Immigrant and Refugee Mental Health

Hello, I'm Suzan Song,

Director of the Division of Child,
Adolescent, and Family Psychiatry

of George Washington University,

and a Humanitarian Protecting Advisor

for survivors of forced displacement
globally and domestically.

There has been an unprecedent surge

in the number
of displaced people worldwide,

including refugees, asylum seekers,
undocumented immigrants

and unaccompanied minors.

Around the world,
more than 65 million people

are currently displaced
by war, armed conflict or persecution.

As of early 2018, almost 31 million
children worldwide

were displaced by violence and conflict.

If these current turns continue,

one in one hundred people will

be a refugee in near future.

Unfortunately, most refugees and
survivors of force-displacement

will not receive needed mental
health care.

due to discrecy of services, lack of
access of qualified care,

and stigma against mental disorders.

Refugees are those who fled
their country urgent

due to well-funded fear of
persecution.

based on race, religion, nationality,
political opinion

or membership on a particular
social group.

Worse refugees request protection
all overseas

are given permission to enter the US.

People seeking asylum also have
well-funded fear persecution.

But the basic protection well
inside the US.

Refugees and other conflict defected
person are reported to have fifteen

to thirty percent prevalence PTSD and
depression,

compare to the 3.5% of prevalence of PTSD
among non-refugee populations.

The strongest predictor support
mental health

are exposure to torture and a cue of
number traumatic events.

But torture, separation from family,
stressful asylum processes,

isolation and disadvantage in the host
country

all worsen mental health.

The post-migration environment may prolong
detention.

Insecure immigration status,

poor access of services and limitation
on work

and education can worsen mental health.

These do not provide the full scope of
emotional issues

that many conflict defected person face

including complicated grief,
complex trauma,

despair, isolation, anger and lack
of trust.

Many people are experiencing
normal responses

to vary abnormal experiences.

Over time, most refugees shall low or
no symptoms

a small number show pattern of gradual
recovery

and a small minority remain chronic.

So we need to evaluate the distinction

between situational forms of distress

and a clear mental disorder for refugees.

We do this by focusing on a dynamic
interplay of exposure

to past magnific experiences

on going daily stressors

and the core psycho social
system that one is invented in.

A psychiatrist can help this population

with culturally
competent clinical work

with refugees and asylum seekers.

At the policy level by conducting
asylum evaluations

and at the advocacy level by
promoting equity of access

sustainability of services for refugees

and forcibly displaces people.

And by partnering with
inter-disciplinary community member

such as lawyers, educators and
policy makers

to provide a safe system for

which refugee and survivor

of forced displacement can rely on.