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Refugee Health Program: Mental Health

Refugees experience many heightened stressors before, during, and after the migration process. These, in combination with the more typical everyday stressors, can lead to a heightened risk of mental health challenges and needs. Mental health care is, therefore, an integral part of refugee health. When working with refugee patients, health care providers should be aware of this potential background of trauma as well as linguistic, cultural, and experiential differences.

This webpage provides resources on refugee mental health screening, general refugee mental health considerations, guides to cultural and trauma-informed care provision, and educational resources for both general and specialized refugee mental health.

Mental Health symbol

Clinician tools

Below are various documents and websites useful for mental health providers caring for refugee populations, including resources for the Refugee Health Screener 15 (RHS-15).

Refugee mental health screening

Introductory and Referral Scripts for the RHS-15 – A sample script by EthnoMed for clinicians on how to have a dialogue with refugee patients about counseling referrals after completion of the RHS-15

Refugee Health Screener-15 – A mental health-specific screening for refugees developed by Pathways to Wellness and created to "sensitively detect the range of emotional distress common across refugee groups"

Harvard Trauma Questionnaire – A screening tool by the Harvard Program in Refugee Trauma that inquires about a variety of trauma events, as well as the emotional symptoms considered to be uniquely associated with trauma.

WE-Check: Minnesota Wellness and Emotions Check – A screening resource by the Minnesota Department of Health focusing on wellness and emotions

General resources

Adult Mental Health – Refugee Health Technical Assistance Center – Provides information on how to assess refugee mental health experiences, typical symptoms of distress, refugee processes, resilience and coping mechanisms, screening, and treatments and services

The National Child Traumatic Stress Network – Provides mental health clinicians and professional interpreters with information about a trauma-informed approach to mental health interpretation that is socio-culturally and linguistically responsive to the needs of children and families receiving services.

Society of Refugee Healthcare Providers – A non-profit organization focused on refugee healthcare and consisting of medical practitioners, social workers, resettlement workers, and other professions

Refugee Mental Health: A Primary Care Approach – An academic article on the mental health needs of refugee populations and how to address them within a primary care setting, including symptoms, characteristics, and recommendations

Please check out the "Trainings and Educational Materials" section of this webpage for more resources and guidance on refugee-specific mental health care.

Cultural and trauma-informed care

It is important when working with refugee populations to be aware of cultural backgrounds and potential past trauma, especially when it comes to mental health.

Guides and resources

Building a Culturally Informed Network of Refugee Mental Healthcare Providers – A guide for refugee service providers to increase cultural awareness in mental health practitioners

Guide to Trauma-Informed Care: Preventing Crises and De-escalating Difficult Situations – A guide to help service providers interact with refugees in a trauma-informed way

Institute on Trauma and Trauma-Informed Care – A website with talks, online modules, and manuals on trauma-informed care

A Trauma-Informed Understanding of Mental Health and Psychosocial Support – A Switchboard guide to the concepts of mental health and psychosocial support (MHPSS) and its implementation in support of resettled refugees’ MHPSS

Trainings and educational resources

See below for various educational resources on refugee mental health best practices.

The 5 Components of Psychological First Aid – An article by NOLS Wilderness Medicine on the tools of Psychological First Aid that can be used to "help patients as they respond to traumatic events"

Mental Health First Aid – A website by the National Council for Wellbeing with trainings, courses, and resources on how to identify and support those with mental health or substance abuse problems

Psychological First Aid During COVID-19 – A Switchboard webinar on how to use Psychological First Aid in the context of refugee health and COVID-19

Psychological First Aid (PFA) for Unaccompanied Children (UC) – A guide by the National Child Traumatic Stress Network (NCTSN) for staff supporting unaccompanied children preparing to reunite with family or transitioning to a permanent Office of Refugee Resettlement (ORR) location, as well as how to practice self-care

Psychological First Aid: Guide for Field Workers – A World Health Organization (WHO) guide to practicing Psychological First Aid in crises, as well as how to care for oneself and colleagues

Psychological First Aid (PFA) to Support Clients Affected by the Crisis in Afghanistan – A Switchboard webinar presenting the principles of PFA, especially as it pertains to clients affected by the Afghanistan crisis

Unbound Medicine -Psychological First Aid – A website with the "Who, What, Where, When, and Why" of Psychological First Aid as well as implementation

Traumatic Stress Among Refugee Children and Youth Series: Below are links to three webinars hosted by Switchboard, created to serve as a foundation for refugee service providers in understanding traumatic stress throughout typical stages of human development:

Access to Mental Health Services for Refugees and Other Vulnerable Immigrants in the US: Overcoming Barriers and Strengthening Enabling Factors – A Switchboard webinar on barriers facing refugee access to mental health care services and promising practices to support refugee engagement

Addressing Mental Health Needs of Refugees in Primary Care Settings – A webinar by the Refugee Health Technical Assistance Center on the mental health needs of refugees in primary care settings

Suicide Among Resettled Refugees – A webinar by the Boston Children's Hospital Center for Refugee Trauma and Resilience on suicide prevention strategies in the context of refugee social and cultural backgrounds

Access to Mental Health Services for Refugees and Other Vulnerable Immigrants in the US: Overcoming Barriers and Strengthening Enabling Factors – A Switchboard informational guide for service providers with recommendations on practices for improving refugee access to mental health services

Listening to and Talking With Our Children (16 languages available): A new mental health resource, developed by the Vermont Language Justice Project, aimed at parents to promote their children's mental health.

Specialized refugee mental health

Refugees are from a variety of backgrounds and demographics and, as such, may need specialized considerations when it comes to mental health practices.

