WEBVTT

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Hello, I'm Suzan Song,

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

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of George Washington University,

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and a Humanitarian Protecting Advisor

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for survivors of forced displacement
globally and domestically.

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There has been an unprecedent surge

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in the number
of displaced people worldwide,

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including refugees, asylum seekers,
undocumented immigrants

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and unaccompanied minors.

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Around the world,
more than 65 million people

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are currently displaced
by war, armed conflict or persecution.

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As of early 2018,
almost 31 million children worldwide

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were displaced by violence and conflict.

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If these current trends continue,

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one in one hundred people
will be a refugee in the near future.

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Unfortunately, most refugees and 
survivors of force-displacement

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will not receive
needed mental health care.

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

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and stigma against mental disorders.

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Refugees are those who've fled 
their country of origin

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due to well-founded fears of persecution

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based on race, religion,
nationality, political opinion

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or membership
in a particular social group.

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Where as refugees request
protection while overseas

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and they're given
permission to enter the US,

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People seeking asylum also have 
a well-founded fear of persecution.

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But they seek protection
while inside the US.

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Refugees and
other conflict affected persons

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are reported to have
a 15 to 30 percent prevalence

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of PTSD and depression,

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

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The strongest predictors
of poor mental health

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

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But torture, separation from family, 
stressful asylum processes,

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isolation and disadvantage
in the host country

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all worsen mental health.

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The post-migration environment,
mainly prolonged detention,

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insecure immigration status,

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poor access of services
and limitations on work and education

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can worsen mental health.

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These do not provide the full scope of
emotional issues

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that many conflict defected person face

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including complicated grief, 
complex trauma,

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despair, isolation,
anger and lack of trust.

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Many people are experiencing 
normal responses

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to very abnormal experiences.

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Over time, most refugees
show low or no symptoms.

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A small number show
a pattern of gradual recovery

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and a small minority remain chronic.

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So we need to evaluate the distinction
between situational forms of distress

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and a clear mental disorder for refugees.

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We do this by focusing on a dynamic 
interplay of exposure

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to past traumatic experiences,

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ongoing daily stressors

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and the core psycho social systems
that one is embedded in.

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Psychiatrists can help these populations

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with culturally competent clinical work
with refugees and asylum seekers.

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At a policy level by conducting 
asylum evaluations

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and at the advocacy level
by promoting equity of access,

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sustainability of services for refugees
and forcibly displaces people,

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and by partnering
with inter-disciplinary community members

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such as lawyers,
educators and policy makers

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to provide a safe system
for which refugees

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and survivors of forced displacement
can rely on.