In 2016, the world’s displaced population reached record levels at more than 65 million people. Half of that number are children, many of whom are unaccompanied. The majority of displaced persons live in low- to middle-income countries as asylum-seekers and refugees. According to the United Nations High Commission for Refugees (UNHCR), the Middle East (39%) and North Africa (29%) are the highest resettlement destinations for people experiencing violence and war, followed by Asia (14%), the Americas (12%) and Europe (6%). We must be more aware of the growing problem and how best to support the mental health of refugees and asylum-seekers.
While there are commonalities among immigrants, refugees, and asylum-seekers such as death of loved ones, exposure to multiple traumatic events, etc., it’s important to understand what each label means:
- Immigrant – A person who comes to a country where they were not born in order to settle.
- Refugee – A person typically forcibly displaced by war or natural disaster, or feeling persecuted because of nationality, race, religion, political opinion, or membership in a group. A refugee receives permission to come to a country and are resettled with the help of a refugee resettlement agency.
- Asylum-seeker – A person already in a secondary country when applying for protection. These individuals have to prove that they have reason to fear persecution in their home country.
Measuring Adverse Experiences
In addition to the need for assessment of Posttraumatic Stress and psychological comorbidities, a useful metric to measure the mental health trauma of a refugee is called an Adverse Childhood Experience (ACE) score. This metric assesses childhood trauma through adulthood. An ACE score is a composite of ten different types of experiences that a refugee may have. If they occur in childhood, we know that it will have a staggering number of effects on physical and mental health – even early death.
It’s common for refugees and asylum-seekers to have very high ACE scores. Parents being separated from their children will likely already have a history of traumatic events. If untreated, that traumatic stress is carried with them and will have serious intergenerational effects on their family and communities.
There’s much talk comparing what’s happening with refugees and asylum-seekers in the United States today with similar instances of oppression and genocide throughout history. Family separation as a social policy to deter immigrants is a unique type of human rights violation towards a vulnerable population his type of traumatic exposure and systematic policy to terrorize families by tearing them apart has parallels to the violence perpetrated against indigenous populations and the slaves brought to the United States against their will.
The Rising Number of Refugees
The record level of 65 million refugees is going to rise and, unfortunately, I don’t believe the world is prepared for it. We have a moral and social-political obligation as global citizens to understand the health and family relational needs of these populations and do our best to assist them in their resettlement process. Part of that process is knowing how to support people who have had prolonged exposure to traumatic stressors and social discrimination.
Resettlement policies should be put in place that are multi-level, systemic, and culturally responsive to the groups they are serving to avoid discrimination and hate-based associations attached to them.
Better Serving the Refugee Population
It’s our duty as members of society to be aware of the social, political and economic consequences of the rise in displaced populations. There are three ways in which we can raise awareness – and be more active in developing policies to help refugees:
- Attending to mental health needs. Countries resettling refugees should attend to their mental and related health needs. This means including services such as individual treatment for post-traumatic stress disorder and family therapies, among others.
- Develop effective interventions. Support the study of multi-component interventions for various refugee populations and tailor them to their needs.
- Spread the word. While developing the proper interventions for refugees and asylum-seekers is important, it is also crucial to find ways to effectively disseminate and implement successful responses in close collaboration with communities.
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