to be treated as victims first and foremost.
Against this backdrop, Central Asian States were among the first to organize large-scale returns of their nationals from camps and places of detention in northeast Syria and Iraq. The ICRC estimates that since 2019, they have collectively repatriated more than 2,200 peopleFootnote 5 – including over 1,600 children, several hundred women and a small number of menFootnote 6 – to Kazakhstan, Uzbekistan, Tajikistan and Kyrgyzstan.Footnote 7
Repatriation pathways for children from northeast Syria and Iraq have not been uniform. Across Central Asia, two distinct scenarios emerged: initially, children who returned without their primary caregiver, often due to orphanhood but also administrative separation, and subsequently, children who returned together with their mothers or other adult relatives. Repatriations from northeast Syria to Central Asia consisted primarily of children and their mothers (in some cases other adult relatives), reflecting efforts to preserve family unity.Footnote 8
Reintegration upon return to Central Asia, and structure of this article
These repatriations constitute an important humanitarian milestone, yet they also pose complex reintegration challenges. Returnees frequently encounter documentation and administrative challenges, difficulties adapting to new social environments, community stigma and discrimination, and significant mental health and psychosocial support (MHPSS) needs.Footnote 9 While national approaches differ globally, ranging from security-oriented frameworks to community-based reintegration initiatives, in Central Asia most emphasize the importance of coordinated, multisectoral support.Footnote 10
Empirical research on the psychosocial trajectories of repatriated families after return remains limited, particularly in Central Asia. Much of the available literature focuses on security concerns, legal frameworks, the logistics of repatriation and the de-radicalization aspects of rehabilitation and reintegration, with comparatively little attention to the lived experiences of return, the interplay between protection and mental health, or the perspectives of local practitioners.
Within this landscape, the ICRC has contributed to and complemented the initiatives of national authorities and partner organizations in Central Asia, supporting the development and implementation of an integrated protection–MHPSS approach since 2021. This approach combines activities such as restoring family links, engaging in dialogue and advocacy with authorities and concerned communities, and supporting individuals with legal and administrative procedures. These protection components are complemented by tailored individual, family and community/group MHPSS interventions delivered by trained local psychologists and community actors, with regular supervision and technical support. The present study is situated at a moment when the ICRC has decided to gradually phase out its MHPSS support in the region by mid-2026, offering an opportunity to reflect on the relevance, outcomes and limitations of the integrated approach as programmes should ideally transition toward national ownership.
This reflection informs the central question of the article: how an integrated protection–MHPSS approach can contribute to safer and more dignified reintegration pathways for children and women repatriated from conflict zones, and where its limits lie. The analysis draws on a convergent mixed-methods study using routine pre- and post-support data and qualitative interviews with returnees and psychologists.
This article does not seek to evaluate the causal effect of a single intervention component in isolation. In the context of reintegration, such an approach would risk obscuring the ways in which psychological distress is intertwined with legal uncertainty, family separation, social stigma, economic insecurity and the quality of relationships with receiving families and communities. Rather, the article examines how distress, protection concerns and social reintegration have evolved within a comprehensive support process, and how returnees and practitioners have made sense of that process.
The central argument is that for returnee families exposed to both conflict-related trauma and post-return stressors, protection and MHPSS are deeply interlinked: psychological well-being is shaped not only by past exposure to violence, but also by a range of contextual factors, including legal status, safety, livelihood, social acceptance, family situation (whether children returned on their own or together with their primary caregiver) and family dynamics. At the same time, individuals’ mental health and coping capacities may influence how they engage with protection processes, services and social relationships. Integrated protection–MHPSS approaches may provide a useful operational framework for addressing these interconnected needs, including by supporting reductions in distress, strengthening protective environments and fostering more sustainable reintegration. However, they must be complemented by broader structural measures addressing stigma, livelihoods and access to services.
After the present introduction, the article proceeds in eight sections. It first outlines the operational framework relevant to the reintegration of repatriated children and women, before presenting the ICRC’s integrated protection–MHPSS approach in Central Asia. It then describes the mixed-methods methodology. The following two sections present the findings: first, changes observed in routine psychological support outcome data, and second, qualitative accounts of lived experiences of repatriation and reintegration. The article then discusses these findings in light of the broader literature on conflict-related mental health, daily stressors and protection, before setting out the study’s limitations and concluding with implications for policy and practice.
Normative and operational framework
International standards on repatriation and reintegration
The prolonged detention and encampment of children in northeast Syria has generated significant humanitarian, protection and legal concerns. Against this backdrop, the repatriation of children and their families has increasingly been recognized as a necessary step towards ensuring the protection of their rights and enabling their recovery and reintegration.
Children returning from northeast Syria or Iraq are entitled to recovery and reintegration, in keeping with the rights of child victims of armed conflict in international human rights law (IHRL). The Convention on the Rights of the Child (CRC) requires States Parties to take all appropriate measures to promote physical and psychological recovery of child victims of armed conflict, as well as their social reintegration in an environment that fosters dignity and self-respect.Footnote 11 The Optional Protocol to the CRC on the Involvement of Children in Armed Conflict further requires, when necessary, the provision of assistance for their physical and psychological recovery and reintegration.Footnote 12 United Nations (UN) Security Council resolutions on children and armed conflict, including Security Council Resolution 2427 (2018), and the Paris Principles and Guidelines on Children Associated with Armed Forces or Armed Groups Footnote 13 set out further standards.
Recovery and reintegration measures should allow children to find their place within their families, communities and society. This requires helping them to recover physically and psychologically, to exercise their rights – including the rights to preserve their identity, nationality and family relations,Footnote 14 not to be separated from their parents against their will,Footnote 15 and to be free from discriminationFootnote 16 – and to be accepted at home, in school and beyond. There is, however, no one-size-fits-all approach; States should tailor their measures to each returnee child’s individual circumstances, ensuring that their laws, policies and practices are guided by the best interests of the child as a primary consideration.Footnote 17
Most States repatriating nationals from northeast Syria and Iraq have adopted measures that aim to facilitate reintegration while simultaneously trying to tackle potential security risks linked to individuals’ actual or perceived affiliation with “terrorism”. These initiatives often combine addressing a child’s needs with security considerations, such as through “de-radicalization” programmes. Regardless of the terms used, such practices only contribute to a child’s recovery and reintegration when they put the child’s needs and best interests at the centre and truly endeavour to improve the child’s situation.
