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Hochstetler E, Taweh O, Mistry AJ, Metz P. Worcester Refugee Assistance Project: An Example of Strengths-Based, Community-Based, Culturally Sensitive Care. Child Adolesc Psychiatr Clin N Am 2024; 33:263-276. [PMID: 38395510 DOI: 10.1016/j.chc.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Refugee populations are diverse and can present with a variety of unique and complex circumstances. The purpose of this article is to examine an organization that provides care to refugee youth, the ways in which this is accomplished, and a few of the challenges that have been faced. Specifically, the work of this organization will be examined using a Systems of Care philosophy to demonstrate how using these concepts can assist in providing sensitive, high-quality care.
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Affiliation(s)
- Emily Hochstetler
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Omar Taweh
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Anushay J Mistry
- Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Peter Metz
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA
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DiClemente-Bosco K, Binyungu A, Shabani C, Pellowski JA, Operario D, Nugent N, Harrison A. 'I am because you are': Community support as a bridge to mental wellbeing for resettled African refugee women living in Rhode Island. Glob Public Health 2024; 19:2314106. [PMID: 38334139 PMCID: PMC10966713 DOI: 10.1080/17441692.2024.2314106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
African refugee women resettled in the United States are exposed to multiple risk factors for poor mental health. Currently, no comprehensive framework exists on which to guide mental health interventions specific to this population. Through a community-based participatory research partnership, we interviewed N = 15 resettled African refugees living in Rhode Island. Here we (1) describe how meanings of mental health within the African refugee community vary from US understandings of PTSD, depression, and anxiety and (2) generate a framework revealing how mental health among participants results from interactions between social support, African sociocultural norms, and US norms and systems. Multiple barriers and facilitators of mental wellbeing lie at the intersections of these three primary concepts. We recommend that public health and medicine leverage the strength of existing community networks and organisations to address the heavy burden of poor mental health among resettled African refugee women.
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Affiliation(s)
- Kira DiClemente-Bosco
- Center for Dissemination and Implementation Science, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI
| | | | | | - Jennifer A. Pellowski
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI
| | - Don Operario
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Nicole Nugent
- Departments of Psychiatry and Human Behavior, Pediatrics, and Emergency Medicine at the Warren Alpert Medical School of Brown University, Providence, RI
| | - Abigail Harrison
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI
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Abdi S, Akinsulure-Smith AM, Sarkadi A, Fazel M, Ellis BH, Gillespie S, Juang LP, Betancourt TS. Promoting positive development among refugee adolescents. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:1064-1084. [PMID: 37807940 DOI: 10.1111/jora.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023]
Abstract
Of the estimated 35.3 million refugees around the world (UNHCR, Figures at a Glance, 2022), approximately 50% are children under the age of 18. Refugee adolescents represent a unique group as they navigate developmental tasks in an unstable and often threatening environment or in resettlement contexts in which they often face marginalization. In addition to physiological, social, and psychological changes that mark adolescence, refugee youth often face traumatic experiences, acculturative stress, discrimination, and a lack of basic resources. In this consensus statement, we examine research on refugee adolescents' developmental tasks, acculturative tasks, and psychological adjustment using Suárez-Orozco and colleague's integrative risk and resilience model for immigrant-origin children and youth proposed by Suárez-Orozco et al. Finally, we discuss recommendations-moving from proximal to more distal contexts.
