Refugee Health Technical Assistance Center

Treatments and Services for Mental Health and Trauma among Refugees

Many refugees have experienced trauma as a result of living through war, imprisonment, torture, rape, loss of property, and separation from family members. After these traumatic experiences, the process of adjusting to life in their country of resettlement presents refugees with a myriad of new daily challenges as they learn a new language, adapt to a foreign culture, search for employment, and look for permanent housing. Recent work has verified that post-migration stress significantly influences the emotional well-being of refugees, and often provides a risk similar or greater to war-related trauma.

Ti Reh, an IRC social worker trained in mental health counseling, talks with a patient. Counseling is a major part of an IRC program that helps treat mental disorders in the refugee camps on the Thailand-Myanmar border.

Photo: Peter Biro/IRC

Healthcare providers must find ways to ask refugees about trauma and provide referrals for mental health services post-migration. A recent study interviewed refugees about how medical providers can initiate these conversations in an acceptable way. This type of research and the Refugee Health Screener-15 (RHS-15), a culturally-informed tool for mental health screening, are valuable resources for healthcare providers. There are still many barriers that prevent refugees from accessing treatment and services for mental health issues after being screened. Additionally, more research is needed to determine the types of mental health treatment that are most effective for a broad range of refugees. Culturally-informed models of care such as adjustment support groups deserve further attention and research to promote healing for refugees experiencing complex distress as a result of past trauma.

It can be difficult to find a screening tool that is culturally appropriate for refugees, available in a variety of languages and can be administered quickly. The RHS-15,by Pathways to Wellness, was developed with this in mind. The RHS-15 is a sensitive tool that is able to detect a range of emotional and somatic distress common among various refugee populations. It is available in languages spoken by resettling refugees, including Arabic, Burmese, Karen, Russian, and Nepali. By detecting mental health issues early, the RHS-15 may ease the transition during resettlement by helping connect symptomatic refugees with services for further evaluation and treatment for behavioral and emotional problems.

North American Refugee Health Conference

In June 2014, hundreds of medical providers, resettlement workers, researchers, community agencies, advocates and many others gathered in Rochester, New York for the 4^th Annual North American Refugee Health Conference, a three day conference to promote and learn about refugee health. New research and best practices were shared on a range a topics from trauma informed care to infectious disease and chronic health conditions to community building initiatives. A comprehensive list of sessions with complete presentation slides from all three days is available at the conference website.

Save the Date!

The 5^th Annual North American Refugee Health Conference will convene on June 4-6, 2015 in Toronto, Canada. The conference will highlight the latest information on refugee health issues locally and internationally. Please visit the conference website for continual updates. The call for abstracts is now open.

Proposed Refugee Admissions for FY2015: Report to Congress

This Annual Report is prepared by the U.S. Departments of State, Homeland Security, and Health and Human Services. It contains information on refugee situations, proposed refugee admissions, and plans for resettlement. A summary of the Report is also available.

RHTAC User Survey Summary

In the spring of 2014, RHTAC gathered information about the usefulness of the products featured on the RTHAC website and newsletters as well as other technical assistance needs that you may have. We truly appreciate your feedback, and here is an executive summary of your responses.

New in the Literature

Exploring the Mental Health Effects of Political Trauma with Newly Arrived Refugees. (2014) Shannon PJ, Wieling E, McClearly JS, Becher E.

Qual Health Rs.

Latent Tuberculosis Infection Screening in Foreign-Born Populations: A Successful Mobile Clinic Outreach Model. (2014) Morano, J. P., Zelenev, A., Walton, M. R., Bruce, R. D., & Altice, F. L. American Journal of Public Health .

Notes from the Field: Update: Vitamin B12 Deficiency Among Bhutanese Refugees Resettling in the United States, 2012. (2014) Kendra Cuffe, MPH, William Stauffer, MD, John Painter, DVM, et al. MMWR.

Implementation of New TB Screening Requirements for U.S.-Bound Immigrants and Refugees -2007-2014. (2014) Drew L. Posey, MD, Mary P. Naughton, MD, Erika A. Willacy, MPH, et al. MMWR.

Violence and reproductive health preceding flight from war: accounts from Somali born women in Sweden. (2014) Carlsson J, Sonne C, Silove D. J New Ment Dis.

View more literature >

Upcoming Events & Trainings

APHA 142nd Annual Meeting and Exposition

November 15-19, 2014, New Orleans, LA

Refugee and Immigrant Health: From Global Policies to Local Practices

October 22, 2014, Waltham, MA

View more events and trainings >

RHTAC is a project of the Division of Global Populations and Infectious Disease Prevention, Massachusetts Department of Public Health. Our collaborators include the Center for Refugee Trauma and Resilience at Children's Hospital Boston, the Pacific Institute for Research and Evaluation (PIRE), the Bellevue/NYU Program for Survivors of Torture, the Cultural Orientation Resource Center at the Center for Applied Linguistics, and JSI Research and Training Institute, Inc. The information contained in RHTAC newsletters does not necessarily represent the views or opinions of RHTAC's partner agencies or funders.

For more information, please email refugeehealthta@jsi.com.

New

Resources

Congolese Refugee Health Profiles

Centers for Disease Control and Prevention (CDC)

A profile highlighting priority health conditions for providers to consider when working with Congolese refugees.

Refugees from the Democratic Republic of Congo

Cultural Orientation Resource Center

A backgrounder that provides basic information about Congolese refugee arrivals.

Somali Women's Health Videos

U.S. Office of Refugee Resettlement presents a four-part video series to educate Somali women on a range of health issues including reproductive health, cancer screening, diet, exercise, pregnancy and other health topics.

Flu Materials

Centers for Disease Control and Prevention (CDC)

Stay up to date with the latest information on the 2014-2015 flu season. Patient information available in plain language and pictures in 11 refugee languages.

Letter from CDC's Division of Tuberculosis Elimination

Centers for Disease Control and Prevention (CDC)

An overview of TB control efforts on behalf of unaccompanied minor children.

Toolkit for PCPs caring for refugees

Pathways to Wellness

A set of resources designed to provide primary care clinics with information, tips and suggestions in providing healthcare to refugee patients.

View more resources >

Webinar Archive

Free CME/CEC available!

Tools and Strategies for Refugee Mental Health Screening: Introducing the RHS-15

Presenter: Michael Hollifield, M.D.

View more webinars >