Archive for the ‘mental health’ Category
Posted by Christopher Coen on March 27, 2012
A single mother of a refugee family from the Central African Republic finds herself alone and isolated (a condition correlated with refugee suicides) five months after resettlement to Portland via Lutheran Community Services Northwest. Interviewed about six weeks after her arrival, she only knew how to get to the grocery store and to an organization which offers employment training and referrals, though her resettlement agency was required to give her community orientation. The family’s apartment is sparsely furnished, with not enough heat to stay warm and little light (this, though the State Department’s Operational Guidance contract document supposedly requires resettlement contractors to provide refugees with one lamp per room unless installed lighting is present). An article in the Portland Tribune describes the refugee family’s initial resettlement to Portland:
Monique Detoloum…[a] new Portland resident has found peace for herself and her four children, after surviving a reign of terror in the Central African Republic and six years in limbo in neighboring Cameroon…
…Monique and her children arrived here in late October, settling in East Portland. They are among the 944 refugees from more than a dozen nations who resettled in Oregon last year, mostly in Portland. Nearly 60,000 refugees from around the world have landed here since 1975. That’s an average of 135 newcomers a month, a steady stream of foreigners who are gradually expanding the Portland area’s ethnic mix and forever changing its complexion…
…Somewhat arbitrarily, since Monique had no family or connections here, she was assigned to Portland, aided by Lutheran Community Services Northwest.
Agency staff picked up Monique’s family at the airport, found her housing in an apartment on Southeast Division Street near 126th Avenue, helped enroll her children into David Douglas schools, arranged medical screenings and financial support.
Within her first week in town, Monique was referred to East Portland’s Immigrant and Refugee Community Organization [IRCO], which offers employment training and referrals, among other services…
…Interviewed about six weeks after her arrival, Monique knew how to get to IRCO and the Winco grocery store on Northeast 122nd Avenue, but hadn’t ventured further on her own. She was too flustered to think about going downtown, feeling pretty helpless without any English skills…
…Now, after five months, here she is still having trouble adjusting to cold weather. She just experienced her first snow, and says she doesn’t like it.
The family’s two-bedroom, one-bath apartment is sparsely furnished, with little light and not enough heat to stay warm…
…Monique has found a Baptist Church she wants to attend. But she says she is feeling isolated here, with no friends to talk to, only her children…
…Refugees rarely go back to their home country, Tauch says, but they do move around once they’re here, especially to find work. In January, a recruiter came to town and offered seasonal jobs to 52 Portland-area refugees at a Kodiak, Alaska, cannery, Tauch says. Last year, a Nebraska employer offered 100 permanent jobs to local refugees… Read more here
Posted in alienation-isolation, Central African Republic, furnishings, lack of, housing, language, Lutheran Community Services Northwest, mental health, Operational Guidance, Portland | Tagged: Central African Republic, Immigrant and Refugee Community Organization, irco, isolation, Lutheran Community Services Northwest, Portland, refugees, resettlement | Leave a Comment »
Posted by Christopher Coen on January 21, 2012
Refugees with post-traumatic stress disorder (PTSD) need specialized and competent care at mental health centers to get back on their feet (why the federal refugee resettlement program doesn’t mandate mental health screening for refugees makes little sense to me). A specialist at a center in Kent, in Washington state, has found that focusing on a patient’s physical symptoms is useful in helping refugee clients. An article at KUOW tells the story of an Iraqi refugee struggling to survive with PTSD (he didn’t get a proper referral until he tried to jump off a roof):
The Kuba family lives in a small ground–floor apartment in Kent…
…But there’s a lot more space here than they had a few weeks ago, when they were living in their car.
Amer Kuba: “I leave my home. And all my stuff in the street cause I don’t have money for truck.”
This is Amer Kuba. He is a refugee from Iraq. At his first apartment, rent was $735. But he only got $560 in refugee cash assistance. It caught up with him, and he was evicted.
Kuba: “I take just my clothes and I sleep in my car almost three month. I drive in night, and my family sleep in car.”
…Amer, his pregnant wife and their young son came to Seattle in April 2010.
Amer says he didn’t leave the house for the first six months. He was afraid al–Qaida would find him here.