IHRL also applies in relation to women, alongside relevant gender equality standards. The Convention on the Elimination of All Forms of Discrimination against Women obliges States Parties to ensure non-discrimination and equal access to education, employment, health care and social services for all women.Footnote 18 The Women, Peace and Security agenda set out in Security Council Resolution 1325 (2000) similarly calls for gender-responsive approaches to relief and recovery, emphasizes the need to protect and support women and girls during and after armed conflict, and requires consideration of women’s specific needs during repatriation, resettlement and reintegration. These instruments articulate normative principles – such as non-discrimination, protection from gender-based harm and equal access to services – that are pertinent to reintegration efforts for women returning from conflict settings, given the gender-specific barriers they may face.
The ICRC’s integrated protection–MHPSS approach in Central Asia
The ICRC’s integrated approach combines protection and MHPSS activities across all phases of the repatriation process, ensuring that legal, social and psychological needs are addressed in a coordinated and mutually reinforcing manner. The extent to which these components can be provided varies according to context and access.
Protection activities take place both before and after repatriation. Pre-repatriation activities include visiting individuals in camps and places of detention to assess their living conditions and treatment, while raising concerns with the responsible authorities. The ICRC also works to re-establish and maintain family links with close relatives, including those in countries of origin, to trace missing family members. It offers third-country nationals visited by ICRC delegates in Iraq and Syria the possibility to notify the authorities of their countries of origin of their whereabouts, so that they may receive consular support and express their wish to be repatriated. These actions help build trust between the beneficiaries and the ICRC; combined with advocacy efforts with authorities in the countries of origin, they contribute to creating conditions conducive to voluntary repatriation (pull factor).
Post-repatriation protection activities include providing one-time material or financial assistance, continuing efforts to re-establish and maintain family links, and conducting tracing activities where needed. They also involve monitoring the situation of repatriates, particularly documenting challenges faced by repatriated children and women, and addressing these issues through protection dialogues with the relevant authorities. Additionally, referrals are made to other organizations or actors capable of addressing specific needs.
Upon arrival, children and women may receive basic assistance and health care in transit centres operated by the State with the support of national and international partners/organizations. Where access is granted, the ICRC complements these efforts by providing additional assistance, including basic psychosocial support delivered by its MHPSS teams. This early contact often helps families feel more at ease with MHPSS services and increases their willingness to continue receiving support once they are back in their family and community. In communities of return, protection and MHPSS teams, where access allows, conduct joint visits to assess families’ needs, identify protection, social and psychosocial concerns and determine appropriate follow-up support. ICRC MHPSS teams then conduct more in-depth psychological assessments to inform tailored follow-up and the provision of more advanced MHPSS interventions where required.
MHPSS activities are implemented in line with the ICRC’s Guidelines on Mental Health and Psychosocial Support,Footnote 19 and in Central Asia consist of a layered, community-based model that includes basic psychosocial support; psycho-education and parenting guidance; psychological interventions for individuals, families and groups; and referrals to appropriately identified and assessed psychiatric services when required. These activities are delivered by national practitioners trained by the ICRCFootnote 20 who work closely with families to strengthen coping strategies, address trauma-related difficulties and help rebuild a sense of safety and connection in unfamiliar environments. Individual and family-based sessions support people experiencing challenges such as disrupted sleep, intrusive memories, irritability, anxiety, emotional dysregulation, difficulties in communication and parenting, and other manifestations of psychological distress that may affect their well-being, relationships and ability to cope with everyday challenges. Group sessions for women provide opportunities for shared recognition and coping. Receiving families are also offered support and guidance, acknowledging the challenges that they face in the reintegration process. Where possible, support extends to communities in collaboration with protection teams, through awareness-raising sessions and activities aimed at reducing stigma and fostering acceptance, involving for instance social workers, health personnel, school staff or religious leaders. This multilayered approach is designed to work alongside and reinforce the more basic psychosocial support activities provided by other actors.
To ensure the quality and sustainability of these interventions, capacity-building of local MHPSS practitioners is a core component of the integrated approach. Regular clinical supervision, case discussions and ongoing technical mentoring strengthen local competencies and help practitioners manage the emotional demands of supporting individuals with complex and sensitive histories.
Together, these protection and MHPSS components seek to address both conflict-related trauma and the ongoing daily stressors that shape reintegration. The approach recognizes that legal status, family situation (whether a child was repatriated with parents or not) and family dynamics, psychological well-being and community acceptance are deeply intertwined, and that sustainable reintegration requires coordinated support across all these domains.
Methodology
Study design
The study adopted a convergent mixed-methods design, combining a quantitative component using routinely collected programme data with a qualitative component based on semi-structured interviews. Quantitative and qualitative strands were analyzed separately and then brought together to identify patterns of convergence, divergence and complementarity. This approach was selected to capture both measurable changes in psychological distress and the lived experiences of repatriated children and women during reintegration.
Quantitative component
The quantitative component drew on anonymized pre- and post-intervention data from ICRC-supported MHPSS programmes in three Central Asian countries (Tajikistan, Kyrgyzstan and Uzbekistan). The dataset included:
• Depression Anxiety Stress Scales – 21-Item Version (DASS-21)Footnote 21 assessments from nineteen women;
• DASS-21 assessments from fifteen adolescents aged 14–17 years (seven girls and eight boys); and
• Paediatric Emotional Distress Scale (PEDS)Footnote 22 scores for eighteen children aged 2–10 years (8 girls and 10 boys).
These tools, while originally developed in different settings, are widely used in humanitarian contexts to monitor changes in psychological distress and emotional and behavioural difficulties. They were back-translated into local languages by the ICRC MHPSS teams. The DASS-21 was administered with the support of trained practitioners rather than as a purely self-administered tool. This approach was considered appropriate in the operational context to ensure comprehension and consistent completion, but it may have increased the possibility of social desirability, expectancy or interviewer effects.
