Trauma and Resilience Among Refugee and Undocumented Immigrant Women

Migration and resettlement processes are often characterized by stressful and traumatic experiences. Immigrants may experience premigration trauma in their countries of origin and trauma during their migration journey. Furthermore, refugee and undocumented immigrant women navigate unique and ongoing stressors postmigration. In this study, the authors used a phenomenological approach to explore refugee and undocumented immigrant women's experiences of trauma and stress and the ways in which they develop resilience to cope with these experiences.     

Secondary migration and relocation among African refugee families in the United States

The purpose of this study was to understand the secondary migration and relocation of African refugees resettled in the United States. Secondary migration refers to moves out of state, while relocation refers to moves within state. Of 73 recently resettled refugee families from Burundi and Liberia followed for 1 year through ethnographic interviews and observations, 13 instances of secondary migration and 9 instances of relocation were identified. A family ecodevelopmental framework was applied to address: Who moved again, why, and with what consequences? How did moving again impact family risk and protective factors? How might policies, researchers, and practitioners better manage refugees moving again? Findings indicated that families undertook secondary migration principally for employment, affordable housing, family reunification, and to feel more at home. Families relocated primarily for affordable housing. Parents reported that secondary migration and relocation enhanced family stability. Youth reported disruption to both schooling and attachments with peers and community. In conclusion, secondary migration and relocation were family efforts to enhance family and community protective resources and to mitigate shortcomings in resettlement conditions. Policymakers could provide newly resettled refugees jobs, better housing and family reunification. Practitioners could devise ways to better engage and support those families who consider moving.     

Review of refugee mental health and wellbeing: Australian perspectives

This review covers refugee mental health and wellbeing within the Australian context to assist psychologists who provide services for, or who conduct research with, refugees. It provides a brief overview of the refugee movement, prior to examining evidence relating to the impacts of pre‐displacement, displacement and resettlement factors on psychological adjustment in the resettlement phase, and the systemic and sociopolitical factors that influence the process of adaptation during resettlement. Australian findings suggest that mental health and wellbeing outcomes are influenced by a complexity of pre‐displacement, displacement, resettlement and systemic factors; the detention or award of temporary residence to refugees who are already experiencing psychological distress on arrival are cases in point. Limitations of the findings are considered. More research into the combined, pathwise relations between the psychosocial pre‐determinants and psychological sequelae of the refugee experience is required. Finally, suggestions for the development of practice, training and ethical guidelines are offered.     

Developing preventive mental health interventions for refugee families in resettlement

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training.     

Mental health help‐seeking and refugee adolescents: Qualitative findings from a mixed‐methods investigation

There is general agreement in Australia and other Western resettlement countries that many refugee adolescents with social, behavioural, and mental health problems are not accessing mental health care. There is, however, a paucity of research on refugee adolescent mental health service utilisation and help‐seeking. Most research to date has centred on adolescents in the general population, and even then is still very limited. This paper presents the findings of 13 focus groups held with 85 refugee adolescents aged 13–17 years from Afghanistan, Bosnia, Iran, Iraq, Liberia, Serbia, and Sudan. The study was part of a wider investigation of mental health service utilisation by refugee parents of children aged 4–17 years, and by adolescents aged 13–17 years. With respect to adolescents, the focus group findings indicate that most are very reluctant to venture beyond their close friendship networks for help with their psychosocial problems due to a range of individual, cultural, and service‐related barriers. Implications for mental health policymakers, service planners, and service providers are discussed.     

Human capital,acculturation and social identity: Bosnian refugees in Australia

This article explores the processes of acculturation and identity among refugees from Bosnia and Herzegovina who resettled in the Australian cities of Perth and Sydney during the 1990s. We start from the idea that refugees, through the process of forced migration, lose aspects of their identities that were embedded in their former communities, jobs, skills, language, and culture. Upon arrival in a new society, they seek to reconstruct their identity, and we argue that this happens in the context of the process of acculturation. We use two social psychological perspectives, social identity theory and acculturation theory, and the sociological theory of the migration of human capital, to examine our data collected by qualitative research methods from refugees and Australian professionals who work in the government‐funded refugee resettlement programme. Our data highlight the loss of identity experienced in forced migration, difficulties in refugee acculturation and identity reconstruction, and collective and individual strategies in acculturation and identity adaptation. We see our perspective as essentially interdisciplinary, and take an interactional view of the acculturation and identity processes, as the characteristics of both the host society and the immigrants affect them. Copyright © 2003 John Wiley & Sons, Ltd.     

