A multitier model of refugee mental health and psychosocial support in resettlement: Toward trauma-informed and culture-informed systems of care.

Abstract

Refugees endure tremendous trauma during migration and resettlement. Despite the wide range of needs and challenges refugees have, previous research on refugee mental health has concentrated on the clinical treatment of certain common mental disorders related to premigration trauma. This narrow attention creates an environment in which positive mental health and social functioning are seen merely as a lack of mental illness among refugee populations. The consequences of such a focus are increased stigma of mental health issues and a negligence of other psychosocial needs critical to the community integration of refugee newcomers. There are few models and studies that focus on service delivery and systematic approaches to guide coordination of mental health services and psychosocial supports for refugee newcomers. To fill such gaps, this paper provides a framework to align stratified interventions and addresses the multilayered mental health needs in refugee communities. We have adopted and applied a multitier mental health and psychosocial support (MHPSS) model developed by the Inter-Agency Standing Committee to provide a holistic framework for a system of care. We have also proposed a two-pillar approach, trauma-informed and culture-informed care, which is embedded into each tier of the MHPSS program. This approach is designed to fill the gaps between mainstream mental health services and refugee resettlement programs, both of which tend to work in silos. Using the case of a statewide refugee mental health initiative in Virginia, we discuss the challenges and opportunities of programs to build capacity and partnerships for coordinated care.

Working towards Culturally Responsive Trauma-Informed Care in the Refugee Resettlement Process: Qualitative Inquiry with Refugee-Serving Professionals in the United States

“…In particular, our findings highlight that trauma-informed care that is culturally responsive and relevant to refugee populations is a vital way to address the chasms between refugee-specific programs and mainstream services. In fact, as a multi-year MHPSS project in the U.S. has shown, culturally sensitive and responsive approaches complement and complete trauma-informed care by filling the gaps in the current refugee resettlement program [ 27 ]. In order for TIC to be culturally relevant and responsive to refugee newcomers, there is a need for additional sensitivity and attentiveness to both the individually unique healing process and the collective cultural impacts of trauma consequences in the community (e.g., loss of community and cultural practice, impeded social support systems).…”

“…A lack of partnership and coordination among communities and sectors also limits the quality and timing of services. One solution suggested in the literature is to better understand refugee mental health needs in the context of cultural impacts, such as loss of cultural practice as a source of emotional distress [ 27 ], which could help begin to destigmatize mental health issues and provide holistic approaches and services in order to overcome a pathologizing model of mental illness.…”

“…A majority of trauma-related programs and models for refugee populations have focused heavily on trauma-specific and trauma-focused interventions, prioritizing clinical treatment and therapeutic modalities rather than organizational- or system-level approaches [ 27 , 28 , 29 , 30 ]. For a broader system- or organizational-level improvement to address the aforementioned challenges in service access and disparities in care, it is not only necessary but also inevitable to apply TIC approaches to refugee resettlement programs and related services.…”

Refugees children and youth social skills education in football activities

“…It is said that the game of football will help to recover from the traumatic shock. DOI: 10.14807/ijmp.v12i6.1780 Although leaders of Islamic religions condemn sport, football activities are a great help in integrating children and youth of that nationality into communities (Maharmeh, 2013;Pastoor, 2017;Im et al, 2020).…”

“We Learn and Teach Each Other”: Interactive Training for Cross-Cultural Trauma-Informed Care in the Refugee Community

“…The Center for Addiction and Mental Health guide (Vasilevska et al, 2010) was produced for people who work with refugees in Canada to enhance the mental health needs of refugees and the need for partnership among refugee-serving agencies. Despite the contributions of such models and programs, capacity-and partnership-building efforts are often separate, and refugee mental health training is limited to either clinical professionals or patients and their caregivers (Im et al, 2021). Given such gaps in this field, this paper introduces an innovative community-based program to build and enhance competences and partnerships among mental health professionals and refugee community leaders, while facilitating intercultural, mutual learning between participants.…”