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Affiliation(s)
- Saida Abdi
- University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | | | | | | | | | - Sarah Gillespie
- University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Saleh EA, Klapprott F, Heinz A, Kluge U. Challenges in substance use treatment as perceived by professionals and Arabic-speaking refugees in Germany. Subst Abuse Treat Prev Policy 2023; 18:69. [PMID: 37978534 PMCID: PMC10656940 DOI: 10.1186/s13011-023-00576-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Substance use (SU) and substance use disorders (SUDs) have been recently documented among forcibly displaced populations as a coping mechanism to migration and postmigration stressors. Although the literature exploring substance use among refugees has grown recently, little is known about SU among Arabic-speaking refugees and, more specifically, on the challenges and experiences in regards to SU treatment. This study investigates this topic from the perspectives of Arabic-speaking refugees and professionals in Germany. METHODS Design and participants To expand our knowledge on this topic, a qualitative approach was employed by conducting in-depth and semi-structured interviews among 26 participants (13 refugees and 13 professionals) in Germany during 2020-2021. Purposive sampling was used to recruit Arabic-speaking refugees in two rehabilitation centers in Berlin. Data and analysis Interviews were conducted with 26 participants of which 13 were refugees and 13 professionals. Refugees were interviewed individually in the rehabilitation centers, they ranged from 21 to 52 years of age, and their average time in Germany was 6.3 years. An open-ended survey was conducted among the professionals via the SoSci-survey platform, and they ranged from 22 to 66 years of age, with an average of 5 to 9 years of work experience. Data were analyzed using thematic analysis. RESULTS Three themes resulted from the thematic analysis: (1) The treatment is facilitated by institutional and emotional support; (2) The affected refugees struggle with complex contextual barriers to access SUD treatment; and (3) Individual and community preventive strategies are needed. CONCLUSIONS This study provides insight into the support and challenges of accessing effective SU treatment and prevention among Arabic-speaking refugees in Germany. Collaborative efforts by the community, professionals, and policymakers are needed to facilitate access to effective treatment and implement culturally and linguistically sensitive approaches for the treatment and prevention of SU among refugees.
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Affiliation(s)
- Ebtesam A Saleh
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany.
- Department of Pharmacology, Faculty of Pharmacy, University of Aden, Aden, Yemen.
| | - Felix Klapprott
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute for Integration and Migration Research (BIM), Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ulrike Kluge
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute for Integration and Migration Research (BIM), Humboldt-Universität zu Berlin, Berlin, Germany
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Neville SE, DiClemente-Bosco K, Chamlagai LK, Bunn M, Freeman J, Berent JM, Gautam B, Abdi A, Betancourt TS. Investigating Outcomes of a Family Strengthening Intervention for Resettled Somali Bantu and Bhutanese Refugees: An Explanatory Sequential Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12415. [PMID: 36231735 PMCID: PMC9566609 DOI: 10.3390/ijerph191912415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Pre- and post-migration stressors can put resettled refugee children at risk of poor mental health outcomes. The Family Strengthening Intervention for Refugees (FSI-R) is a peer-delivered preventative home visiting program for resettled refugees that aims to draw upon families' strengths to foster improved family communication, positive parenting, and caregiver-child relationships, with the ultimate goal of reducing children's risk of mental health problems. Using an explanatory sequential mixed methods design, this study draws upon qualitative interviews with caregivers (n = 19) and children (n = 17) who participated in a pilot study of the FSI-R intervention in New England, as well as interventionists (n = 4), to unpack quantitative findings on mental health and family functioning from a randomized pilot study (n = 80 families). Most patterns observed in the quantitative data as published in the pilot trial were triangulated by qualitative data. Bhutanese caregivers and children noted that children were less shy or scared to speak up after participating in the FSI-R. Somali Bantu families spoke less about child mental health and underscored feasibility challenges like language barriers between caregivers and children. Interventionists suggested that families with higher levels of education were more open to implementing behavior change. In both groups, families appreciated the intervention and found it to be feasible and acceptable, but also desired additional help in addressing broader family and community needs such as jobs and literacy programs.
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Affiliation(s)
- Sarah Elizabeth Neville
- Intenational Health Institute, School of Public Health, Brown University, Providence, RI 02903, USA
| | - Kira DiClemente-Bosco
- Center for Dissemination and Implementation Science, Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Lila K. Chamlagai
- Brown Mindfulness Center, Behavioral Health and Social Science Department, School of Public Health, Brown University, Providence, RI 02903, USA
| | - Mary Bunn
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Jordan Freeman
- Bill & Melinda Gates Institute for Population and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jenna M. Berent
- Research Program on Children in Adversity, School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
| | - Bhuwan Gautam
- College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA
| | | | - Theresa S. Betancourt
- Research Program on Children in Adversity, School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
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