Kuba: “And I have psychological problem. And I can’t speak with anybody and confuse all the time and I still inside my house, I don’t go outside because I afraid.”…
…Beth Farmer runs the International Counseling Service, a community mental health center. Almost all of her clientele are refugees from Africa, the former Soviet Union and the Middle East.
Farmer: “If you are already having post–traumatic stress disorder symptoms, you are really poised to fall through the cracks.”
That’s because there is no standardized way to make sure refugees with severe mental health problems are funneled into treatment as soon as they arrive.
Amer didn’t get sent to Beth’s clinic until he attempted suicide. He tried to jump off the roof of the Department of Social and Health Services building in Downtown Seattle.
Overall, Beth says refugees are 10 times more likely to have PTSD than the general population. But it can be hard to get patients like Amer into treatment.
Many refugees with PTSD share his fear of going outside. And that’s only amplified by how hard it can be to find your way around a new city, especially if you don’t have a car or speak the language.
Even the idea of mental health treatment can be scary.
Farmer: “For a long time, people didn’t think that they could address mental health issues because the stigma in the refugee community was so high.”
Getting counseling or psychiatric treatment might be seen as selfish or wimpy, or even dangerous. For some refugees, mental hospitals are a place where political dissidents are sent.
Beth has found that focusing on physical symptoms gets the best results. She starts by asking a patient how they’re sleeping… Read more here
Posted in Iraqi, Kent, PTSD | Tagged: Iraqi, Post-traumatic stress disorder, PTSD, refugees, resettlement | Leave a Comment »
Posted by Christopher Coen on December 28, 2011
An article in the San Francisco Chronicle identifies the many Iraqi refugees who have been attacked in East Oakland. In response, the State Department’s PRM spokeswoman, Beth Schlachter, reminds us about its lax, partner-friendly regulations by saying that the department’s guidelines for relocating refugees don’t even consider crime rates (funny how that works). A reader commenting on the article reminds us that Bosnian refugees had similar problems in the 90s, so the private resettlement agencies and their friends at government oversight agencies have obviously long-known about this problem. Refugees from Burma/Myanmar in the area have also experienced muggings and robberies, as have refugees from Bhutan/Nepal. The article details the situation in Oakland for Iraqi refugees:
…In June 2008, [Ghazwan Al-Sharif] moved in with two other Iraqi refugees, sharing a two-bedroom apartment in Oakland’s Fruitvale neighborhood – a situation arranged by the nonprofit International Rescue Committee…
…One night, he decided to walk home alone. Two men attacked him, bashing him in the face with a metal object and robbing him of some money, his cell phone and his ID. He was left screaming on the ground, his face gushing blood.
He said the police never identified his attackers.
Al-Sharif, 40, is one of more than 50 Iraqi refugees who have been moved to East Oakland by the International Rescue Committee. The nonprofit’s officials say they won’t settle refugees in unsafe neighborhoods, but Al-Sharif and dozens of other Iraqis blame the organization for exposing them to an unfamiliar type of violence – one perpetrated by gangs rather than political militants…
…Like many of his fellow Bay Area refugees, Al-Sharif does not believe the International Rescue Committee has done enough. “Why are you putting them in Oakland and letting them suffer?” he said, referring to his fellow refugees. “I want to be safe. … I can find work and manage to survive, but I need to be safe.”
Oakland as refuge
Oakland has a long history of hosting immigrants from around the world. Affordable housing, easy access to city services, efficient transportation such as BART, and an accepting, multicultural society make the city a great place for refugees, said rescue committee spokeswoman Melissa Winkler.
But the nonprofit receives only $1,800 in federal funding to provide each refugee with housing, employment and other basic needs. That doesn’t go far in the Bay Area, and refugees are expected to be financially self-sufficient within four months.
That’s why the IRC chose to resettle many of them in Oakland, where housing is often inexpensive…
…Unfortunately, the city also has one of the country’s highest crime rates, according to federal statistics and other studies.
Beth Schlachter, spokeswoman for the Bureau of Population, Refugees and Migration at the State Department, said government guidelines for relocating refugees don’t consider crime rates. The requirements for “decent, safe and sanitary housing,” she said, extend only “from the apartment itself to the building or apartment complex they’re living in.”…
…[Harith Al-Kaiate, 47] hasn’t forgotten the time a nighttime gunfight near his home left his car, which was parked outside, riddled with bullets…
…Ragheed Abdulameer, 32, another recent arrival, [was] robbed at gunpoint earlier this year just a few blocks from his home at East 24th Street and 14th Avenue…One of Abdulameer’s friends has yet to bring his wife and children from Iraq, believing they’re safer in Basra. The friend declined to be interviewed or identified for this article, saying he fears retaliation from federal authorities and the rescue committee.
