Pub Date : 2019-01-15DOI: 10.1093/oso/9780198814733.003.0006
P. Ventevogel, X. Pereira, S. Verghis, D. Silove
Mental health and psychosocial problems among refugees are increasingly being recognized as a priority issue. This chapter will critically examine and synthesize what is known about mental health problems among refugees. The scope will be broad, extending beyond post-traumatic stress disorder, and include brief information on other common mental disorders in refugees (such as prolonged grief, depression as well as severe mental disorders such as psychosis and bipolar disorder). The chapter briefly introduces social-ecological frameworks that assist in conceptualizing the psychosocial problems facing refugees. Emphasis is given to the need for multi-sectoral, multi-level interventions that are sensitive to culture and context, and that are evidence-informed and scalable. Key issues are: the integration of mental health into general health using brief psychological interventions; use of task shifting approaches; and interventions to strengthen self-help and family and community support in refugee settings.
{"title":"Mental health of refugees","authors":"P. Ventevogel, X. Pereira, S. Verghis, D. Silove","doi":"10.1093/oso/9780198814733.003.0006","DOIUrl":"https://doi.org/10.1093/oso/9780198814733.003.0006","url":null,"abstract":"Mental health and psychosocial problems among refugees are increasingly being recognized as a priority issue. This chapter will critically examine and synthesize what is known about mental health problems among refugees. The scope will be broad, extending beyond post-traumatic stress disorder, and include brief information on other common mental disorders in refugees (such as prolonged grief, depression as well as severe mental disorders such as psychosis and bipolar disorder). The chapter briefly introduces social-ecological frameworks that assist in conceptualizing the psychosocial problems facing refugees. Emphasis is given to the need for multi-sectoral, multi-level interventions that are sensitive to culture and context, and that are evidence-informed and scalable. Key issues are: the integration of mental health into general health using brief psychological interventions; use of task shifting approaches; and interventions to strengthen self-help and family and community support in refugee settings.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124534103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/OSO/9780198814733.003.0010
Anushka Ataullahjan, M. Gaffey, P. Spiegel, Z. Bhutta
Globally, it is estimated there are a minimum of 9.8 million forcibly displaced adolescents (10–19 years old). Forcibly displaced adolescents face difficulties obtaining health services with conflict disrupting care, aggravating existing health concerns, and introducing new health issues. Displaced adolescents experience increased injury, psychological trauma, nutritional deficiencies, and physical and sexual violence. This chapter describes the health impact of conflict, and several factors that exacerbate the health of adolescents. It then describes the evidence base on the most effective interventions to address the health of adolescents. Lastly, it points to gaps within the literature suggesting how adolescent health can be mainstreamed in refugee health services.
{"title":"The health impacts of displacement due to conflict on adolescents","authors":"Anushka Ataullahjan, M. Gaffey, P. Spiegel, Z. Bhutta","doi":"10.1093/OSO/9780198814733.003.0010","DOIUrl":"https://doi.org/10.1093/OSO/9780198814733.003.0010","url":null,"abstract":"Globally, it is estimated there are a minimum of 9.8 million forcibly displaced adolescents (10–19 years old). Forcibly displaced adolescents face difficulties obtaining health services with conflict disrupting care, aggravating existing health concerns, and introducing new health issues. Displaced adolescents experience increased injury, psychological trauma, nutritional deficiencies, and physical and sexual violence. This chapter describes the health impact of conflict, and several factors that exacerbate the health of adolescents. It then describes the evidence base on the most effective interventions to address the health of adolescents. Lastly, it points to gaps within the literature suggesting how adolescent health can be mainstreamed in refugee health services.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117134464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/oso/9780198814733.003.0005
K. Kanhutu, K. Leder, B. Biggs
There is mounting evidence that the mass population movements associated with the current global refugee and asylum seeker crisis have profound infectious diseases consequences. Key contributory factors identified include disruption of health systems building blocks, malnutrition, inadequate housing, and poverty. A literature review informs the content of this chapter, using recent examples to illustrate principles such as the decline in vaccination rates among refugees and asylum seekers and outbreaks of vaccine-preventable illnesses; the observed increased risk of tuberculosis in RAS populations; clustering of emerging infectious diseases in conflict zones; and transportation of arthropod vectors leading to emergence of disease in new geographical zones. A final section covers communicable disease assessments after settlement, identifying key barriers and enablers of best-practice care.