Predictors of Secondary School Completion Among Refugee Youth 8 to 9 Years After Resettlement in Melbourne,Australia

Being able to attend school and achieve an education is one of the most desired opportunities among resettled refugee young people. However, turning educational aspirations into reality is not straightforward. There is a large body of research documenting the barriers associated with educational achievement among refugees who resettle as teenagers, both in Australia and internationally. No studies, however, have identified the factors that predict completion of secondary school among resettled refugee youth over time. This paper reports the predictors of completion of secondary school among a cohort of 47 refugee youth resettled in Melbourne, Australia. Eight to 9 years after resettlement, 29 (62 %) had completed secondary school and 18 (38 %) had left school prior to completing year 12. Age on arrival and experiences of discrimination in Australia were significant predictors of secondary school completion. Older refugee youth (on arrival) and those who reported experiences of discrimination over the first 8 to 9 years in Australia were significantly less likely to complete secondary school. This longitudinal study confirms that, as a group, refugee youth are particularly at risk of not completing secondary school education, which can have an impact on their wellbeing and long-term socio-economic standing in their settlement country. Our study provides further evidence of the negative impact of discrimination on the educational outcomes of disadvantaged young people.     

“It is Good to Know Now…Before it’s Too Late”: Promoting Sexual Health Literacy Amongst Resettled Young People With Refugee Backgrounds

Little is known about access to sexual health information amongst young people with refugee backgrounds living in countries of resettlement. This paper reports on a study of sexual health amongst recently arrived young people from refugee backgrounds in Melbourne, Australia. The study employed qualitative research methods to explore and describe how resettled youth access, interpret and implement sexual health information. Between August and December 2007, data was collected through 23 focus group discussions and 14 in-depth interviews involving 142 young people with refugee backgrounds. Participants were purposively selected to reflect the ethnic composition of humanitarian entrants to Australia over the past 3 years. Their countries of origin included Iraq, Afghanistan, Burma, Sudan, Liberia, and Horn of Africa countries. The findings highlight how young people with refugee backgrounds are disadvantaged in relation to access to sexual health information. Young people had little knowledge of sexual health or STIs apart from HIV/AIDS. While they are aware of potential sources of sexual health information, few of these sources are utilized. Specific barriers to learning about sexual health include concerns about confidentiality, shame and embarrassment when discussing sexual health, and the competing demands of resettlement. The paper argues for sexual health promotion to be an explicit part of early resettlement services for refugee youth, and the implications for the development of appropriate sexual health education programs are discussed.     

A Comparison of Wages by Gender and Region of Origin for Newly Arrived Refugees in the USA

The resettlement model supported by the US government aims to help recently arrived refugees achieve economic self-reliance within the first 90 to 180 days of arrival. In addition to the challenges they face in adapting to their new locations, however, refugees enter a US labor market characterized by preexisting wage disparities based on race and gender. Meanwhile, recent changes in US refugee and immigration policies have infused debates over nationalism, Islamophobia, and the economics of resettlement. In this context, it is critical to assess whether refugees face wage discrimination that may affect their ability to become economically self-reliant. Drawing on the International Rescue Committee’s administrative data on refugee resettlement, we examine the extent to which starting wages for newly arrived refugees differ by region of origin and gender. The study found consistent gender pay gaps among the majority of new arrivals. The study also identified lower wages for refugees arriving from sub-Saharan Africa, Latin America, and the Caribbean compared to other regions. These trends suggest a need for more consistent agency monitoring of employment placement, and the development of strategies to ensure more equitable employment outcomes for refugees.     