Pre- and post-support scores were compared to explore changes in reported distress over time. Assessments were administered at the beginning of psychological follow-up and again at the end of the follow-up period, generally before the first and after the last individual or family-based session. Only individuals with complete pre- and post-intervention assessments were included in the quantitative analysis. Participants received a flexible, needs-based package of support rather than a standardized intervention. On average, women received seven sessions (SD=5; range: 2–21), adolescents ten sessions (SD=4; range: 4–18) and younger children twelve sessions (SD=8; range: 2–31). The duration of psychological follow-up ranged from four to eighteen months, with a mean of approximately eight months. The frequency, number and content of sessions varied according to participants’ needs, availability and access constraints, and practitioners’ clinical judgement. As a result, the number of sessions and the length of follow-up should be understood as reflecting a flexible, needs-based humanitarian intervention rather than a fixed treatment protocol. Work with young children and adolescents was complemented by psychoeducation with caregivers and included family sessions when relevant to strengthen communication and address relationship dynamics. Practitioners applied techniques that included rapport-building, structured psychological assessment, psycho-education, cognitive restructuring, narrative approaches, grounding and stabilization, emotion regulation skills and reinforcement of adaptive coping strategies, while ensuring that these interventions were responsive to cultural norms and expectations.
Quantitative analyses involved comparing pre- and post-intervention scores using paired-samples t-tests for normally distributed data and Wilcoxon signed-rank tests for non-parametric data. Assumptions of normality were examined using the Shapiro–Wilk test. Effect sizes were calculated to support interpretation of the magnitude of change. Given the small sample size, heterogeneous intervention content and absence of a comparison group, these analyses should be interpreted as descriptive evidence of change over time rather than evidence of causal effects.
Qualitative component
The qualitative strand consisted of semi-structured interviews with seven repatriated women aged 22–45 (three of whom were children whilst in the Middle East) and six psychologists delivering ICRC-supported MHPSS services in Uzbekistan, Tajikistan and Kyrgyzstan. Participants were identified through MHPSS teams using purposive criteria, including experience with reintegration processes and willingness to reflect on their trajectories.
Interviews were conducted in local languages by six trained ICRC psychologists from all three countries, who worked in pairs to ensure coherent data collection and a safe space for participants. All six interviewed psychologists consented to audio recording. Among the women, three consented to audio recording, while four preferred not to be recorded; in the latter cases, interviewers relied on detailed simultaneous note-taking. Although initially planned, no children were interviewed following concerns expressed by families. To ensure children’s experiences were still reflected, child-related questions were incorporated into interviews with the women.
Transcripts and interview notes were analyzed using Braun and Clarke’s six-step reflexive thematic analysis,Footnote 23 with an inductive, data-driven approach. Qualitative and thematic analyses were managed using manual coding. The research team held two reflexive discussions to compare interpretations, address ambiguities and ensure that emerging themes remained closely aligned with participants’ accounts. The interviewing psychologists were not directly involved in the participants’ ongoing clinical follow-up, and reflexive discussions were used to consider the influence of practitioners’ roles on data interpretation.
Ethical considerations
The study received approval from the ICRC Ethics Review Board.Footnote 24 Participation was voluntary, with informed consent obtained from all interviewees. Confidentiality and psychological safety were prioritized and access to further MHPSS support was ensured if needed. Given the dual role of the ICRC as both service provider and research initiator, particular attention was paid to minimizing potential coercion and courtesy bias. In line with institutional ethical requirements, the relevant authorities in all three countries were also transparently and formally informed about the research, its purpose and its methodology.
Findings from routine psychological support outcome data
Women
Paired-sample t-tests were carried out to examine changes in DASS-21 depression, anxiety and stress sub-scales among women. Assumptions of normality were checked using the Shapiro–Wilk test.
Among women, DASS-21 scores decreased across all three sub-scales (see Table 1). Depression scores decreased from a pre-intervention mean of 12.53 (SD=9.66) to 5.89 (SD=6.45), with a mean reduction of 6.63 points, 95% CI [0.94, 12.33], a statistically significant change, with a moderate effect size. Anxiety scores showed a larger decrease, from 13.05 (SD=9.25) to 3.68 (SD=4.96), with a mean reduction of 9.37 points, 95% CI [4.33, 14.41], corresponding to a large effect. Stress scores declined from 12.42 (SD=8.21) to 6.84 (SD=6.30), with a mean reduction of 5.58 points, 95% CI [1.04, 10.12], and with a moderate effect size. Around two thirds to three quarters of women showed reductions in DASS-21 scores, including shifts from severe or extremely severe categories into the normal or mild range. These shifts are reported descriptively, as the DASS-21 does not have universally established minimum clinically important improvement thresholds. These findings indicate that reported distress among women decreased during a period in which they received comprehensive support, including psychological support, protection services, referrals, family-related support and, where relevant, material assistance. The changes observed are consistent with women’s descriptions of improved sleep, fewer intrusive memories and greater emotional stability. These findings should be interpreted in light of the broader support context in which they occurred, rather than as evidence of the independent effect of MHPSS alone.
Changes in DASS-21 scores among women and adolescents during the period of support
Table 1 Long description
The table reports pre-support and post-support mean DASS-21 scores with standard deviations for depression, anxiety, and stress in women (19 participants) and adolescents aged 14 to 17 (15 participants). Women improved across all measures: depression fell from 12.53 to 5.89 (mean reduction 6.63, confidence interval 0.94 to 12.33, p less than .05, moderate effect), anxiety from 13.05 to 3.68 (reduction 9.37, confidence interval 4.33 to 14.41, p less than .01, large effect), and stress from 12.42 to 6.84 (reduction 5.58, confidence interval 1.04 to 10.12, p less than .05, moderate effect). Adolescents also improved on all measures with very large effects and p values less than .01: depression decreased from 11.34 to 5.20 (reduction 6.13, confidence interval 1.65 to 10.61), anxiety from 10.80 to 4.27 (reduction 6.53, confidence interval 2.80 to 10.27), and stress from 11.73 to 5.60 (reduction 6.13, confidence interval 2.85 to 9.42). Statistical testing used paired t-tests for all outcomes, with confirmatory Wilcoxon tests additionally reported for adolescents. Overall, both groups show consistent reductions from pre- to post-support, with adolescents showing stronger effect size ratings than women.