{"title":"Populations in transition and post-settlement: an infectious diseases and travel medicine perspective","authors":"K. Kanhutu, K. Leder, B. Biggs","doi":"10.1093/oso/9780198814733.003.0005","DOIUrl":"https://doi.org/10.1093/oso/9780198814733.003.0005","url":null,"abstract":"There is mounting evidence that the mass population movements associated with the current global refugee and asylum seeker crisis have profound infectious diseases consequences. Key contributory factors identified include disruption of health systems building blocks, malnutrition, inadequate housing, and poverty. A literature review informs the content of this chapter, using recent examples to illustrate principles such as the decline in vaccination rates among refugees and asylum seekers and outbreaks of vaccine-preventable illnesses; the observed increased risk of tuberculosis in RAS populations; clustering of emerging infectious diseases in conflict zones; and transportation of arthropod vectors leading to emergence of disease in new geographical zones. A final section covers communicable disease assessments after settlement, identifying key barriers and enablers of best-practice care.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"222 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131796689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/OSO/9780198814733.003.0008
R. Khosla, S. Krause, M. Tanabe
The Sustainable Development Goals commit to an international development agenda based on the fundamental principle of leaving no one behind. However, the global convergence between conflict, crisis, migration, poverty, and young populations is driving serious health and human rights consequences for those living in humanitarian settings, especially for sexual and reproductive health and rights. Despite marked progress in the policy sphere over the past quarter-century, with high-level recognition of sexual and reproductive health risks as well as the need to address these concerns, gaps remain in availability, funding, equitable access to and quality of services, and realization of these rights. A common agenda is needed that promotes a rights-based, participatory, empowering approach; strengthens the evidence base for effective interventions; and promotes continued advocacy and leadership. A transformative leadership agenda is vital if women and girls everywhere are to realize their health and well-being.
{"title":"Addressing the rights of women in conflict and humanitarian settings","authors":"R. Khosla, S. Krause, M. Tanabe","doi":"10.1093/OSO/9780198814733.003.0008","DOIUrl":"https://doi.org/10.1093/OSO/9780198814733.003.0008","url":null,"abstract":"The Sustainable Development Goals commit to an international development agenda based on the fundamental principle of leaving no one behind. However, the global convergence between conflict, crisis, migration, poverty, and young populations is driving serious health and human rights consequences for those living in humanitarian settings, especially for sexual and reproductive health and rights. Despite marked progress in the policy sphere over the past quarter-century, with high-level recognition of sexual and reproductive health risks as well as the need to address these concerns, gaps remain in availability, funding, equitable access to and quality of services, and realization of these rights. A common agenda is needed that promotes a rights-based, participatory, empowering approach; strengthens the evidence base for effective interventions; and promotes continued advocacy and leadership. A transformative leadership agenda is vital if women and girls everywhere are to realize their health and well-being.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127964277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/oso/9780198814733.003.0007
S. Verghis, Susheela Balasundram
There has been a sharp increase in forced displacement in recent decades, particularly of urban refugees who comprise 60% of refugees worldwide. Urban refugees are largely concentrated in the developing world. Non-recognition of their status as refugees in countries of asylum contributes to unique legal, social, and material precarity which engenders a range of protection challenges, including health risks. This chapter provides an operational definition for urban refugees and discuss their unique health risks within the legal and policy contexts they live in, their access to health care, and the challenges experienced by host countries grappling with resource constraints and stretched health-care systems.