More than a dozen Iraqi refugees who have been resettled in Oakland say they live in varying degrees of fear.
“Had I known about this place, I’d never have agreed to come,” said Oday Fatah, 33…
…the only solution for you is to get beaten or mugged and then you can get out,” quipped Al-Sharif, who says he became depressed and attempted suicide after he was mugged. His condition persuaded the International Rescue Committee to help relocate him to San Francisco.
The rescue committee agreed to move another refugee and his family after he was shot multiple times in a drive-by shooting outside a Fruitvale mini-mart earlier this year, Climent said.
[Iraqi refugees who make it to the US] almost certainly suffered horrendous trauma in their home country.
“They’ve survived, and they’ve come to the U.S. to start a new life, and if you settle them in an environment like that, you bring back all these things,” Abdulkhaleq said… Read more here
Posted in dangerous neighborhoods, Iraqi, IRC, Oakland, PRM, public/private partnership, safety, San Francisco, State Department, suicide | Tagged: crime, International Rescue Committee, Iraqi, IRC, mugging, Oakland, refugees, resettlement, shooting, State Department | Leave a Comment »
Posted by Christopher Coen on December 12, 2011
A story from our friends Down Under about the healing power of justice involving a Somali refugee gives us a hint of the world we could create if justice was an actual priority. An article in The Age tells the story:
…It was Valentine’s Day 2007 when Dini was hit in the mouth during an incident between police and some African youths. As well as damage to three teeth, Dini copped a cluster of police charges that included affray, assault and recklessly causing injury.
What irony – he had avoided the violence that plagued his six years in a Kenyan refugee camp only to be hurt in the family’s safe haven...
…Initially I was really angry – why would the police charge me? I was so stressed, I knew I had done nothing wrong but a lot of friends told me the court system would not work. So there was a tear in my eye when the judge said I was not guilty. I sat back in my chair. It was the biggest relief in my life.”
A dentist could fix that broken tooth, of course, and Dini had intended to have it done but now he sees it almost as a badge of honour. “This makes me Ahmed Dini now,” he says, “the man with the gap in his teeth. The thing that fixed my heart, that fixed me as a person, was the court decision, and that’s why I love this country more than any in the world. When I say that, some of my Somali friends ask: ‘are you serious?’ But for me to spend 10 days in court and to hear the judge say: I believe Ahmed Dini’s version of the story, well …”…
…Dini completed secondary education in Melbourne and did two years of university before deciding to help young Africans. “There was a lot of trouble in the community, no role models,” he says, “so I decided as a young person I would become the public voice.
”I went to any meeting involving Africans – council, police meetings. African elders were going but not young people. Slowly, but slowly I saw change. Then I got a role coaching the under 13s at the Flemington Eagles, a refugee-based soccer club.”
Last year, Dini formed the Australian Somali Football Association. It held a tournament, which drew 4500 spectators, where eight teams played over six days. The 2011 tournament is at the end of this month and 12 teams will play.
At 24, Ahmed Dini makes an impressive advocate… Read more here
Posted in Australian refugee resettlement prgm, court, democracy, men, mental health, police, Somali | Tagged: Australia, justice, police, refugee, refugees, resettlement, Somali | Leave a Comment »
Posted by Christopher Coen on November 30, 2011
Although the US refugee resettlement program does not mandate mental health screenings for refugees, some resettlement locations have provided these screenings, such as Utica, New York. Refugees there, however, will no longer get the screenings since services which are not mandated are the first to go during budget cuts. An Observer-Dispatch article gives the details:
Mid-year funding cuts by the financially struggling state are hitting social programs that help the mentally ill.
Some programs that received money through the Oneida County Department of Mental Health are seeing their funding dry up at the end of the year, while others are seeing steep reductions.
Oneida County Executive Anthony Picente didn’t hold out much hope that the money might be restored.
“It’s the consequences of the state cuts,” he said. “We can obviously fight for it, but it’s one of those areas that aren’t going to get resolved.”
