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More than three quarters of Syrian refugees and internally displaced living in Lebanon, Turkey and in Idlib suffer serious PTSD symptoms, the Syria Relief report said, urging host countries to improve access to mental health facilities.

The charity surveyed 721 Syrians living in those locations and found that 89% of them have experienced "at least one PTSD symptom and thus need to be seen by a medical professional", according to the report.

For refugees in Turkey and Lebanon, those numbers are 76% and 74% respectively. For the internally displaced in Idlib, that number shoots up to 99%, with all but two of the 393 people surveyed having symptoms of PTSD.

Of the 15 possible symptoms, 42% of Syrians have experienced at least one life threatening event and have 10 or more PTSD symptoms - 37% in Idlib, 50% in Lebanon, 52% in Turkey.

Eighty-four per cent of Syrians surveyed have seven or more symptoms - 88% in Idlib, 73% in Lebanon and 80% in Turkey.

"My mental health has affected me to points where I cannot control my actions anymore," says Tahini, who left Syria when she was 15-years-old and seven months pregnant, moving from refugee camp to refugee camp with her children in the years that followed.

"Living in a tent and my children just want to play. But sometimes, I hit them, because I just cannot bear to listen to their noise. I know it's not their fault, they are just children and they need to play, but I can't control myself.

"The pressure inside me was so intense that I couldn’t cook, I was scared of seeing people because if they would try to talk to me I would just want to scream at them. I know this is not me. This is not the way I behave.

"This behaviour is not part of my personality, I am behaving in this way because there are so many things inside me that are pushing me to be like this."

Twenty-four-year old Ahmad from Aleppo says he can still hear air strikes hitting his home.

"My fear has become my obsession," he says.

"I’m afraid of aircrafts, displacement, injustice, oppression and everything I’ve been through since I was injured.

"Whilst I received medical help, psychologically no one has taken care of me. I don’t even know if there is any mental health support for people like me."

The report argues that while the world's focus is on the Covid-19 pandemic, Syrian refugees suffer yet more challenges.

"Refugees and IDPs may have escaped the conflict physically, but PTSD means many will be unable to truly escape this conflict, even when the brutal fighting finally ceases, unless their condition is treated," says Othman Moqbel, Chief Executive Officer of Syria Relief.

"This report does not just prove that this unseen crisis exists with empirical evidence, but it gives it a face," Moqbel said.

"I hope the numbers you see and the stories you read will work towards generating more international support to alleviate the humanitarian catastrophe that we can’t see – mental health amongst the victims of this decade of inhumanity."

Syria Relief’s head of communications and advocacy, Charles Lawley, the report’s author, added: "We have a lot more success in getting aid for physical issues like food or schools.

"This is the damage you can see from the war, but what I wanted to give a picture of is there is a huge amount of damage you can’t see – the mental trauma."