Browsing by Subject "Refugee"

Over 100,000 Bhutanese refugees are in the process of being resettled from southeastern Nepal to eight different Western countries--the majority of whom are resettling to the United States. Refugees are universally at higher risk of mental illness, due to the large number of stressors to which they are exposed. Preliminary studies have suggested that resettled Bhutanese refugees may have particularly poor mental health outcomes, including high rates of suicide. This study conducted 23 in-depth life story interviews with Bhutanese refugees in Nepal, in attempt to explore the psychosocial context of mental illness among this population, and to understand the risk factors that they are, or will be, exposed to during their resettlement transition. Throughout the interviews the theme of "expectations of resettlement" emerged and revealed potentially large discontinuities between expectations of resettled life and the likely realities. Interestingly, these expectations were closely tied to many of the themes that emerged when discussing sources of mental illness within their population--suggesting that the failure of the expectations might greatly affect mental health outcomes. The results of this study are only preliminary and suggestive, but they add to the currently limited literature on Bhutanese refugee mental health. Additionally, they offer a detailed insight into the risks and needs of the Bhutanese as we prepare to incorporate them into our communities.

The scope of my dissertation project was to investigate the training of community leaders, including religious leaders, in the delivery of individual cognitive-behavioral support for depression in the community from Burma in NC. My research aims were to train community leaders a) to recognize the signs and symptoms of depression and associated problems, including intergenerational conflict, substance abuse, domestic violence and suicide; b) to use reflective listening and cognitive-behavioral therapy (CBT) skills, and c) to increase awareness of stigma toward treatment-seeking for depression and its related problems. Positive training outcomes were found for knowledge of depression and CBT strategies, and for attitudes toward treatment-seeking for depression; suggesting community leaders could be a valuable resource for expanding evidence-based mental health services delivery within the community from Burma and potentially within Burma as well, where there is a scarcity of mental health professionals. This study extends existing research on training paraprofessionals and religious leaders in the use of CBT. In particular, it adds to the knowledge base on providing mental health services within the community from Burma, which may extend to other refugee and immigrant communities in the U.S.

Political upheaval in Syria makes Jordan a temporary home to over one million Syrian refugees. More than half of these individuals, due to limited resources and challenging financial circumstances, do not have adequate access to reproductive health and family planning mechanisms. Among pregnant refugee women in Jordan, approximately one in five are at risk for poor obstetrical outcomes, including premature and underweight births. Due to increased rates of birth in humanitarian and lower resource settings, and the crucial need for addressing sexual and reproductive health in these settings, this study conducted a comparative analysis of the sexual and reproductive health climate among Syrian refugee and Jordanian men and women.

Using a case study research design, semi-structured qualitative interviews were conducted with 34 study participants, including 15 Syrian women, 8 Jordanian women, 6 Syrian men, and 5 Jordanian men. These interviews examined participants’ migration experiences, pregnancy outcomes, influencers for reproductive decisions, and gaps in sexual and reproductive health care.

Qualitative interviews revealed that Syrian refugees indicated greater reproductive and sexual health need than Jordanians, more specifically related to education on reproductive health and contraceptive methods. Syrian refugees were married at earlier ages than Jordanians, and, overall, had more children. Additionally, Syrian refugees confirmed that healthcare in Syria was more accessible, affordable, and comprehensive in comparison to Jordan. The greatest contributors to gaps in care for both Jordanians and Syrians were financial constraints and apathy regarding refugee welfare among providers in public facilities.

Increasing access to comprehensive sexual and reproductive healthcare among refugees in low-resourced, humanitarian settings, while also continuing to meet the needs of the nation’s own population, is a healthcare priority. The findings of this study have the potential to guide and influence policy affecting family planning mechanisms afforded to migrants in Jordan in both public and private facilities. Action is required immediately by policymakers and government officials to create budgetary resources for sexual and reproductive health education programs in Jordan in order to meet the family planning needs of refugee and migrant populations residing there.

Social interactions with civil society are an essential component of the refugee experience, actively shaping humanitarian aid as well as policies towards refugee needs (Barnes, 2011; Van der Leun & Bouter, 2015). However, material needs are frequently depicted as the main endeavor for refugee support. This overlooks the moral components of the refugee experience, through the need for dignity (del Soto, 2008), mental health resources (Silove et al., 2017) and a sense of security (Eby et al., 2011) which are essential support structures if refugees are to, even temporarily, live in the new communities they join. Notably, current research on existing systems emphasizes material refugee provisions with little focus on mental health (Weine, 2011) or the cultural implications of integration (Esses et al., 2017). This thesis explores refugees’ perceptions of integration in host countries with an emphasis on the lack of support structures beyond material humanitarian response in Egypt and Jordan as a secondary data analysis project. It is based on 108 qualitative life-story interviews with Iraqi refugees conducted by the Kenan Refugee Project of Duke University between 2012 and 2019 primarily in Cairo, Egypt and Amman, Jordan. Through this analysis, I determined a pressing need for a temporary, informal integration process with much needed social support and mental health resources beyond the current legal standards in place. I further argue that the multi-dimensional, multi-disciplinary nature of refugee needs are frequently overlooked and underestimated and that a new approach beyond materialprovisions at the global decision-making table is long overdue for the dignity, human rights and quality of life refugees deserve across the globe.