Adolescents (14–17 years)
Among adolescents, DASS-21 scores decreased across all three sub-scales during the period of support (see Table 1). Depression scores decreased from 11.34 (SD=9.93) to 5.20 (SD=6.40), with a mean reduction of 6.13 points, 95% CI [1.65, 10.61]. Anxiety scores decreased from 10.80 (SD=6.32) to 4.27 (SD=4.59), with a mean reduction of 6.53 points, 95% CI [2.80, 10.27]. Stress scores decreased from 11.73 (SD=6.71) to 5.60 (SD=4.91), with a mean reduction of 6.13 points, 95% CI [2.85, 9.42].
Given the small sample, both paired t-tests and Wilcoxon signed-rank tests were conducted. Across all three DASS-21 sub-scales, adolescents showed statistically significant, substantial reductions in symptoms, with all p-values below .01 across both parametric and non-parametric analyses. The Wilcoxon results indicate a consistent pattern in which all adolescents who changed showed improvement and none worsened.
Overall, the findings indicate that reported emotional distress among adolescents decreased over the period of support. This pattern complements qualitative reports of improved sleep, reduced fear and easier school attendance. Effect sizes were very large, but should be interpreted cautiously given the small sample and the flexible, needs-based nature of the support provided.
Children (2–10 years)
Children’s outcomes, measured through caregiver-reported PEDS scores, also improved (see Table 2). PEDS total scores decreased from 27.11 (SD=6.42) to 22.72 (SD=5.82), with an average reduction of 4.39 points. The median reduction was 3.5 points, IQR [0.0, 11.5]. A Wilcoxon signed-rank test confirmed a statistically significant reduction in caregiver-reported symptom severity, with a large effect size. This pattern suggests overall caregiver-perceived improvement, although the wide interquartile range indicates variability in children’s trajectories. Before intervention, seven children were below the PEDS clinical threshold and eleven were above; after intervention, fifteen were below the threshold and only three remained above. In total, eight children moved from the clinically concerning to the non-concerning range.
Changes in caregiver-reported PEDS scores among children during the period of support
Table 2 Long description
The table reports caregiver-reported PEDS total scores for children aged 2 to 10 years, based on 18 participants, comparing scores before and after a support period. The mean score decreased from 27.11 with a standard deviation of 6.42 before support to 22.72 with a standard deviation of 5.82 after support. The mean reduction was 4.39 points. The median reduction was 3.5 points, with an interquartile range from 0.0 to 11.5, indicating that some children showed little or no change while others improved more. A Wilcoxon signed-rank test found the pre to post change statistically significant, with a p value less than .05. The effect size is reported as large.
These changes suggest caregiver-perceived improvements in emotional and behavioural functioning, and are consistent with caregivers’ further descriptions of children being calmer, sleeping better and expressing less fear. As both the PEDS scores and these qualitative descriptions rely on caregiver perspectives, this convergence should be interpreted not as independent validation but rather as contextualizing the daily-life meaning of the caregiver-reported changes. A small number of children showed stable or slightly higher scores, emphasizing that change is uneven and that continued or more advanced support may be needed for some. Participants who exhibit moderate to severe distress during post-test are provided with continued psychological follow-up and, where appropriate, are referred to specialized mental health or psychiatric services for further care.
Overall pattern
Across all age groups, the findings indicate a consistent trend of reduced reported emotional distress over the period during which participants received psychological, family-based, protection and other forms of assistance. The results suggest positive developments in psychological well-being among women, adolescents and younger children within a broader process of integrated support. These quantitative trends are consistent with qualitative accounts of reduced symptoms, increased emotional stability, improved family dynamics and greater confidence in navigating daily life, although the small qualitative sample limits the generalizability of this convergence.
The quantitative results take on fuller meaning when considered alongside participants’ own narratives, which illustrate how these symptom changes are embedded within broader, ongoing processes of adaptation, family adjustment, social acceptance and recovery, as explored in the following section.
Lived experiences of repatriation and reintegration
Qualitative interviews with seven women and six psychologists were analyzed thematically. The following sections present the main themes, illustrated with anonymized quotes.
Between relief and disorientation: The emotional ambivalence of return
Women described repatriation as a moment of intense relief and gratitude, but also of confusion and grief. For many, returning home had been a distant hope during years spent in camps – yet once back, they felt disoriented in environments that no longer resembled the homes they had left. Some returned without close relatives, including children and spouses, whose fate remained unknown. Feelings of relief and safety, as well as appreciation towards the authorities who facilitated their return, coexisted with the pain of loss and the practical pressures of securing housing, income and schooling. As one participant noted, “Coming back here was the most difficult part as I was alone without my family, especially without my mother and sister.”
Children’s reactions were similarly mixed. Mothers recalled their children’s excitement at seeing greenery and toys and experiencing relative freedom after years in arid camps (one mother recalled that “[w]hen they arrived, the children said, ‘What’s going on here? Is it heaven?’, because of the green trees and flowers around”), but also described nightmares, fear of loud noises and clinging behaviour. For both children and women, repatriation marked not an end-point but the beginning of a demanding process of rebuilding identity and belonging.
Enduring trauma, loss, and stigma
Participants’ accounts revealed long sequences of violence, deprivation and uncertainty before, during and after their time in camps. Exposure to combat and military operations, with their attendant destruction, injuries and deaths, including those of close relatives, left lasting emotional scars. Ambiguous loss – uncertainty regarding the fate of missing family members – complicated mourning and sustained cycles of hope and despair. One woman recalled, “While we were escaping from the bombs, I saw a man completely burnt; I quickly overtook him, not even suspecting that the corpse of another little girl lying near him was my own daughter.” Others spoke of constant fear for their children’s safety. As one mother described, “I could not sleep; I was so afraid my son would be taken away from me. He was only 12 at the time.”
Return did not always bring closure. Some women reported encountering suspicion and discrimination from communities and at times from institutions. Some reported being refused certain professions, losing jobs when their past became known or facing humiliating comments when seeking assistance. Others felt subtly feared or avoided by neighbours and relatives. To protect themselves, several chose to conceal their histories, instructing their children to give alternative accounts of where they had lived. As one participant explained, “I always tell my children to say they came from Russia, to avoid blaming from the community.”