{"title":"Urban refugees: the hidden population","authors":"S. Verghis, Susheela Balasundram","doi":"10.1093/oso/9780198814733.003.0007","DOIUrl":"https://doi.org/10.1093/oso/9780198814733.003.0007","url":null,"abstract":"There has been a sharp increase in forced displacement in recent decades, particularly of urban refugees who comprise 60% of refugees worldwide. Urban refugees are largely concentrated in the developing world. Non-recognition of their status as refugees in countries of asylum contributes to unique legal, social, and material precarity which engenders a range of protection challenges, including health risks. This chapter provides an operational definition for urban refugees and discuss their unique health risks within the legal and policy contexts they live in, their access to health care, and the challenges experienced by host countries grappling with resource constraints and stretched health-care systems.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117325555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/oso/9780198814733.003.0011
V. Pillai, Alison Mosier-Mills, K. Khoshnood
This chapter outlines key methodological and ethical issues that researchers face when conducting social science and health research with forcibly displaced populations. It highlights specific considerations for researchers, using case studies from research conducted with refugees in Malaysia and asylum seekers in Israel. The Malaysian case considers patient safety, accessing hidden populations, non-maleficence, beneficence, the nuances of researcher–participant relationships, and the importance of input from local ethics committees. The Israel case describes the intricacies of working with asylum seekers in non-camp settings, benefits for participants, the threat of deportation, the risk of participant reliance on researchers for support services, working as a cultural liaison, and the potential for hostility from the government. The chapter underscores the unique challenges stemming from the complexity and diversity of these populations. Finally, it provides guidelines and recommendations for ethical review boards evaluating proposals for research with forcibly displaced populations.
{"title":"Methodological and ethical challenges in research with forcibly displaced populations","authors":"V. Pillai, Alison Mosier-Mills, K. Khoshnood","doi":"10.1093/oso/9780198814733.003.0011","DOIUrl":"https://doi.org/10.1093/oso/9780198814733.003.0011","url":null,"abstract":"This chapter outlines key methodological and ethical issues that researchers face when conducting social science and health research with forcibly displaced populations. It highlights specific considerations for researchers, using case studies from research conducted with refugees in Malaysia and asylum seekers in Israel. The Malaysian case considers patient safety, accessing hidden populations, non-maleficence, beneficence, the nuances of researcher–participant relationships, and the importance of input from local ethics committees. The Israel case describes the intricacies of working with asylum seekers in non-camp settings, benefits for participants, the threat of deportation, the risk of participant reliance on researchers for support services, working as a cultural liaison, and the potential for hostility from the government. The chapter underscores the unique challenges stemming from the complexity and diversity of these populations. Finally, it provides guidelines and recommendations for ethical review boards evaluating proposals for research with forcibly displaced populations.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131843331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/OSO/9780198814733.003.0003
D. Reidpath, P. Allotey
In this chapter, the authors outline the layers of disadvantage that exist for refugees within the context of national policies that restrict their access to services, including health care and social services, in countries where they hope to seek refuge, despite the existence of long-standing international conventions on the rights of refugees and other displaced persons. The chapter explores theories that entrench othering and social exclusion of these populations. The authors also outline the potential entry points to addressing the health of refugees and other migrants as a result of recent initiatives offered through the Sustainable Development Agenda and universal health coverage.
{"title":"Social exclusion, othering, and refugee health policy","authors":"D. Reidpath, P. Allotey","doi":"10.1093/OSO/9780198814733.003.0003","DOIUrl":"https://doi.org/10.1093/OSO/9780198814733.003.0003","url":null,"abstract":"In this chapter, the authors outline the layers of disadvantage that exist for refugees within the context of national policies that restrict their access to services, including health care and social services, in countries where they hope to seek refuge, despite the existence of long-standing international conventions on the rights of refugees and other displaced persons. The chapter explores theories that entrench othering and social exclusion of these populations. The authors also outline the potential entry points to addressing the health of refugees and other migrants as a result of recent initiatives offered through the Sustainable Development Agenda and universal health coverage.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130074418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/oso/9780198814733.003.0013
M. Grodin, S. Crosby, G. Annas
Over 25 years of experience from the field have resulted in important lessons learned concerning how to best approach the multifaceted, complex treatment of immigrants and refugees. Continuing this work, it is important to educate medical communities about tried-and-true best practices and cultural sensitivity, as well as the integration of culturally-related practices in different clinical contexts. The medical model is inadequate to address the systematic challenges inherent in caring for displaced and traumatized populations. Beyond the clinical realm, systems are needed to advocate on behalf of immigrant and refugee communities using policy and law instruments; system-level intervention is the most effective way to address structural barriers to the highest possible standard of health and human rights.
