The trauma experienced by refugees is not accidental … It is difficult to even define all of the types of events they have suffered, because refugee trauma often precedes the primary war-related event that causes them to flee. The sections below provide information about Refugees and Refugee Trauma, including basic definitions, a description of refugee core stressors, and recommendations related to screening, assessment, and intervention. It’s no wonder then, that a high percentage of them experience Post Traumatic Stress Disorder (PTSD). Having misanthropic actions of others become a major factor controlling the lives of refugees has significant implications for health and for their ability to develop trusting interpersonal relationships, which are critical to resettlement and healing. 5,6. The Refugee Experience: Improving the Mental Health of War-Affected Populations, by Kenneth E. Miller, Ph.D. 11. Comprehensive Psychiatry. The Experience of Immigrants and Refugees 40 Historic Trauma: ... experience the trauma can be impacted by it, especially if they have a close relationship to the individual who experienced the trauma. Western conceptualizations and eastern experience: A cross-cultural study of traumatic stress reactions among Tibetan refugees in India. 2004; 192(5): 363-72. 5. Trauma experiences. Many refugees, especially children, have experienced trauma related to war or persecution that may affect their mental and physical health long after the events have occurred. Torture (Thematic Issue). The most common mental health issue for refugees is post-traumatic stress disorder and related symptoms of depression, anxiety, inattention, sleeping difficulties, nightmares, and survival guilt. Traumatic experiences of refugees. She has extensive experience working with refugees therapeutically in issues of migration, grief and loss, identity issues, uprootedness, resettlement and compounded trauma. For example, in more recent work, sixty-seven Vietnamese and Kurdish refugees endorsed 612 war-related traumatic events on in-depth interviews during development of the Comprehensive Trauma Inventory-104 (CTI-104).2. These experiences stay with them, they form a part of who they are, and for refugees who are finally resettling in a safe place, they face the challenge of learning to Trauma (experienced or witnessed situations where their lives have been threatened or people close to them have been threatened, injured, raped, tortured or killed). The present overview examines whether contemporary notions of trauma, and especially a focus on the category of posttraumatic stress disorder (PTSD), are adequate in assessing the multiple effects of such experiences. The overall experience of war directly resulted in conditions that led people to experience trauma and emotional suffering. The Australian and New Zealand Journal of Psychiatry. Many studies on refugees suggested that refugees’ traumatic events associated with post-traumatic stress disorder (PTSD). Refugees, in particular, experience sequential stresses that may compound each other over prolonged periods of time. The flight process can last days or years. Refugee children may feel relieved when they are resettled in the US. North Korean refugees crossing the border to China, already beset by traumatic experiences in their homeland, encounter tremendous numbers of stressful events. 2012). Australia, are so far out of the realm of experience for most of us, that we can not fully comprehend the trauma, loss and adversities they have faced. Events that refugees have experienced related to war or persecution can all be called “traumatic events.”. Refugees often experience multiple sources of trauma including targeted violence and torture (Slewa-Younan et al. Schweitzer RD, Brough M, Vromans L, Asic-Kobe M. Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience. 2008; 78(1): 109-20. Trauma can look very different across the developmental stages. In several studies, asylum seekers reported experiencing not just one instance of trauma, but several during multiple stages of … Moving Beyond Trauma: Child Migrants and Refugees in the United States Visit disclaimer page is a resource by Child Trends. The trauma experiences of refugee young people may have included: constant exposure to physical and emotional danger; loss of home and family; displacement in refugee camps; injury and abuse; exploitation - sometimes forced as child soldiers into acts of violence, abuse, torture and rape or watching others commit these abuses; The monograph brings together writers who have an impressive background in working with refugees who have multiple experiences of trauma in their pre-arrival experience and since settlement. European Child & Adolescent Psychiatry. Quiroga J, Jaranson, J.M. Toronto: University of Toronto Press; 1999. Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun C. Mental health of Cambodian refugees 2 decades after resettlement in the United States. Secondly, traumatic experience will lead to negative impacts on refugees’ mental health. Age. 2. Westermeyer J, Vang TF, Neider J. Migration and mental health among Hmong refugees. 2005; 294(5): 571-9. Alcock, 2003; Boehnlein & Kinzie, 1995) is a general term that covers the whole spectrum of phenomena connected with the specific refugee reality and range of experiences. Refugees, in particular, experience sequential stresses that may compound each other over prolonged periods of time. Handbook of Refugee Experience: Trauma, Resilience, and Recovery is a comprehensive resource for students, scholars, and practitioners who work with refugee populations. The American Journal of Orthopsychiatry. Many refugees, especially children, have experienced trauma related to war or persecution that may affect their mental and physical health long after the events have occurred. These traumatic events may occur while the refugees are in their country of origin, during displacement from their country of origin, or in the resettlement process here in the US. Based on the Refugee Council’s therapeutic care model, the course facilitates professional sharing via delegate experience and relevant Refugee Council case studies, with a focus on adults and families. Early studies showed that post-migration stress contributed to the poor mental health of refugees.5–7  