Participants also described perceived differences in how returning children and women were approached by various authorities and services. One woman who had been repatriated as a child reflected: “When we returned, I was a child, and the communication and support were good for children; it was not strict. But for women it was strict. I did not like that. It would be good to have equal support.” Such discrepancies were noticeable to children, who were highly attuned to their caregivers’ emotional reactions.
Family dynamics: Refuge and constraint
Family relationships emerged as a central axis of reintegration. Some relatives received women and children warmly, providing emotional and material support. When relatives offered consistent affection and helped navigate institutions, children and women felt less alone and more hopeful. One participant shared, “My parents accepted me and my children very warmly and my brother helped me financially. I had my own home; I felt safe.”
Yet families were also sources of strain. Receiving relatives themselves carried fears of stigma, security concerns and economic hardship. Some relatives offered more conditional acceptance, combining care with blame, control or intrusive questions. Some responded by imposing strict rules, limiting phone access or restricting participation in group activities. As one woman put it, “When I talk with my relatives about my experience in Syria, they make me feel guilty for having been there and say that I might go back, so I need constant monitoring because they cannot trust me.” Participants described feeling both welcomed and judged. Emotional needs could be overshadowed by immediate concerns about housing and income, leaving little space for grief. Attempts to talk about their experiences were sometimes met with minimization or criticism.
Others struggled to understand trauma-related behaviours, interpreting irritability, withdrawal or hypervigilance as defiance or danger. One woman described how these fears extended to her children: “My relatives were scared of my children, thinking they were dangerous because they had seen war and blood.” These tensions created cycles of mutual misunderstanding, shame and silence.
Coping and finding strength
Despite profound adversity, women described diverse ways of coping and finding strength. Many drew on faith, framing survival as part of a divine plan and expressing gratitude for children and the possibility of starting anew. Others turned to everyday activities, such as sewing, cooking or walking, as means of calming the mind, structuring time and reclaiming a sense of agency.
Some women reported learning, often through MHPSS sessions, to identify triggers, use breathing or grounding techniques and organize their days in order to avoid being overwhelmed by memories, but also to help them face administrative hurdles with more confidence. For many, children were both a source of worry and a primary motivation to persevere. Comparing current difficulties with the ordeal of life in camps helped some to contextualize their distress and to recognize their own resilience. As one woman explained: “Whenever I face difficulties, I compare my life in Syria with my life here. It helps me remember that the hardest days are behind me, and that I am strong enough to handle what comes.”
Persistent trauma symptoms and the need for advanced support
Across interviews, women described emotional numbing, avoidance of memories and efforts to stay constantly occupied in order to prevent intrusive thoughts. As one participant shared: “A lot of the time I am busy with tailoring … when a person sits without a job, they start to remember everything.” Such strategies provided short-term relief but limited opportunities for deeper processing. Persistent hypervigilance, startle responses, somatization, intrusive memories, guilt, shame and overwhelming grief pointed to unresolved trauma. One woman said, “The only moment that is always with me is my son’s death … it is unforgettable.” Another recalled, “I had suicidal thoughts for a long time. I thought, what is the point of living if I don’t have anyone?”
For several participants, especially those who had lost children or endured prolonged violence, avoidance and maintaining a facade of coping enabled day-to-day functioning but constrained longer-term adaptation. As one woman reflected: “At the beginning, I thought I was doing well, because I was smiling. But with time I understood it was a mask.”
Support networks and the role of the ICRC
For many women, support from the ICRC and its partners marked a turning point after years of fear and deprivation. The organization was remembered not only for material assistance but also for the continuity and care that it provided, from the camps and transit centres through to communities of return. One woman recalled: “Since the first day we were in the camp, we have been familiar with the ICRC … alhamdulillah! Its presence calmed us down and gave us a sense that not everyone had forgotten us.” A psychologist from Tajikistan similarly observed that “children cried with excitement when they recognized the ICRC logo on vehicles arriving at the transit centre”.
Women also highlighted the importance of the ICRC’s role in restoring family links, remembering how teams supported health needs and helped them reconnect with relatives. These contacts often represented the first fragile thread of hope after long periods of separation: “They helped us prepare letters to our relatives.”
Psychological support was valued for alleviating distress and providing a safe, non-judgemental space to speak. As one woman explained, “I could share with the psychologist openly … some feelings I could not even share with my mother.” Women linked this support to improved sleep, fewer intrusive memories, stronger relationships with children and relatives – “I stopped having nightmares or being afraid of noises” – and a renewed capacity to plan for the future.
Support also extended to the family system. Mothers described learning to recognize and respond to their children’s emotions: “My eldest son was introverted and closed. … The sessions helped him to open up, including in school.” Many caregivers initially encouraged children to “forget”, a protective strategy that can inadvertently cause harm by reinforcing avoidance; psychologists helped caregivers reframe children’s memories as normal aspects of their life story and encouraged safe, open communication. As one mother put it, “Letting them share and supporting them was actually calming them down.” Such guidance reduced caregivers’ anxiety and supported more adaptive parent–child interactions.
Group sessions helped counter isolation and the sense of being uniquely marked by past experiences: “We shared our experiences and supported each other.” One woman also noted her appreciation for the support received from a psychiatrist to whom she was referred.
Looking ahead: Rebuilding lives and investing in the future
Looking toward the future, many women voiced a strong desire to rebuild stability and regain a sense of autonomy after years marked by loss, displacement and dependence. This aspiration was not limited to material needs; it reflected a deeper wish to reclaim control over their lives and re-establish a sense of dignity. Participants spoke of wanting stable housing, opportunities to work and the ability to provide care for children or other relatives. As one woman explained, “I want to live independently and take custody of my niece. I want to find a job and learn something new.”
For some, independence was closely linked to emotional security and the hope of sharing responsibilities with a supportive partner. In this sense, marriage was sometimes perceived as one possible pathway toward greater stability and increased financial security for the family. Education, both for themselves and especially for their children, emerged as a powerful symbol of renewal and protection, representing a pathway out of vulnerability and a means of reshaping their futures. Several women challenged prevailing social expectations that prioritized early marriage over schooling, expressing a clear determination to invest in learning and skills development. One participant emphasized, “Here everyone thinks about marriage, but I want this money to spend on my children’s education.”
