Capacity Building for Refugee Mental Health in Resettlement: Implementation and Evaluation of Cross-Cultural Trauma-Info
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ORIGINAL PAPER
Capacity Building for Refugee Mental Health in Resettlement: Implementation and Evaluation of Cross‑Cultural Trauma‑Informed Care Training Hyojin Im1 · Laura E. T. Swan1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Refugee mental health needs are heightened during resettlement but are often neglected due to challenges in service provision, including lack of opportunities for building capacity and partnership among providers. We developed and implemented culturally-responsive refugee mental health training, called Cross-Cultural Trauma-Informed Care (CC-TIC) training. We evaluated CC-TIC, using a free listing and semi-structured retrospective pre- and post-training evaluation with five localities in two states in the U.S. The results showed significant improvement in providers’ knowledge of trauma impacts, cultural expressions of trauma/stress-related symptoms, and culturally-responsive trauma-informed care. Trauma-informed care specific to refugee resettlement was regarded as the most helpful topic and community partnership building as the most requested area for future training. This study emphasizes that culturally-responsive trauma-informed approaches can help bridge gaps between mental health care and resettlement services and promote exchanges of knowledge and expertise to build collaborative care and community partnership. Keywords Refugee resettlement · Mental health training · Trauma-informed care · Cultural competence · Retrospective evaluation
Background Refugees commonly experience trauma, such as social conflicts and violence, witnessing tragic deaths, torture, forced confinement, and numerous human rights violations [1–3], which likely increases risk for various mental health issues and disorders [3, 4]. In fact, more than one in four refugees who have been exposed to mass conflict report posttraumatic stress disorder (PTSD), and more than one in four report symptoms of major depressive disorder [5]. In a recent review [6], asylum seekers and refugees reported high rates of depression, anxiety, and PTSD (all up to 40%), despite variation across settings (e.g., displacement or resettlement, high- or low-income countries). In addition, psychiatric disorders are notable when assessment includes mental illness beyond common mental disorders. In a German study * Hyojin Im [email protected] 1
School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, VA 23284, USA
with refugees from Syria, Iraq, and Afghanistan, 27% of those receiving neurological emergency services reported a non-epileptic seizure or psychiatric disorder, which is much higher than the 15% prevalence in native Germans [7]. Although mental health issues are more prevalent among refugees, mental health care for refugees resettled in the U.S. is sometimes neglected due to multiple challenges in service provision [8]. The concept of mental health care and psychotherapy are foreign in many refugee communities [9, 10], and mental health is a stigmatized issue
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