Mental health care for refugees and the need for cultural competence training in mental health professionals

Practical approaches to conducting biopsychosocial research with refugee and internally displaced communities

Refugees and internally displaced people comprise one percent of the world population. Forced migration involves a multitude of ongoing stressful and traumatic experiences, often resulting in lasting psychological symptoms for people resettling as refugees. Despite these risks, the underrepresentation of refugee populations in research-particularly in biological sciences-has impeded the allocation of effective resources and the development of novel interventions for these groups. This paper identifies and addresses key methodological challenges to successfully and appropriately conducting research with refugee and internally displaced communities, many of which have served as barriers to improving research representation for these populations. Methodological challenges discussed include language and literacy barriers; political fears; differing cultural dynamics between participants and researchers; and others. We provide practical recommendations for overcoming each challenge, often sourced from our experience conducting multi-year studies and interventions in refugee mental health. Several key strategies include the recruitment of researchers and research assistants from similar cultural and linguistic backgrounds as participants; providing detailed, ongoing communication about informed consent; avoiding assumptions regarding participants' understanding of concepts that may vary based on culture or experience (e.g., "voluntary" research; confidentiality); and adopting flexible data collection procedures compatible with participants' needs and restrictions. Finally, we discuss the role of the researcher in regard to cultural competencies and partnering with the refugee community. Given the increasing global population of refugees, the strategies discussed in this paper are suggested in order to encourage future research in this underrepresented population and empower investigators to logistically carry out studies with refugees.