Among the cuts:…
…* The Mohawk Valley Resource Center for Refugees is losing $38,583, which funded mental health screenings for refugees…
…State funds for the county Mental Health department have been slashed from $9,542,793 in 2011 to $9,122,378 in 2012, budget documents show.County officials said the department had to cut programs that do not provide mandated services.
Mental health advocates said the cuts might save money in the short term but will cost more in the end.
“It ends with people unfortunately losing services, ending up in emergency rooms, homeless or in the criminal justice system,” said Glenn Liebman, of the Mental Health Association of New York State. “No one wants those outcomes, and it’s more costly for the taxpayers.”… Read more here
Posted in mental health, Mohawk Valley Resource Center for Refugees, Utica | Tagged: budget cuts, mental health screening, Oneida County, refugees, resettlement, Utica | Leave a Comment »
Posted by Christopher Coen on November 29, 2011
Post-traumatic stress disorder, or PTSD, is covered in an article in Crosscurrents:
Over the past decade, California has resettled more Middle Eastern refugees than any other state in the country. In Northern California, Santa Clara County in the South Bay is a resettlement hub for Middle Eastern refugees – more than 1,300 moved there since 2006. About one out of three of those refugees are from Iraq. And most have seen or suffered through violence related to the war.
- JASMINE: What happened will remain like a scar inside yourself. Especially like we saw a lot of stuff not normal. Like dead people in the street. People killed in front of your eye. I don’t believe like I’m going to forget them.
Iraqi refugee Jasmine asked that we not use her full name for this story. After two years in the U.S., she’s been diagnosed with post-traumatic stress disorder, and she’s receiving therapy for it. But Iraqi culture, like many others, often considers mental health problems shameful, and Jasmine is concerned about embarrassing her family. Reporter Shuka Kalantari shares Jasmine’s story…
…Jasmine’s social worker recommended she see a therapist and referred her to the Center for Survivors of Torture. Doctor James Livingston is a psychologist at the center. He says just the experience of having to flee your home country is usually enough to cause post-traumatic stress disorder, or PTSD.
- JAMES LIVINGSTON: The re-experiencing symptoms are very painful and disruptive because they’re typically accompanied by the kinds of feelings that were experienced in the original situation. And so terror, horror, all sorts of very painful emotions…
- …LIVINGSTON: We get people who were professionals in their home countries who are very intelligent and very educated and find themselves unable to learn because they’re traumatized…. Read more here
Posted in Iraqi, PTSD, San Jose, women | Tagged: Center for Survivors of Torture, Iraqi, mental health, Post-traumatic stress disorder, PTSD, refugees, resettlement, San Jose, traumatization | Leave a Comment »
Posted by Christopher Coen on November 22, 2011
A refugee man from Burma/Myanmar in St. Paul allegedly stabbed another refugee to death and then stabbed and blinded his own wife in an incident Saturday involving hallmarks of severe mental illness. The murder victim was purportedly another refugee from Burma/Myanmar, employed at a meat processing plant in Albert Lea, Minnesota. This tragedy may be another consequence of not consistently screening or treating refugees for major depressive disorder, schizophrenia, PTSD and other mental illnesses. An article in the St. Paul Pioneer Press tells what happened:
A 48-year-old St. Paul man has been charged with murder and attempted murder after he allegedly killed a man he believed had designs on his wife, then turned the weapon on her.
Police were called to an apartment in the 1400 block of Farrington Street about 7 a.m. Saturday. A witness yelled, “He killed him. There is a body in there,” and pointed to the window of the apartment, according to a criminal complaint filed Monday in Ramsey County District Court.
Police found Po Lye, 40, deceased, with “a very deep and wide laceration to (his) neck,” the complaint said. The wife was blinded in both eyes from stab wounds.
Officers said previously that Lye was from Albert Lea, Minn. Alleged assailant Pah Ber was arrested at the scene… Read more here
The federal refugee resettlement program does not require contractors to screen incoming refugees for mental illnesses – medical screening during refugees’ first 30 days in the US only involves physical health issues (State Department’s requirements for contractors – see Health at bottom of list). This is obviously foolhardy when we know that the traumatic experiences and upheaval involved in the refugee experience is associated with suicide, post-traumatic stress disorder (PTSD), major depression, and other mental disorders. We need look no further than incidents of tragedy among refugees from Bhutan/Nepal (and here), Burma/Myanmar, Sudan, Somalia (and here), and other refugees.
