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Social Work with Refugees and Migrants

  • Maree HigginsEmail author
Living reference work entry
Part of the Social Work book series (SOWO)

Abstract

Migration, and particularly forced migration, creates unique psychosocial vulnerabilities that bring affected individuals, families, and communities into contact with social workers and mental health systems. Longitudinal studies with migrant and refugee communities indicate that mental health often remains low years after resettlement in Western countries, particularly due to marginalization and social exclusion which layers upon experiences of trauma and loss. Conversely, unique resilience factors are also present in migrant and refugee communities, including their constructions of health and illness and community values and beliefs. Notably, the biomedical model, which is dominant in the field of mental health, tends to pathologize and medicalize distress and may denigrate or ignore diverse perspectives on health and illness. Broader economic, social, and political factors that impact so profoundly on mental health of migrants and refugees are also often ignored by service provision that is underpinned by biomedical models of care. This chapter draws upon scholarly evidence to explore these intersecting themes and then propose essential knowledge, skills, and values for mental health-focused social work. The chapter describes how social workers can integrate clinical and critical perspectives in practice and, by harnessing lived experience and cultural expertise of people from refugee and migrant backgrounds, enhance power and autonomy; restore individual, family, and community well-being; facilitate safe and effective intercultural interactions; and advance principles of social justice. It argues for a model of mental health practice that is deeply attuned to diverse constructions of health and illness, holistic, justice-oriented, and informed by expertise from below.

Keywords

Refugees Migrants Mental health and illness Lived experience Risk factors Cultural shape of resilience Transforming the foreign 