ACEs in Child Refugee and Asylum Seeking Populations – A report by Public Health Wales, Bangor University, and the Cymru Well Wales ACE Support Hub on the effect of adverse childhood experiences (ACEs) in child refugee and migrant populations, as well as the risks, impact, and potential paths to resilience

Applying Trauma-Informed Practices to the Care of Refugee and Immigrant Youth: 10 Clinical Pearls – An academic article on the increased risk of mental health challenges for refugee and immigrant youth and recommendations for practitioners, including clinical examples of helpful skills and dialogue prompts

Helping Children Cope with Stress During Coronavirus – An infographic by the World Health Organization on how to help children cope with stress during the COVID-19 pandemic (English | Burmese | Arabic)

Harvard Program in Refugee Trauma – A website and program with screening tools, clinical resources, educational materials, projects, relevant policies, and research

National Child Traumatic Stress Network – Refugee Trauma – A website with information on the experience of refugees, the effects of trauma, screening and assessment tools, intervention techniques, and resources as well as an Afghan-specific page which can be found listed under the Afghan section of this page

Promoting Successful Adjustment for Refugee Youth – A webinar by the Refugee Health Technical Assistance Center on the challenges of adjustment for refugee youth as well as how to promote positive adjustment through family strengthening models and mentoring, and protective processes

Trauma-Informed Care: Understanding and Addressing the Needs of Unaccompanied Children - A webinar series on different aspects of culturally and trauma-informed care for refugee youth, including assessment, socio-cultural responsive interventions, and secondary traumatic stress on professionals, led by the NCTSN, Refugee Trauma and Resilience Center in Boston and the UCLA-Duke University National Center for Child Traumatic Stress

Fundamentals of Gender-Based Violence (GBV) for Refugee Service Providers: What Does a Culturally Responsive Approach Mean? – A Switchboard guide outlining GBV within refugee and migrant communities and how to approach GBV services with a culturally-informed lens

Refugee Womens Alliance - Domestic Violence – A webpage describing the need for support of refugee women from domestic violence as well as domestic violence brochures in English, Amharic, Dari, Swahili, Somali, Spanish, Russian, Vietnamese, Arabic, Burmese, Lao, Thai, and Tigrinya

Tips and Strategies for Culturally Sensitive Care – A guide by the Refugee Health Technical Assistance Center guiding how to provide culturally-informed care to refugee women, including how to navigate language, modesty, religious observations, and traditional practices

Treating Immigrant and Refugee Patients Who Have Experienced Intimate Partner Violence (PDF) – A guide by the American Psychiatric Association on risk factors of intimate partner violence (IPV) in refugee and immigrant populations, assessment, and treatment considerations

Applying Ambiguous Loss Theory to Torture Survivors: A Conversation with Pauline Boss – A webinar by the Center for Victims of Torture outlining the principles and application of Ambiguous Loss theory in caring for torture survivors

Enhancing Empathy by Measuring Torture Symptoms with Survivors – A webinar by the Center for Victims of Torture that identifies a range of tools for working with survivors of torture as well as how to improve clinical practice, evaluation, and empathetic capacity

Group Therapy Model for Refugee and Torture Survivors – An academic article on the clinical application of the Center for Torture and Trauma Survivors' therapy group model and its two variants

Therapy for Refugees and Torture Survivors: New H.E.A.R.T. Model – A webinar series by the Harvard Program in Refugee Trauma describing the mental health challenges facing refugees and how the H.E.A.R.T. model ("Healing Environment and Restorative Therapy") can be applied in a therapy setting

Effective Treatment for Refugee Adults with Post-Traumatic Stress Disorder (PTSD): A Summary of Practice Recommendations for Clinicians – A provider-oriented, evidence-based summary of recommendations for treatment of PTSD in refugees created by the Pennsylvania Refugee Resettlement Program, Children’s Hospital of Philadelphia’s Refugee Health Program, Multicultural Health Evaluation Delivery System, Inc., and PolicyLab

Glossary of Post-Traumatic Stress Disorder Terms in Different Languages: Glossary of terms pertaining to the treatment of PTSD for use by those working with refugee populations (Arabic | Karen | Nepali | Swahili)

Talking About PTSD: Improving Care and Communication for Refugee Patients - A PolicyLab webinar where content experts discuss evidence-based practices for treating PTSD in refugees with cultural and linguistic differences through better communication and care techniques

Note: For cultural resources and other Afghan-specific information, check out Wisconsin's Afghan Health Resources webpage.

Afghan Culture: Understanding Cultural Values, Attitudes, and Approaches to Mental Health – A webinar by the Office of Refugee Resettlement with a panel of mental health professionals and educators experienced in refugee trauma, education, and literacy (Passcode: vCF08@Jr)

Afghan Humanitarian Arrivals: Post Resettlement Stressors, Coping Strategies, and the Afghan Symptom Checklist – An excellent webinar on resettlement stressors, the potential mental health risks facing Afghans, Afghan perceptions of stress, mental health, and treatment, and an Afghan symptom checklist

NCTSN Resources in Response to the Recent Terrorist Attack and Afghanistan Transition – A PDF with links to resources regarding military and veteran families, families transitioning out of Afghanistan, Psychological First Aid, and relevant helplines

Psychological First Aid (PFA) to Support Clients Affected by the Crisis in Afghanistan – A Switchboard webinar presenting the principles of PFA, especially as it pertains to clients affected by the Afghanistan crisis

Questions about refugee health? Contact us!
Phone: 608-261-6319 | Fax: 608-266-0049

Last revised November 13, 2023