Reflections from psychologists: From fear to empathy and growth
Psychologists’ narratives echoed the ambivalence of returnees. Many recalled initial fear and uncertainty when first working with repatriated families, influenced by public narratives portraying them as dangerous or “difficult”. One psychologist explained, “They told me that the child was very difficult and aggressive. I was even given a sealed letter that only I could open.”
Practitioners also reflected on the gap between their previous training and the complexity of the situations they encountered. Several described feeling cautious at the beginning, not because they lacked professional commitment, but because the histories, stigma and protection sensitivities surrounding returnee families required skills and confidence that had not been fully developed through their prior academic or clinical training. One psychologist explained that when the first returnee families arrived, the team had to learn how to adapt existing psychological knowledge to a highly complex and sensitive reintegration context.
Over time, however, supervision and exposure to families’ stories transformed this apprehension into empathy and professional confidence. Group supervision and peer case discussions functioned as spaces to share dilemmas, process emotional reactions and refine interventions.
At the same time, the work was experienced as “energy-intensive”. Practitioners reported fatigue, self-doubt and the need for their own psychological support. They highlighted the importance of institutional support, including regular supervision and recognition of staff well-being as an integral part of programme quality.
Across all accounts, professional growth was strongly linked to ICRC support and supervision: “At university, we studied theory, but not much about therapeutic approaches for trauma. The consultations, supervision, and seminars provided by the ICRC gave us real practical knowledge.” The collaborative space created through discussions with colleagues and supervisors also helped practitioners to process challenging situations. These exchanges strengthened their confidence in supporting people with complex needs: “Working with people facing very complex situations and the technical support provided by the ICRC helped me grow more confident, and now I feel ready to support anyone who comes to me.”
Discussion
The findings align with broader evidence that mental health needs in conflict-affected populations are elevatedFootnote 25 and that ongoing daily stressors such as poverty, social exclusion, housing precarity and bureaucratic obstacles can predict distress in addition to direct exposure to violence.Footnote 26 In the case of repatriated families, these stressors are compounded by stigma and uncertainty regarding legal status and social and family acceptance. Within this context, the integrated protection–MHPSS approach appears to have several strengths.
The findings should not be read as evidence that one specific programme component independently caused the reductions in distress observed in the quantitative data; rather, they point to the limits of separating mental health outcomes from the broader conditions in which recovery and reintegration take place. In this context, changes in distress were embedded in a wider process involving renewed safety, family contact, legal and administrative support, material assistance, relationships with practitioners and gradual re-engagement with community life. The value of the integrated approach lies precisely in its capacity to respond to these interdependent dimensions, rather than treating psychological symptoms, protection concerns and social reintegration as separate problems.
MHPSS and protection as interlinked dimensions of reintegration support
Firstly, the findings illustrate how protection and MHPSS concerns are interlinked in the lived experience of returnees. Quantitative findings indicated reductions in distress among women, adolescents and younger children during the period of support, while qualitative accounts described improved sleep, fewer intrusive memories, greater emotional stability and increased confidence in facing everyday challenges. These individual-level changes unfolded in the context of broader protection measures, including restoration of family links, practical assistance, support with civil documentation, referrals to services and dialogue with relevant authorities where applicable.
While the study cannot demonstrate interaction effects between the protection and MHPSS components, participants’ accounts suggest that these forms of support were experienced as connected rather than separate. For example, restoring family contact, addressing documentation issues or receiving practical assistance could reduce daily stressors and increase a sense of safety, while psychological support could help individuals better manage distress, communicate with family members and engage with available services. From an operational perspective, the findings therefore support the relevance of coordinated protection–MHPSS programming in settings where emotional distress, legal uncertainty, family separation, stigma and socio-economic pressures interact closely.
Centrality of family systems and receiving relatives
Secondly, the findings underscore that reintegration is a profoundly relational process. Family contact and unity lie at the heart of the ICRC’s Restoring Family Links work; in this study, women’s and children’s narratives confirm that being reunited with close relatives – or, conversely, remaining separated from them – shaped both their emotional recovery and their social reintegration. Reports from participants that supportive family members provided a sense of safety and stability align with evidence that stable caregiving relationships and family acceptance can buffer the effects of severe trauma and are associated with better emotional and behavioural outcomes among conflict-affected children.Footnote 27 Also, while not based on comparative statistical analysis, programme staff observed that children who returned together with their mothers generally presented with fewer acute signs of distress in the immediate post-repatriation period and appeared to adapt more easily to school and community life than those repatriated without a primary caregiver. One psychologist from the ICRC observed: “Separation from their mother is one of the most distressing experiences these children may face. It can have important implications for their emotional well-being and development, particularly when they are also separated from their siblings.”
At the same time, receiving families themselves were navigating fears of stigma, security concerns and economic hardship. Many had lived for years with uncertainty about the fate of their relatives, experienced social pressure or discrimination linked to association with conflict and carried their own unaddressed psychological distress. As a result, family relationships could be both a source of support and a source of tension. Receiving families could serve as a refuge, providing affection and practical assistance, but also a source of constraint, with some relatives responding with blame, control or heightened monitoring. The programme’s inclusion of support for receiving relatives – including psycho-education, parenting guidance and joint sessions – was therefore crucial. These activities helped relatives to better understand trauma-related reactions, reduce blaming narratives and create spaces for more supportive communication, including with children, who were acutely sensitive to their caregivers’ emotions.
However, the findings also indicate that needs within these complex family systems remain high and require sustained support. Trauma, unresolved grief and long-term economic pressures are not problems that can be resolved within a short time. Integrating support for receiving families into national reintegration policies and community services is thus not an optional complement, but a core component of any sustainable response.