Posted in Burma/Myanmar, mental health, Twin Cities | Tagged: Burma, mental health, Myanmar, refugees, resettlement, st paul | Leave a Comment »
Posted by Christopher Coen on November 21, 2011
The US Department of State and the International Institute of Akron are resettling about 350 refugees annually in Akron. Secondary migration from other areas of the US is significant, with 350 more refugees arriving annually. Adult refugees here face the usual barriers to medical care, such as transportation issues, the language barrier, and cultural differences that hinder understanding and communication between medical staff and patients. Medical workers treat refugees for parasites, hepatitis, tuberculosis, dental problems, post-traumatic stress disorder (PTSD) and other health issues. Although most refugee children are in good health when they arrive, some have medical concerns not typically seen in American-born children — e.g., hepatitis, latent tuberculosis, anemia, failure to thrive, parasites, chronic ear infections and certain oral health problems. An article in the Beacon Journal has more:
…Each year, about 350 refugees from Myanmar, Nepal, Iraq and other countries arrive in the Akron area with the help of the International Institute of Akron, according to Kate Sass, the institute’s director of refugee resettlement. Another 350 refugees who have been living in other cities throughout the United States also relocate to the region in a typical year…
...Cultural differencesAlong with the obvious language barrier, things such as transportation issues and cultural differences create challenges, Van Nostran said. Some patients also struggle with post-traumatic stress disorder from their past experiences.
The staff has learned, for example, that it is considered rude in some cultures to only use one hand instead of two to give patients their prescriptions or other paperwork.
In another case, Van Nostran said, hospital staff were concerned that a refugee couple were ignoring their newborn shortly after birth. The staff later learned this was the custom in the family’s native culture, which believes doting on a newborn will draw the attention of “evil spirits.”
“It has challenged us not to make assumptions but to ask specifically about cultures,” she said…
…When refugees arrive, they must have an initial health exam within 30 days for parasites, hepatitis, tuberculosis, dental problems and other health issues.
Some refugees have latent tuberculosis, which isn’t active or contagious but still must be treated with a nine-month course of antibiotics to avoid an active infection in the future, she said.
“You learn a lot,” Erme said. “Health-care providers who take care of refugee patients need to be open to learning and realize that what we were taught in our medical professional education may not always apply to this population.”…
…Caring for children
…Although the majority of children are in good health when they arrive, he said, refugees have some medical concerns that typically aren’t seen in American-born children — things such as oral health problems, latent tuberculosis, parasites, anemia, failure to thrive, chronic ear infections and hepatitis… Read more here
I think that the International Institute of Akron resettling refugees into crowded housing with rats and roaches also must not have been particularly healthful for refugees in Akron.
Posted in health, housing, substandard, housing, overcrowding, secondary migration, refugee, children, PTSD, cultural adjustment, language, RMA (Refugee Medical Assistance), Akron, International Institute of Akron | Tagged: refugees, resettlement, International Institute, PTSD, language barrier, Akron, hepatitis, latent tuberculosis, anemia, failure to thrive | Leave a Comment »
Posted by Christopher Coen on November 20, 2011
A roundtable panel discussion In Austin addresses the issue of older refugees. Panelists included Zarni Tun (resettlement case manager with Refugee Services of Texas); Lorel Donaghey (employment specialist with Caritas of Austin); Casey Kasper (ESL teacher with Interfaith Action of Texas) and Rebecca Tulis (extended case manager with Refugee Services of Texas). The discussion is described at Austin Refugee Roundtable:
…Some of the problems faced by older refugees –identified as refugees over the age of 50- included:
- General fear of being a burden on family members.
- It is more difficult for them to learn English which makes it more difficult to pass the US citizenship test. This makes them not eligible to receive SSI/SSDI beyond 7 years.