Social capital and refugee resettlement: The social networks of refugees in Canada

Survey data from a large sample of recent refugees (N=525) living in Canada are used to profile the size and structure of refugees' social networks and to highlight the value (or function) of such social capital in the resettlement process. Despite the traumas associated with becoming a refugee, most adult refugees remain part of at least some familial networks. A large minority are connected with more extented family networks, and almost half plant to build these networks by sponsoring other family members. As resettlement continues, more extensive extra-familial networks involving neighbours, co-workers and employers, other community members, and a wide range of service providers are constructed. These many formal and informal social networks are extremely valuable, providing much-needed support and assistance when refugees are faced with financial, employment, personal, or health problems. Policy challenges arising from these findings are discussed.     

A Review of the Use of Trauma Systems Therapy to Treat Refugee Children,Adolescents, and Families

ABSTRACT

Children and adolescents within refugee families face adverse childhood experiences emanating from multiple sources. These traumatic events can begin with persecution within their country of origin, during the migration process, and within their re-settled countries. More specifically, these children and their families are more prone to the four core stressors being: traumatic, acculturative, isolative and resettlement stress. Trauma Systems Therapy for Refugees (TST-R) is a promising treatment model to address child and adolescent mental health disparities revolving around direct and vicarious trauma. In TST-R, the treatment team systematically targets the needs of the child, while collaborating with cultural brokers from the refugee community, their school, and family unit. Researchers have used TST-R as an intervention for reducing trauma symptoms in Somali, Somali-Bantu, and Bhutanese children, adolescents, and their families. We review the strengths and limitations of this model. Further research is needed to determine its applicability to other communities within the United States and abroad.     

Establishing Therapeutic Dialogue with Refugee Families

The article describes an investigation into dialogues between native Swedish psychotherapists and refugee families. Dialogue is needed to establish the therapeutic alliance, which is ultimately important for healing, whether of individual sickness or family crisis. However the development of dialogue is hindered by cross-cultural and language barriers. We concentrate on one aspect of research originally presented in a Doctoral Thesis by the first author, asking how culture and power differences, together with their resettlement in a strange country, affected meetings with refugee families, and how these problems were overcome; language and the presence of an interpreter are not discussed. A multi-perspective methodology was used in the original research, combining text analysis, review of video-recordings by the participating therapists, and interviews with the families. All these forms of investigation are drawn on here, but particularly text analysis. Significant hindrances to dialogue turn out to be differences in cultural values between refugee and therapist, their different power positions, and the refugee’s weariness and distrust of meetings. Strategies to minimise power differences are an essential aspect of the Finnish open dialogue approach, which turns out to be particularly relevant to such refugee meetings.     

Partition,memory and trauma: Voices of Punjabi refugee migrants in Lahore and Amritsar

The article draws on first-hand accounts of the violence, migration and resettlement which accompanied the 1947 division of the subcontinent. The testimonies were provided by members of refugee families in the neighbouring Pakistani and Indian cities of Lahore and Amritsar. These former ‘twin cities’ were demographically and culturally transformed by the drawing of the Punjab boundary line between them. The interviews which were conducted in Punjabi and English are supported by documentary sources from this period. The oral testimonies reveal the common experiences, hopes and fears of all communities caught up in the upheaval which accompanied the division of the subcontinent. The determination to start afresh, despite unconscionable loss, is a feature of many of the accounts. They also reveal ambivalence regarding the role of the state in the resettlement process. Finally, there are hints of the differential class and gender-based experience of uprooting.     

Clinical issues in mental health service delivery to refugees

Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.     

Food Systems Change and the Environment: Local and Global Connections

Making changes to the way food is produced, distributed, and processed is one strategy for addressing global climate change. In this case study, we examine the "forming" stage of an emergent and locally-based coalition that is both participatory and focused on promoting food security by creating food systems change. Social network analysis is used to compare network density, centrality, and centralization among coalition partners before the formation of the coalition and at its one-year anniversary. Findings reveal that the coalition facilitated information seeking, assistance seeking, and collaborative efforts related to food security among a group of organizational stakeholders that were relatively disconnected pre-coalition. Results also illuminate tensions related to increased centralization of the network, coalition efficiency, and the goals of democratic decision-making. This study highlights the utility of social network analysis as a tool for evaluating the aims and trajectory of locally-based coalitions focused on global concerns.     

