Refugee Mental Health

This book is an in-depth practical guide for mental health practitioners working across diverse theoretical orientations to provide mental health services tailored to the needs of refugees.

This book provides a framework to guide mental health providers who work with refugees and immigrants. Nearly 70 million people today are refugees or forcibly-displaced migrants. More than half of them are children suffering from the effects of dislocation and violence. The authors describe the unique needs and challenges of serving these populations, and offer concrete steps for providing evidence-based, culturally-responsive care. Using the socioecological model, the authors conceptualize the developing child as living within concentric circles that include family, school, neighborhood, and society, embedded within a cultural context. Mental health providers identify and provide targeted support to combat disruptions within any or all of these ecological layers. Chapters examine the complex ways in which culture impacts the refugee experience, barriers to engagement in mental health practice and strategies for overcoming them, assessment, collaborative and integrated mental health interventions, and efforts to increase resilience in children, families, and communities. The book is an essential guide for mental health providers, and all who seek to help children in need.

Taking an interdisciplinary approach and focusing on the social and psychological resources that promote resilience among forced migrants, this book presents theory and evidence about what keeps refugees healthy during resettlement. The book draws on contributions from cultural psychiatry, anthropology, ethics, nursing, psychiatric epidemiology, sociology and social work. Concern about immigrant mental health and social integration in resettlement countries has given rise to public debates that challenge scientists and policy makers to assemble facts and solutions to perceived problems. Since the 1980s, refugee mental health research has been productive but arguably overly-focused on mental disorders and problems rather than solutions. Social science perspectives are not well integrated with medical science and treatment, which is at odds with social reality and underlies inadequacy and fragmentation in policy and service delivery. Research and practice that contribute to positive refugee mental health from Canada and the U.S. show that refugee mental health promotion must take into account social and policy contexts of immigration and health care in addition to medical issues. Despite traumatic experiences, most refugees are not mentally ill in a clinical sense and those who do need medical attention often do not receive appropriate care. As recent studies show, social and cultural determinants of health may play a larger role in refugee health and adaptation outcomes than do biological factors or pre-migration experiences. This book’s goal therefore is to broaden the refugee mental health field with social and cultural perspectives on resilience and mental health.

This comprehensive reference book provides both background information and practical, clinical advice on all areas of nutrition for the cancer patient at all stages of their disease trajectory.

Print version originally published: Mahwah, NJ : Lawrence Erlbaum, 2004.

The increasing number of refugees, asylum seekers, and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during, and after migration. The prevalence of psychotic, mood, and substance-use disorders in these groups varies but overall resembles that in the host populations. Refugees and asylum seekers, however, have higher rates of post-traumatic stress disorder. Poor socioeconomic conditions are associated with increased rates of depression five years after resettlement. Refugees, asylum seekers, and irregular migrants encounter barriers to accessing mental health care. Good practice for mental health care includes promoting social integration, developing outreach services, coordinating health care, providing information on entitlements and available services, and training professionals to work with these groups. These actions require resources and organizational flexibility.

More than half of the 25.9 million refugees in the world are under the age of 18 and the mental health of these children and adolescents constitutes a growing global public health priority. Refugee children and their families are at increased risk to develop mental health problems, but they often face major challenges in accessing adequate treatment and mental health professionals frequently feel ill-equipped to assist this group. Refugees are faced with a plethora of issues including the ambiguous loss of loved ones, psychological trauma related to past experiences of violence and atrocities, the complexities of daily life as a refugee, and the challenges to adapt to new systems of care and support. Refugees’ life circumstances all too often undermine their agency, asthey face discrimination, stigma, and social isolation or exclusion. Refugees are frequently disconnected from the usual family and community supports that they once had, which creates additional mental distress. As parents struggle with these changes, their children often find it even more difficult to adapt and connect with them. This all leads to increased prevalence of mental health conditions among refugees. Humanitarian policies recommend family-centered interventions that are multi-sectoral,multi-disciplinary, and focus on optimizing resource utilization. Over the last decade, a considerable body of research has emerged around socio-ecological models of mental health, family and community approaches, and resilience and strengths-based theories, but these insights are insufficiently incorporated in the practice of mental health care for refugee children. Clinicians often struggle to grasp the common unique stressors that families face and are not familiar with working with families as units for intervention. Using culturally and contextually informed assessment methods and family-oriented management approaches not only help individual children or adolescents, but also their families. This book aims to provide an overview of the latest theoretical insights from research on sociocultural aspects of mental health and connect these with clinical insights from practical mental health care provision. Using strengths-based, resiliency-oriented and family-centered approaches can enrich clinical practice in refugee mental health, but clinicians need to translate the emerging evidence into concrete steps and interventions. This requires additional skills for the assessment and management of mental health conditions in refugee children and families. The chapters in this book are written by a diverse group of authors using global, multi-disciplinary approaches. The chapters provide examples from various contexts including refugees who are displaced to neighboring countries, refugees ‘on the move’, and refugees and asylum seekers in resettlement settings. This book is therefore a unique resource for clinicians, researchers and policy makers working on mental health issues of refugee children and adolescents around the world.

This book provides an overview of theoretical, empirical, and clinical conceptualizations of mental health following exposure to human rights violations (HRV). There are currently hundreds of millions of individuals affected by war and conflict across the globe, and over 68 million people who are forcibly displaced. The field of refugee and post-conflict mental health is growing exponentially, as researchers investigate the factors that impact on psychological disorders in these populations, and design and evaluate new treatments to reduce psychological distress. This volume will be a substantial contribution to the literature on mental health in refugee and post-conflict populations, as it details the state of the evidence regarding the mental health of war survivors living in areas of former conflict as well as refugees and asylum-seekers.