Stigma
Stigma emerged as a cross-cutting barrier to reintegration rather than as a discrete psychosocial issue. It shaped how women and children were perceived by neighbours, relatives, employers and, at times, service providers. Participants’ decisions to conceal their histories, avoid certain social interactions or instruct children to provide alternative explanations of where they had lived illustrate how stigma can affect both psychological well-being and access to social participation. For children, stigma may also influence school adaptation, peer relationships and identity formation. These findings suggest that reintegration support should focus not only on individual distress, but also on the social environments into which returnees are expected to reintegrate. Community awareness, careful engagement with receiving families, and work with schools, social workers, health personnel and local leaders are therefore essential to reduce fear-based narratives and foster acceptance.
Limits of basic and focused psychosocial support
While the quantitative outcomes and qualitative accounts point to meaningful improvements, some women reported persistent intrusive memories, hypervigilance, somatic complaints, avoidance and profound guilt or grief, including in relation to the death or disappearance of children and other relatives. For these individuals, strategies such as staying constantly occupied or maintaining a facade of coping enabled day-to-day functioning but limited opportunities for deeper processing.
These findings suggest that while psychosocial and psychological support may offer stabilization and symptom relief for many participants, a proportion of women may benefit from more specialized, evidence-based trauma-focused interventions. In several instances, more structured therapeutic approaches – such as narrative exposure therapy – were implemented by some psychologists who had received additional training through the programme. Nevertheless, the consistent availability of such interventions, and their integration into national services, remains limited and continues to pose operational and sustainability challenges.
Importantly, a small number of women and younger children showed increased distress scores over time. In some cases, practitioners interpreted this not as deterioration caused by the intervention, but as a sign of greater trust and emotional safety over time, enabling participants to acknowledge and report difficulties they had previously suppressed, including for their children. In others, higher scores likely reflected ongoing or newly emerging stressors such as financial strain, school adaptation problems or renewed exposure to stigma. In practice, individuals with persisting moderate-to-severe distress continued to receive support or were referred to more specialized services.
Structural constraints and the boundaries of humanitarian action
The findings also point to the influence of broader structural conditions on reintegration trajectories. Persistent socio-economic precarity, gendered expectations, limited employment opportunities and uneven access to services continued to affect some families, shaping both protection concerns and psychological well-being. Women’s future-oriented goals – securing stable housing, accessing decent work, investing in their children’s education – reflect both their resilience and the structural barriers they may face. These factors extend beyond the scope of humanitarian programming and underline the importance of situating reintegration support within broader social and policy frameworks developed by national authorities.
Local capacities, staff well-being and programme transition
Finally, the study sheds light on the experiences of front-line practitioners and the importance of investing in local capacities and staff care. Psychologists described an initial phase marked by fear and uncertainty, influenced by public narratives about “dangerous” returnees and by the novelty and complexity of the situations and needs they were asked to address. Over time, however, regular training, supervision and peer case discussions enabled them to move from apprehension to empathy and professional confidence. Working with highly stigmatized individuals in very complex situations was experienced as “energy-intensive”, requiring space to process emotional reactions and institutional recognition of staff well-being as integral to programme quality.
As the ICRC gradually phases out its MHPSS support in the Central Asia region, these insights are particularly salient. The gains in local expertise and confidence represent an important resource for national systems, but they also highlight the need for continued supervision, professional development and support structures if this work is to be sustained ethically and effectively. Ongoing dialogue and advocacy with authorities and concerned communities will be crucial to ensure that national actors are equipped, mandated and resourced to carry forward integrated protection–MHPSS approaches, including for future returnees or other groups affected by conflict.
Limitations
Several limitations qualify the findings. The quantitative component relied on a relatively small sample of participantsFootnote 28 for whom paired pre- and post-support data were available: eighteen younger children, fifteen adolescents and nineteen women. This limits the generalizability of results to all repatriated families in the region. Participants included in the analysis may also differ from those for whom complete data were not available, creating a risk of selection bias. Missing data, operational constraints and the fact that many women and children from the programme were still receiving support at the time of analysis affected the sample size.
The study design does not allow causal attribution. There was no comparison group, and participants received support in a context where several potentially beneficial factors were present at the same time, including reaching relative safety, family reunification or renewed family contact, protection services, material or financial assistance, referrals, school reintegration, community-based support and natural recovery over time. The observed reductions in distress therefore cannot be attributed to MHPSS alone, nor can the study determine the added value of MHPSS compared with other components of the integrated response. The findings should instead be interpreted as evidence of positive changes observed during a period of comprehensive and integrated support.
The MHPSS interventions themselves were heterogeneous. Participants did not receive a single standardized treatment package, but rather were provided with a flexible, needs-based combination of individual, family and group support delivered by different practitioners over varying periods of time. However, this flexibility was grounded in a common programme framework: practitioners were trained and supervised to conduct structured needs assessments, provide trauma-informed support and adapt interventions to each person’s and family’s situation. Depending on needs and practitioners’ training, this could include focused psychosocial support, psycho-education, grounding and stabilization techniques, work on emotional regulation and coping, family sessions or, in some cases, more advanced trauma-focused techniques. The number of sessions, duration of follow-up and therapeutic techniques varied according to need, access and clinical judgement. This reflects a deliberate, needs-based approach suited to the realities of humanitarian practice and the complexity of reintegration support, but it also limits comparability across participants. The small sample size did not allow meaningful dose-response analysis or systematic exploration of whether number of sessions, duration of follow-up or type of intervention was associated with greater improvement.
The DASS-21 was used with adolescents, which requires some caution, as the scale was originally developed for adults; however, studies have reported acceptable psychometric performance in adolescent samples.Footnote 29 A youth-specific version of the Depression Anxiety Stress Scales, the DASS-Y, has been developed for ages 7–18 and demonstrates satisfactory psychometric properties,Footnote 30 indicating that future research could explore its use with younger populations. In addition, the DASS-21 was administered with practitioner support rather than as a fully self-administered tool, which may have introduced social desirability, expectancy or interviewer effects.
The qualitative component was limited in scope. Seven women were interviewed, and no children participated directly in the interviews following concerns expressed by families. Children’s experiences were therefore captured indirectly through mothers’ accounts and caregiver-reported measures, which limits the ability of the study to represent children’s own perspectives. Perspectives from male returnees could not be included, as children and women constitute the vast majority of those repatriated. Likewise, the views of extended family members and community actors, including other humanitarian actors as well as local and national authorities, were not included. Four interviews with women were not audio recorded, potentially reducing the richness and precision of the transcripts. In addition, the ICRC’s dual role as service provider and research sponsor may have influenced how comfortable participants felt expressing criticism, despite measures taken to minimize this risk.
