Understanding the Mental Health Needs of Refugees

An interview with Jenny Hwang on the effects of forced migration.

Posted Mar 11, 2020 | Reviewed by Gary Drevitch

Jenny Hwang, used with permission
Source: Jenny Hwang, used with permission

Each day, refugees are forced from their homes. Most often, the places they go lack access to mental health resources. Luckily, work is being done to learn more about refugee mental health and address this growing worldwide need.

We interviewed Jenny Hwang to understand refugee mental health needs better. She is the Managing Director of the Humanitarian Disaster Institute at Wheaton College. She earned a bachelor’s degree in clinical psychology from Boston College and a master’s degree in international disaster psychology from the University of Denver. As an undergraduate, she worked at the Cambridge Women's Center with women who experienced violence, homelessness, mental illnesses, and trauma. She has worked in Cambodia with local organizations on preventative initiatives for human trafficking. While pursuing her master’s degree, she worked with refugees on a domestic level as part of the family stabilization unit of Lutheran Family Services. As the Managing Director of HDI, she administers and manages research activities of the Institute.

JA: How would you define refugee mental health?

JH: I do have some hesitancy using the term "refugee mental health" because, often, it can undermine the vastness of mental health concerns and implications of the refugee experience. It’s a term that seems nuanced but any practitioner who has ever worked with refugees will note the complexities of the term "refugee mental health" and its possible implications.

But to give a broad definition, I would say it is an overall concern for the well-being of anyone who has experienced forced migration; it is the unique attention to the mental health concerns that arise from this experience, which is often webbed in political oppression, exposure to violence, discrimination, socioeconomic burdens, disruptions of identity, acculturation, and more. 

JA: How can understanding mental health needs for refugees help our communities?

JH: Becoming educated on the experiences of forced migration and its possible mental health impact can help us think more critically about our existing mental health care accessibility not only in regard to physical access but also the diversity of culturally appropriate interventions.

We will start to move toward an attitude of inclusivity when people are concerned with the well-being of others; take into account the similarities and differences; and build appropriate resources. This fosters more resilient communities.

JA: What are some ways people can learn more about refugee mental health issues?

JH: There are great resources out there that provide general information on refugee issues worldwide such as the United Nations High Commissioner of Refugees (UNHCR), Amnesty International, and International Office of Migration (IOM). Organizations like the Center for Victims of Torture (CVT) and National Child and Traumatic Stress Network (NCTSN) provide great research, resources, and training focused specifically on psychological well-being.

But before we inundate ourselves with information about mental health challenges of forced migration, I think it’s vital to humanize the refugee experience and understand that forced migration is not a vacuumed issue happening in the distance. I would recommend getting in touch with your local refugee resettlement organizations, like Catholic Charities, World Relief or Lutheran Social Services, to learn about the refugee communities that exist in your own town and city. The first step begins with awareness.  

JA: Any advice for those working with refugees in their own communities or abroad?

JH: Collaborate. Helping people who have been forced to leave their homes can be incredibly challenging. Mental health for refugees involves more than addressing trauma. Everyday stressors like the uncertainty of the future, language barriers, health concerns, discrimination, and livelihood concerns are all crucial factors influencing mental health.

In the resettled refugee contexts, addressing the multitude of these concerns means taking an ecological framework by working collaboratively with a diverse team of lawyers, community navigators, social workers, doctors, advocates, and, when appropriate, religious leaders or indigenous healers.

In the international context, working collaboratively with the host communities (when applicable) and other organizations that are present allows a higher probability of engaging more holistic mitigation efforts. Also, the people you are hoping to serve are most likely the experts of their own needs. So engage, when feasible, the people you are serving as participatory agents.

JA: What projects are you currently working on?

JH: You and I are working on an edited book about refugee mental health that is geared toward practitioners working with resettled refugee communities. We purposively asked a diverse network of practitioners and researchers to contribute in hopes of drawing wisdom from many different mental health perspectives. In the book, we feature social workers, MDs, clinical psychologists, counseling psychologists, and lay counselors about their experience in working with resettled refugee communities.