Society for Social Work and Research 18th Annual Conference: Research for Social Change: Addressing Local and Global Challenges

January 15 - 19, 2014

Of the 58,236 refugees resettled to the United States in 2012, the largest groups fled protracted wars and political instability in Burma (14,020), Bhutan (15,021), Iraq (12,122) and Somalia (4,914) (Office of Refugee Resettlement, 2013). A significant portion of these refugees suffer with torture and war trauma related health and mental health distress and may be unfamiliar with how to access health services. Many refugees spend years in camps where they face severe conditions including limited access to adequate nutrition and drinking water, disease and continued violence (Adams, 2004). A recent meta-analysis of 181 surveys of over 80,000 refugees from 40 different countries reported a prevalence rate of 30.6% for posttraumatic stress disorder (PTSD) and 30.8% for depression (Steel et al., 2009).  In addition, there is a growing body of literature that indicates that refugees struggle with substance use and families may be vulnerable to domestic violence both in camps and after they are resettled (Bauer, Rodriquez, Quiroga, Flores-Ortiz, 2000; Crosby, et. al, 2006; D’Avanzo, Frye, Froman, 1994; Khawaja, Barazi, 2005; Westermeyer, Lyfoung, Neider, 1989).

When resettling in the United States, refugees face multiple barriers to stability including lack of employable skills and language and cultural adjustment difficulties (Morris, Popper, Rodwell, Brodine, & Brouwer, 2009).    Such ongoing stressors may lead to worsened mental health outcomes when added to pre-existing, untreated trauma-related mental distress (Courtois, 2008; Porter & Haslam, 2005; Silove, 1999). Recent research suggests that the daily stressors of living may mediate health and mental health outcomes as living with poverty, family violence, unsafe housing and social isolation taxes the coping resources of refugees in enduring ways (Miller, 2010).  Developing social support networks has also been found to mediate the post-trauma impact of such stress (Norris et.al, 2004).  For refugees in need of health or mental health services, language differences, acculturation processes and cultural beliefs about health care and mental health pose significant barriers to accessing care (Morris, et. al, 2009; Ferguson & Candid, 2002; Shannon, O’Doughterty, & Mehta, 2012).

This symposium presents findings from four studies focused on innovative approaches to addressing the adverse health and mental health outcomes of refugees in resettlement.  The first paper investigates quality of life and access to health care among Cambodians through training Cambodian community health workers to use iPad technology to outreach to their communities and collect health related data.  Building on the mediators of health outcomes, the second paper explores the impact of developing social enterprise on the overall well-being and self-esteem of Bhutanese refugee women.  The third paper challenges Western models of alcohol abuse and proposes culturally informed treatment through an ethnographic and phenomenological exploration of alcohol use in the Karen refugee community.  The fourth paper uses the critical incident technique to conduct a community based participatory research study of the effectiveness of a statewide mental health services delivery system for refugees.