Recent work has verified that post-migration stress significantly influences the emotional well-being of refugees, and often provides a risk similar to or greater than war-related trauma.8-13  Pre- and post-migration stress may differentially predict specific kinds of symptoms and distress in both children and adults.14, 15  This information is important; it is during the period of resettlement where stress is high and the refugee may be reminded of other traumatic events of their lives, when resettlement agencies and health care workers might start to reverse the effects of trauma across the lifespan of the refugee by providing culturally sensitive care that gives the refugee support. The most common mental health issue for refugees is post-traumatic stress disorder and related symptoms of depression, anxiety, inattention, sleeping difficulties, nightmares, and survival guilt. The term presupposes that all those who experience this kind of adversity will become psychologically traumatized. Psychologists tend to use trauma theory to approach refugees ‘Refugee Trauma’ (e.g. Journal of Nervous & Mental Disease. 2008; 43(2): 121-31. Refugees and people from refugee-like backgrounds may have been through many traumatic experiences, including torture, as a result of the actions of other human beings in the context of war and persecution that could have a long-term traumatic impact. Moving Beyond Trauma: Child Migrants and Refugees in the United States Visit disclaimer page is a resource by Child Trends. Section VI is a discussion of gender issues. 2011; 199(1): 3-10. Another stressor, therefore, becomes the possibility of “statelessness,” or being without a recognized legal status in a host country. The sense that one’s life was in constant danger created conditions for participants to experience fear (3.2.1) and other mental health stress (3.2.2). Soc Psychiatry Psychiatr Epidemiol. The increased vulnerability to mental health problems that refugees and asylum seekers face is linked to pre-migration experiences (such as war trauma) and post-migration conditions (such as separation from family, difficulties with asylum procedures and poor housing). She is now a highly regarded and respected consultant in the field of refugees and trauma. 3. Med J Aust. It is difficult to even define all of the types of events they have suffered, because refugee trauma often precedes the primary war-related event that causes them to flee. 6. Indeed, many refugees have experienced multiple losses and forms of trauma. JAMA. However, trauma can affect a refugee child’s emotional and behavioral development. Intellectual and Developmental Disabilities, Trauma-Informed Organizational Assessment. Finally, Section VII suggests ways in which public mental health systems Red Flags. The following resources on Refugee Trauma were developed by the NCTSN. Reports from the United Nations High Commissioner for Refugees (UNHCR) indicate that as of 2013, there were over 10 million refugees worldwide, with more than half of them coming from Afghanistan, Iraq and Somalia (UNHCR, 2012, 2014a). 2006; 185(7): 357-61. Momartin S, Steel Z, Coello M, Aroche J, Silove D, Brooks R. A comparison of the mental health of refugees with temporary versus permanent protection visas. This is a fact that. To browse resources for a particular audience, visit the NCTSN Resources page below. 2. While this has been a useful research tool, it is clear that the breadth and depth of trauma for refugees is far greater than 17 events. focuses on trauma interventions, including 1) the application of current trauma treatment models to refugees, and 2) new approaches to trauma healing emerging from direct experience with refugee communities. What do we mean by trauma-informed services and why is such an approach important? When you (ask) which one is the most severe … they were all severe, they were all unpleasant things…you didn’t give me a very good measurement to measure this.”   -A Kurdish Woman, 2001, Refugees have experienced many extremely stressful events because of political or religious oppression, war, migration, and resettlement. 1997; 170: 351-7. However, the term ‘refugee trauma’ implies something more than that – it presupposes that all those who experience this kind of adversity Refugees, trauma and Adversity-Activated Development 303 3-12. According to a UNHCR report (2014a), the 1951 Refugee Convention defines a refugee as someone who "owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outsi… This collection explores contemporary issues including migration, war, oppression, genocide, health crises, and racial and cultural identities to shed light on the refugee experience. However, the difficulties they face do not end upon their arrival. 10. The Refugee Experience Improving the Mental Health of War-Affected Populations Kenneth E. Miller, Ph.D ., is a Senior Researcher at War Child Holland and a writer currently based in Amsterdam. J Trauma Stress. Heptinstall E, Sethna V, Taylor E. PTSD and depression in refugee children: associations with pre-migration trauma and post-migration stress. 2015). Before being forced to flee, refugees may experience imprisonment, torture, loss of property, malnutrition, physical assault, extreme fear, rape and loss of livelihood. These traumatic events may occur while the refugees are in their country of origin, during displacement from their country of origin, or in the resettlement process here in the US. 1999; 12(3): 421-35. When refugees resettle to a host country, which is most often in a place that is not of the refugee’s choosing, the refugee must adapt to a new place and language under uncertain circumstances and with uncertain futures. 13. This course helps delegates to further their understanding of complex trauma and discover trauma-informed approaches to providing timely and effective therapeutic support. 1983; 171(2): 92-6. Red Flags. Refugee’s experience many stressful experiences including war-trauma, migration stress, and post-migration stress. 8. 14. Refugees have complex trauma profiles, often including various functional limitations and comorbid conditions (Betancourt et al. Information and resources are available for multiple audiences including mental health professionals, healthcare providers, school personnel, policy makers, and more.