Feeling at home: A multisensory analysis of former refugee and host society residents’ integration in Wellington,Aotearoa New Zealand

In this article we explore the multisensory experiences through which former refugee and host society residents develop, maintain, negotiate, and co-construct feelings of homeliness in Wellington, Aotearoa New Zealand. Drawing upon data generated through semi-structured interviews and collaborative painting workshops with eight participants, we found that everyday multisensory stimuli were significant in shaping individual feelings towards different places, and evoking memories which further shaped unique place-based experiences. Whilst negative sensory memories at times caused anxiety and stress, individuals could also draw upon their past experiences to make connections that helped them to navigate complex sociospatial environments. These multilayered connections enabled individuals to (re)construct cultural identities in their new city, which was significant in enhancing a sense of homeliness and belonging. However, the consequences that resettlement had on changing social demographics and place dynamics also diminished a sense of homeliness for host society residents, leading to pressure being placed upon former refugees to adopt dominant cultural norms. The significant impact of everyday multisensory experiences and associated memories of place on individual resettlement and social integration suggest that these affective processes require greater attention in conceptualisations of home and belonging during refugee resettlement.     

Pathways to Help-Seeking and Mental Health Service Provision for African Female Survivors of Conflict-Related Sexualized Gender-Based Violence

ABSTRACT

African migration to Canada is a relatively new development. There is a dearth of literature on the mental health of this newer immigrant population, especially those from the conflict zones of Sub-Saharan Africa. Our exploratory study examined the experiences of African female survivors of conflict-related sexualized violence based on the insights of six community mental health professionals. Guided by interpretive inquiry, semi-structured interviews were analyzed thematically and interpreted in light of multicultural feminist and transnational perspectives. Findings highlight refugee women’s resilience in the face of threats of social isolation and stigma. Their prioritization of assistance with practical needs, parenting, community/social supports, and education attainment in the context of counseling raises questions about agency and identity in understanding the relationships between female survivors, what they identify as important to their recovery, and their pathways to accessing mental health services.     

Portrayals of Global Health Worker Migration in Canadian Print News Media: Domestic Concerns vs. Global Awareness

The global migration of physicians and nurses has implications for health human resources in both source and recipient countries. Of particular concern to academics and policy experts is the “brain drain” of health professionals from under-resourced nations to developed countries, which promote immigration of physicians and nurses to solve their own health worker shortages. How does the general public in these destination countries understand and respond to concerns over migration and immigration of health professionals? This understanding is likely to be influenced in large part by how the issues are portrayed in the news media. News media treatment of this issue was explored by surveying news articles; newspaper columns/editorials; and op-ed pieces; and letters to the editor published in four prominent Canadian newspapers between May 2004 and January 2009, a time frame that included two federal elections in which physician immigration was highlighted as a political issue. Despite the prominence among academics of concern over the brain drain of physicians and nurses from developing countries to Canada and other Western nations, this issue received little attention in print news media discussions, which focused on domestic physician shortages and the role of international medical graduates in filling Canadian needs. While recent federal elections brought concerns about immigrant physicians into the political spotlight in Canada, they did so by focusing on Canadians' health care provision needs to the exclusion of promoting a broader, global awareness that the immigration of health professionals to developed nations such as Canada exacerbates global health disparities.     

A Qualitative Study of the Career Aspirations of Resettled Young Sudanese and Somali Refugees

The study documents and explicates the academic experiences, visions, hopes and desires which shape the vocational aspirations of young Sudanese and a Somali refugee who have resettled in Australia. Semi-structured interviews were conducted to examine the experiences of a sample of 14 young resettled refugees in Brisbane, Australia. Adopting a qualitative methodology, the interviews covered the aspirations of the participants across three time periods: life in the country of origin, transit and resettlement. Participants expressed high ambitions despite their experiences of school disruption pre resettlement and language difficulties post resettlement. The situation in the country of origin emerged as influential upon their aspirations in both pre and resettlement life. English language difficulties emerged as the most common consideration influencing aspirations following resettlement. A number of considerations were found that influenced their vocational aspirations before and after resettlement. Such considerations may enlighten service providers working with resettled young African refugees.