1. SPECIAL POPULATIONS: REFUGEES AND ASYLUM SEEKERS PSYC 377

2. Who is a refugee? ‘ 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 outside the country of his nationality and is unable or owing to such fear is unwilling to avail himself of the protection of the country’ Article 1 of 1951 UN Convention

3. Mental health of refugees - evidence Evidence comes from: 1.Epidemiological studies of mental illnesses within refugee populations 2.Studies of aetiological factors in mental illnesses, including post-migration environment 3.Research into mental health service provision 4.Reserach on the socio-legal context of mental health care

4. Mental health of refugees - issues 1.Post-traumatic stress disorder (PTSD) – disagreements regarding PTSD and its consequences of over-emphasizing this topic 2.Impact of stressors (external events such as displacement and resettlement) and stresses (subjective reactions to these events). – pre-flight (economic hardship, social disruption, political oppression and physical violence) – Flight – ‘flight from one’s motherland represents a major life event is likely to prompt emotional and cognitive turmoil. Refugees might be subjected to sexual and economic exploitation – Post-migration - bureaucratic procedures, living conditions, discrimination, low social support leading to PTSD and depression – Resettlement – seeking asylum where they are granted refugee status or recieve leave

5. Mental Health Services for Refugees Great variety – in countries which recieves small numbers of asylum seekers the services are integrated but in others very little planning Problems with services are : – Lack of monitoring and evaluation – A bottom-up unplanned approached resulting in differences in service availability and quality – Absence of consultation of service users – Poor access to appropriate counselling services – Presence of racial discrimination in some services – Poor quantity of staff training

6. What is needed? Cultural sensitivity – development of mental health services that are knowledge-based and reflect the cultures of the refugee groups Integrated approach – Integration of mental health and social care services Political Awareness – up to date awareness of where and what the refugees are fleeing from Accessible Services – user friendly environments, speaking appropriate community language

7. Organizations that help refugees UNHCR Red Cross and Red Cresecent WHO (Rapid Assessment Tool in 2001 report titled Mental Health: New Understanding New Hope)

8. Activity Through UNCHR, Red Cross and Red Cresent sites: 1.summarize the most recent refugee crisis and refugee situation 2.What are the current issues that could affect the mental health of refugees 3.How would you go about finding what the refugees need as a psychologist working with refugees 4.Suggest mental health services you would offer to refugees