{"title":"The politics of immigrant and refugee health in the United States","authors":"M. Grodin, S. Crosby, G. Annas","doi":"10.1093/oso/9780198814733.003.0013","DOIUrl":"https://doi.org/10.1093/oso/9780198814733.003.0013","url":null,"abstract":"Over 25 years of experience from the field have resulted in important lessons learned concerning how to best approach the multifaceted, complex treatment of immigrants and refugees. Continuing this work, it is important to educate medical communities about tried-and-true best practices and cultural sensitivity, as well as the integration of culturally-related practices in different clinical contexts. The medical model is inadequate to address the systematic challenges inherent in caring for displaced and traumatized populations. Beyond the clinical realm, systems are needed to advocate on behalf of immigrant and refugee communities using policy and law instruments; system-level intervention is the most effective way to address structural barriers to the highest possible standard of health and human rights.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126468513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/OSO/9780198814733.003.0009
S. Bissell, J. Bhabha
An unprecedented number of young people are crossing borders; many more are ‘internally displaced’. This chapter explores the vulnerability and resilience of refugee children and adolescents. It examines standards and policies designed to protect and enable these young people to survive and thrive. Given the growth in its importance, the matter of minors being ‘returned’ to countries of origin is also examined. This is followed by an analysis of some real-life situations in which these standards and policies are applicable. What is ultimately clear is that for a range of reasons—including the political and the practical—there are growing challenges to the safety of children and youth who are ‘on the move’.
{"title":"The health challenges facing children on the move","authors":"S. Bissell, J. Bhabha","doi":"10.1093/OSO/9780198814733.003.0009","DOIUrl":"https://doi.org/10.1093/OSO/9780198814733.003.0009","url":null,"abstract":"An unprecedented number of young people are crossing borders; many more are ‘internally displaced’. This chapter explores the vulnerability and resilience of refugee children and adolescents. It examines standards and policies designed to protect and enable these young people to survive and thrive. Given the growth in its importance, the matter of minors being ‘returned’ to countries of origin is also examined. This is followed by an analysis of some real-life situations in which these standards and policies are applicable. What is ultimately clear is that for a range of reasons—including the political and the practical—there are growing challenges to the safety of children and youth who are ‘on the move’.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"os-52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127791351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.1093/OSO/9780198814733.003.0012
C. McMichael, C. Nunn
Research involving resettled refugees presents many complexities. In particular, how do we engage ethically with research participants and also ensure that the data we produce is rigorous and makes a productive contribution to knowledge about refugee health? This chapter reflects on two qualitative research projects involving people from refugee backgrounds who have resettled in Victoria, Australia: one project with refugee-background women living in the capital city, Melbourne; another with refugee-background youth living in Bendigo, a regional city. Both projects focused on refugee settlement and psychosocial health. Focusing on three key aspects of the research process: conceptualizing the field site, ethics in practice and qualitative research methods, we suggest that the dual imperatives of refugee research—significance to people with refugee backgrounds and relevant agencies, institutions and governments, and ethical and rigorous research practice—are best served by a reflexive, sensitive and creative relationship with both the research process and with refugee-background participants.
{"title":"Conducting health research with resettled refugees in Australia: field sites, ethics, and methods","authors":"C. McMichael, C. Nunn","doi":"10.1093/OSO/9780198814733.003.0012","DOIUrl":"https://doi.org/10.1093/OSO/9780198814733.003.0012","url":null,"abstract":"Research involving resettled refugees presents many complexities. In particular, how do we engage ethically with research participants and also ensure that the data we produce is rigorous and makes a productive contribution to knowledge about refugee health? This chapter reflects on two qualitative research projects involving people from refugee backgrounds who have resettled in Victoria, Australia: one project with refugee-background women living in the capital city, Melbourne; another with refugee-background youth living in Bendigo, a regional city. Both projects focused on refugee settlement and psychosocial health. Focusing on three key aspects of the research process: conceptualizing the field site, ethics in practice and qualitative research methods, we suggest that the dual imperatives of refugee research—significance to people with refugee backgrounds and relevant agencies, institutions and governments, and ethical and rigorous research practice—are best served by a reflexive, sensitive and creative relationship with both the research process and with refugee-background participants.","PeriodicalId":298255,"journal":{"name":"The Health of Refugees","volume":"253 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114188479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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