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.