- Employment difficulty since many jobs that would be a good fit (caring for others, childcare, sewing) require individuals to be fluent in English or able to work fast on big machines… Read more here
Posted in alienation-isolation, Austin, Caritas of Austin, elderly refugees, employment/jobs for refugees, ESL & ELL, language, mental health, Refugee Services of Texas, Refugee Services of Texas | Tagged: Austin, Caritas of Austin, elderly, ESL, Interfaith Action of Texas, panel discussion, Refugee Services of Texas, refugees, resettlement, Roundtable | Leave a Comment »
Posted by Christopher Coen on November 9, 2011
An in-depth article on the events surrounding the December 2009 attack on dozens of Asian refugee children at a south Philadelphia school, that resulted in 13 refugee children taken to the emergency room, reveals the extent that teachers, the principle, security guards and other staff were present and unresponsive as the attacks occurred. Refugee students report that the principle disappeared while walking children home just before vicious beatings took place. Teachers and cafeteria staff called the students “Yo Dragonball” or “Yo Chinese” and even mocked their accents. The School District of Philadelphia also apparently has an ongoing pattern of unresponsiveness to reports of students bullying refugee students, despite an early 2011 settlement with the Justice Department.
The article also points to relatively large number of refugees from Burma/Myanmar that the State Department resettled in a relatively short period, which the school district was not ready to accommodate. These are some of the considerations the State Department needs to make when reading glowing annual resettlement proposals from their private resettlement contractors
We should not underestimate the catastrophic long-term damage to refugees resulting from these brutalities during their formative years. The article points out that bullying can lead to a lifetime of low self-worth, suicide attempt or depression, and that doesn’t even consider the trauma, tumult and deprivation that refugee have already endured before their resettlement. Hyphen Magazine magazine published this article:
On a cold December day in 2009, just weeks before Christmas, 15-year-old Trang Dang was walking home from school with her sister and eight friends, all recent Vietnamese immigrants. Also part of their group: the principal of their school.
Dang, who is 5’9” with a medium build and a dimpled, contagious smile, asked the principal to accompany them because she and the others were terrified by the intense bullying and violence against Asian students that had taken place earlier that day at their school, South Philadelphia High School. Midway through the walk, the principal, LaGreta Brown, disappeared, Dang said. “She walked to the corner with us and then we didn’t see her anymore,” Dang said. They debated whether to stay or continue walking. “Our friends said if we stand here, we’ll get in trouble,” Dang said. So they opted to try to make it home that day on their own.
They never did.
About half a block from school, a mob of at least two dozen students started chasing them. Dang was the first to be caught. She was punched in the face, shattering her glasses. “It was a quick hit and then they ran,” she said. “After I got hit, then my mind just went blank. I was crying. It wasn’t that painful, I think, but I don’t really remember. I think because I’ve tried to forget about that day.” The entire group was cornered, and all were hit. Dang still doesn’t know for sure why the principal seemingly left the group…
…The entire day, roving gangs of high schoolers searched for and attacked Asian teenagers in a nightmarish ordeal. Most of the attacks took place on the premises of this poor school in south Philadelphia while teachers, security guards and other staff were present.
In total, at least 26 Asian immigrant students were physically assaulted in a series of violent conflicts. Thirteen Asian students ended up in the emergency room for injuries ranging from a broken nose to black eyes. One had to have surgery because he could no longer breathe through his nose…
…Some speculate that the ethnic tensions at the school can be attributed to lack of adult intervention, adults modeling bad behavior such as racially charged name calling, stereotypes and an influx of Asian students in a relatively short time period without the school or district adequately addressing the changes…
…In the last five years, there were 534 documented assaults at the school, more than any other in the district…
…In some cases, bullying can lead to thoughts of suicide, according to Eliza Noh, an Asian American studies professor at California State University, Fullerton, who has studied suicide among Asian Americans. “Some Asian American women I interviewed reported being victims of racist bullying when they were young, contributing to their low self-worth, suicide attempt or depression later in life,” Noh said. Liu pointed out bullying victims are essentially trauma victims who experience post-traumatic stress disorder similar to war veterans. He warned that young people may experience psychosomatic symptoms like feeling ill, as well as hypervigilance, heightened startled responses, depression and social withdrawal… Read more here
Posted in abuse, Burma/Myanmar, capacity, children, dangerous neighborhoods, Dept. of Justice, FBI, mental health, Philadelphia, safety, schools, State Department, teenagers | Tagged: Asian, bullying, Burmese, children, Myanmar, Philadelphia, refugees, resettlement, South Philadelphia High School, State Department | Leave a Comment »
Christopher Coen
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