Abstract
Good mental health is essential to successful integration for refugee populations that resettle in the U.S. We explored perceptions of mental illnesses and barriers to mental health service use as well as solutions to current mental health problems from the perspective of refugees. The interviews with a convenience sampling of 11 community leaders (6 men and 5 women) from various Burmese ethnic communities revealed three major categories, including sources of mental illnesses (e.g. traumatic experiences and post-resettlement challenges), barriers to service use (e.g. lack of understanding about mental health, linguistic challenges, cultural stigma, alternative treatments, and unresponsive system), and proposed community solutions (e.g. community education, culturally-competent providers, and beyond mental health treatment). The findings suggest that the ethnic community can be a source of potential solutions to mitigate barriers to mental health service use.
References
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Cardozo, B. L., Talley, L., Burton, A., & Crawford, C. (2004). Karenni refugees living in Thai-Burmese border camps: Traumatic experiences, mental health outcomes, and social functioning. Social Science and Medicine, 58(12), 2637–2644. https://doi.org/10.1016/j.socscimed.2003.09.024.
Chan, Z. C. Y., Fung, Y., & Chien, W. (2013). Bracketing in phenomenology: Only undertaken in the data collection and analysis process? The Qualitative Report, 18, 1–9.
Charmaz, K. (2014) Constructing grounded theory (2nd ed.). Sage.
Colucci, E., Szwarc, J., Minas, H., Paxton, G., & Guerra, C. (2014). The utilisation of mental health services by children and young people from a refugee background: A systematic literature review. International Journal of Culture and Mental Health, 7(1), 86–108. https://doi.org/10.1080/17542863.2012.713371.
Johnson, H., & Thompson, A. (2008). The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review. Clinical psychology review, 28(1), 36–47. https://doi.org/10.1016/j.cpr.2007.01.017.
Kim, I. (2018). Behavioral Health symptoms among refugees from Burma: Examination of sociodemographic and migration-related factors. Asian American Journal of Psychology, 9(3), 179–189. https://doi.org/10.1037/aap0000103.
Kim, I., & Kim, W. (2014). Post-resettlement challenges and mental health of Southeast Asian refugees in the United States. Best Practices in Mental Health, 10(2), 63–77. https://doi.org/10.1007/s10903-015-0251-8.
Lee, S., & Matejkowski, J. (2012). Mental health service utilization among noncitizens in the United States: Findings from the National Latino and Asian American Study. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 406–418. https://doi.org/10.1007/s10488-011-0366-8.
Liu, X., Cook, G., & Cattan, M. (2017). Support networks for Chinese older immigrants accessing English health and social services: The concept of bridge people. Health and Social Care in the Community, 25(2), 667–677. https://doi.org/10.1111/hsc.12357.
Morris, M. D., Popper, S. T., Rodwell, T. C., Brodine, S. K., & Brouwer, K. C. (2009). Healthcare barriers of refugees post-resettlement. Journal of Community Health, 34(6), 529–538. https://doi.org/10.1093/bjsw/bcw076.
Refugee Processing Center. (2019). Admissions and arrivals. U.S. Department of State. Retrieved December 11, 2019 from https://www.wrapsnet.org/Reports/InteractiveReporting/tabid/393/Default.aspx
Saechao, F., Sharrock, S., Reicherter, D., Livingston, J. D., Aylward, A., Whisnant, J., et al. (2012). Stressors and barriers to using mental health services among diverse groups of first-generation immigrants to the United States. Community Mental Health Journal, 48(1), 98–106. https://doi.org/10.1007/s10597-011-9419-4.
Schweitzer, R. D., Brough, M., Vromans, L., & Asic-Kobe, M. (2011). Mental health of newly arrived Burmese refugees in Australia: Contributions of pre-migration and post-migration experience. Australian and New Zealand Journal of Psychiatry, 45(4), 299–307. https://doi.org/10.3109/00048674.2010.543412.
Shannon, P., O'Dougherty, M., & Mehta, E. (2012a). Refugees' perspectives on barriers to communication about trauma histories in primary care. Mental Health in Family Medicine, 9(1), 47–55.
Shannon, P. J. (2014). Refugees’ advice to physicians: How to ask about mental health. Family Practice, 31(4), 462–466. https://doi.org/10.1093/fampra/cmu017.
Shannon, P. J., Im, H., Becher, E., Simmelink, J., Wieling, E., & O’Fallon, A. (2012b). Screening for war trauma, torture, and mental health symptoms among newly arrived refugees: A national survey of U.S. Refugee health coordinators. Journal of Immigrant & Refugee Studies, 10(4), 380–394. https://doi.org/10.1080/15562948.2012.674324.
Shannon, P. J., Vinson, G. A., Wieling, E., Cook, T., & Letts, J. (2014). Torture, war trauma, and mental health symptoms of newly arrived Karen refugees. Journal of Loss and Trauma. https://doi.org/10.1080/15325024.2014.965971.
Shannon, P. J., Wieling, E., Simmelink-McCleary, J., & Becher, E. (2015). Beyond stigma: Barriers to discussing mental health in refugee populations. Journal of Loss and Trauma, 20(3), 281–296. https://doi.org/10.1080/15325024.2014.934629.
Simmelink, J. A., & Shannon, P. J. (2012). Evaluating the mental health training needs of community-based organizations serving refugees. Advances in Social Work, 13(2), 325–339. https://doi.org/10.18060/1963.
Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: A systematic review and meta-analysis. JAMA, 302(5), 537–549. https://doi.org/10.1001/jama.2009.1132.
Tufford, L., & Newman, P. (2010). Bracketing in qualitative research. Qualitative Social Work, 11, 80–96. https://doi.org/10.1177/1473325010368316.
Wong, E. C., Marshall, G. N., Schell, T. L., Elliott, M. N., Hambarsoomians, K., Chun, C.-A., et al. (2006). Barriers to mental health care utilization for US Cambodian refugees. Journal of Consulting and Clinical Psychology, 74(6), 1116–1120. https://doi.org/10.1037/0022-006X.74.6.1116.
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Kim, W., Yalim, A.C. & Kim, I. “Mental Health Is for Crazy People”: Perceptions and Barriers to Mental Health Service Use among Refugees from Burma. Community Ment Health J 57, 965–972 (2021). https://doi.org/10.1007/s10597-020-00700-w
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DOI: https://doi.org/10.1007/s10597-020-00700-w