Finally, the study did not systematically compare different repatriation pathways or national frameworks or levels of community acceptance, limiting the ability to draw conclusions about variations across contexts. Although the findings offer operational insights into the implementation of integrated protection–MHPSS approaches in Central Asia, they should not be generalized without caution to other contexts. Further independent, multi-actor and longitudinal research would be needed to assess post-return trajectories, compare integrated and non-integrated models, and better understand which components of support are most relevant for whom, under what conditions and over what time frames.
Conclusion
This study examined the reintegration of children and women repatriated from areas formerly controlled by IS in Syria and Iraq to Central Asian States, through the lens of the ICRC’s integrated protection–MHPSS approach. Drawing on mixed methods, it combined routine outcome data with qualitative accounts from repatriated women and front-line psychologists.
Integrated protection–MHPSS support as an operational framework
This study suggests that an integrated protection–MHPSS approach is feasible and operationally relevant in such contexts and may provide a useful framework for addressing the interconnected legal, social, family and psychological dimensions of reintegration. Read together, the findings show how psychological recovery was embedded in a wider reintegration process involving family relationships, legal and administrative support, practical assistance, social acceptance and trust in practitioners. By linking legal and administrative support, restoring family links, engaging in dialogue and advocacy with authorities and concerned communities, and providing layered MHPSS interventions, the ICRC’s approach seeks to address both symptoms of distress and the contextual conditions that shape them. Such approaches may support safer and more dignified reintegration trajectories, while requiring further research to assess their potential benefits compared with less integrated models of support.
The need for layered MHPSS care
During the period of integrated support, quantitative data showed reductions in reported distress across women, adolescents and younger children. These changes were mirrored in qualitative narratives describing improved sleep, reduced fear, stronger family communication and renewed capacity to plan for the future. At the same time, women’s and psychologists’ testimonies reveal that reintegration remains an ambivalent, often precarious process, shaped by unresolved loss, stigma and sometimes limited livelihood opportunities and constrained access to more specialized mental health care. This points to the need for layered MHPSS care, with interventions ranging from basic psychosocial support to focused and specialized individual and family-based support, including trauma-focused care where needed.
Family relationships as a central dimension of reintegration and recovery
Children repatriated with their mothers appeared to fare better in the immediate post-return period than those separated from primary caregivers. Receiving families were crucial buffers against the psychological impact of trauma exposure, but they also carried their own fears, stigma and grief, and needed support themselves. Psycho-education and joint family sessions were described as important in reducing blame and improving parent–child communication. Reintegration programmes should therefore include receiving families as active participants in the support process: family-based assessment, psycho-education, parenting guidance and joint sessions can help reduce fear and blame, strengthen communication, and create a more protective environment for children and women returning from conflict-affected settings.
Repatriation as a first step to reintegration, not an end-point
For women, the moment of return often marked a transition into new forms of uncertainty rather than resolution. For States, the findings underscore that repatriation cannot be treated solely as a security or logistical operation. At the same time, with due respect for the principle of non-refoulement, repatriation is a necessary first step to the reintegration of third-country nationals – and the cornerstone of an effective protection approach with respect to the populations concerned.Footnote 31
The importance of long-term investment in reintegration as part of a multisectoral approach
Sustainable reintegration requires long-term investment in housing, education, employment and social protection, as well as accessible health services and MHPSS delivered through national systems. Recent policy initiatives and guidance developed by Central Asian States in cooperation with international organizations, such as UN agencies, reflect this increasingly multisectoral approach.Footnote 32 These efforts benefit from complementary community-level measures that are essential to foster acceptance of returnees and reduce stigma.
Sustaining local MHPSS capacities and staff care
For humanitarian actors, the study further highlights the importance of maintaining principled, confidential engagement that combines protection and mental health expertise, and of supporting national authorities by strengthening local capacities, supervision and staff care. It also underscores the need to continue advocating for sustained, government-embedded MHPSS and protection support, so that returning families can access assistance and safeguards through stable national structures over the long term. National authorities and humanitarian actors should therefore invest not only in training, but also in sustained supervision, peer support, referral pathways and staff care mechanisms for local MHPSS practitioners, in order to maintain quality, support work with people facing complex needs, and prevent practitioners from being left unsupported when international programmes transition or are phased out.
Trust and continuity as foundations of integrated support
Beyond specific interventions, participants’ accounts point to the importance of human proximity and trust. For many women and children, the steady, respectful engagement of ICRC teams provided a rare sense of continuity and empathy after years marked by fear and uncertainty. This relational thread – being seen, heard and not abandoned – was often described as both reassuring and transformative. Reintegration programmes should therefore recognize continuity, trust and respectful engagement as core components of effective support. Stable relationships with well-supervised practitioners can help rebuild a sense of safety, strengthen engagement with services and ensure that families do not experience repatriation as another form of abandonment.
Relevance beyond the context of Central Asia
Although grounded in the Central Asian context, the findings may offer insights for other settings where families return from conflict areas and counterterrorism environments. They suggest that integrated protection–MHPSS approaches may be relevant where individuals face layered vulnerabilities linked to displacement, violence, stigma, family separation or legal precarity. However, any transfer of lessons to other contexts should be undertaken carefully, with attention to local legal frameworks, service systems, social norms, security dynamics, available capacities and the views of returnees, families and communities themselves.
This article contributes to a growing body of work at the intersection of protection, mental health and humanitarian policy. It invites further independent, multi-actor research on post-return trajectories, including the perspectives of extended families, communities and local authorities, and on the conditions under which integrated Protection–MHPSS approaches may most effectively support those whose displacement and return expose them to layered vulnerabilities. Future research could also examine the potential benefits and limits of integrated approaches compared with less integrated or single-sector models of support. Ultimately, supporting the reintegration of repatriated children and women is not only a question of compliance with legal standards; it is a matter of human dignity and of ensuring that the communities to which they return are able to include and protect them.
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