References

  1. AIHW (2019) Mental health services in Australia 2019 V20.0: web report. Media release. Australian Institute for Health and Welfare (AIHW), CanberraGoogle Scholar
  2. Allan J (2009) Weaving together the personal and the political in loss and grief. In: Allan J, Briskman L, Pease B (eds) Critical social work: theories and practices for a socially just world. Allen & Unwin, Crows NestGoogle Scholar
  3. American Psychological Association (APA) (2014) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Retrieved 28 Apr 2019, from https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
  4. Andary L et al (2003) Assessing mental health across cultures. Australian Academic Press, Bowen HillsGoogle Scholar
  5. Australian Association of Social Workers (AASW) (2014) Practice standards for mental health social workers. Australian Association of Social Workers, CanberraGoogle Scholar
  6. Bates L et al (2005) Sudanese refugee youth in foster care: the “lost boys” in America. Child Welfare 84(5):631–648Google Scholar
  7. Bhugra D et al (2014) EPA guidance mental health care of migrants. Eur Psychiatry 29(2):107–115CrossRefGoogle Scholar
  8. Black Dog Institute (2018) Treatments for post-traumatic stress disorder. Retrieved 28 Apr 2019, from https://www.blackdoginstitute.org.au/clinical-resources/post-traumatic-stress-disorder/treatment
  9. Bland R et al (2015) Social work practice in mental health: an introduction. Allen & Unwin, Crows NestGoogle Scholar
  10. Briskman L et al (2008) Human rights overboard: seeking asylum in Australia. Scribe Publications, Carlton NorthGoogle Scholar
  11. Brown C et al (2010) Vietnamese immigrant and refugee women’s mental health: an examination of age of arrival, length of stay, income, and English language proficiency. J Multicult Couns Dev 38:66–76CrossRefGoogle Scholar
  12. Centers for Disease Control and Prevention (2013) Suicide and suicidal ideation among Bhutanese refugees – United States, 2009–2012. MMWR Morb Mortal Wkly Rep 62(26):533–536Google Scholar
  13. Chantler K (2012) Gender, asylum seekers and mental distress: challenges for mental health social work. Br J Soc Work 42(2):318–334CrossRefGoogle Scholar
  14. Colic-Peisker V, Tilbury F (2007) Refugees and employment: the effect of visible difference on discrimination. Final report. Centre for Social and Community Research, Murdoch University, PerthGoogle Scholar
  15. Collins S et al (2010) Enhancing reflective practice in multicultural counseling through cultural auditing. J Couns Dev 88(3):340–348CrossRefGoogle Scholar
  16. Congress E, Kung W (2013) Using the culturagram to assess and empower culturally diverse families. In: Congress E, Gonzalez M (eds) Multicultural perspectives in social work practice with families. Springer Publishing Company, New York, pp 2–21Google Scholar
  17. Connolly M, Healy K (2018) Social work practice theories and frameworks. In: Connolly M, Harms L, Maidment J (eds) Social work: contexts and practice. Oxford University Press, South Melbourne, pp 19–33Google Scholar
  18. Cummings S et al (2011) Correlates of depression among older Kurdish refugees. Soc Work 56(2):159–168CrossRefGoogle Scholar
  19. de Arellano MAR et al (2014) Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence. Psychiatr Serv 65(5):591–602CrossRefGoogle Scholar
  20. De Haene L et al (2010) Adult attachment in the context of refugee traumatisation: the impact of organised violence and forced separation on parental states of mind regarding attachment. Attach Hum Dev 12(3):249–264CrossRefGoogle Scholar
  21. Deacon Z, Sullivan C (2009) Responding to the complex and gendered needs of refugee women. AFFILIA 24(3):272–284CrossRefGoogle Scholar
  22. Drummond PD et al (2011) Barriers to accessing health care services for West African refugee women living in Western Australia. Health Care Women Int 32(3):206–224CrossRefGoogle Scholar
  23. Fanon F (2004) On national culture. The wretched of the Earth. Grove Press, New YorkGoogle Scholar
  24. Fazel M et al (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365(9467):1309–1314CrossRefGoogle Scholar
  25. Ferrada-Noli M et al (1998) Suicidal behavior after severe trauma. Part 1: PTSD diagnoses, psychiatric comorbidity, and assessments of suicidal behavior. J Trauma Stress 11(1):103–112CrossRefGoogle Scholar
  26. Flatau P et al (2014) Refugees, housing, and neighbourhoods in Australia. AHURI final report no. 224. Australian Housing and Urban Research Institute Limited, MelbourneGoogle Scholar
  27. Fozdar F, Hartley L (2013) Refugee resettlement in Australia: what we know and need to know. Refug Surv Q 32(3):23–51CrossRefGoogle Scholar
  28. Gilliver SC et al (2014) Recent research on the mental health of immigrants to Sweden: a literature review. Eur J Public Health 24(Suppl 1):72–79CrossRefGoogle Scholar
  29. Gušić S et al (2017) Dissociative experiences and trauma exposure among newly arrived and settled young war refugees. J Aggress Maltreat Trauma 26(10):1132–1149CrossRefGoogle Scholar
  30. Han M et al (2012) Development and implementation of the culturally competent program with Cambodians: the pilot psycho-social-cultural treatment group program. J Ethn Cult Divers Soc Work 21(3):212–230CrossRefGoogle Scholar
  31. Hansson E et al (2012) Rates of mental illness and suicidality in immigrant, refugee, ethnocultural, and racialised groups in Canada: a review of the literature. Can J Psychiatry 57(2):111–121CrossRefGoogle Scholar
  32. Higgins M (2019) ‘Like gold scattered in the sand’: human rights as constructed and understood by African families from refugee backgrounds. Faculty of Health Sciences, School of Allied Health Sydney, NSW, Australian Catholic University. Doctor of PhilosophyGoogle Scholar
  33. Hightower B (2015) Refugees, limbo and the Australian media. Int J Semiot Law 28:335–358CrossRefGoogle Scholar
  34. Hollander A-C et al (2011) Gender-related mental health differences between refugees and non-refugee immigrants – a cross-sectional register-based study. BMC Public Health 11:180–186CrossRefGoogle Scholar
  35. Hughes G (2014) Finding a voice through ‘The Tree of Life’: a strength-based approach to mental health for refugee children and families in schools. Clin Child Psychol Psychiatry 19(1): 139–153CrossRefGoogle Scholar
  36. Hutchinson M, Dorsett P (2012) What does the literature say about resilience in refugee people? Implications for practice. J Soc Incl 3(2):55–78Google Scholar
  37. Hynie M (2018) The social determinants of refugee mental health in the post-migration context: a critical review. Can J Psychiatry 63(5):297–303CrossRefGoogle Scholar
  38. Ife J (2010) Human rights from below: achieving rights through community development. Cambridge University Press, MelbourneGoogle Scholar
  39. Ife J (2016) Community development in an uncertain world: vision, analysis and practice. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  40. IOM (2018) Global migration indicators 2018: insights from the global migration portal. United Nations, BerlinGoogle Scholar
  41. Jatrana S et al (2017) Investigating the dynamics of migration and health in Australia: a longitudinal study. Eur J Popul 34:519CrossRefGoogle Scholar
  42. Kaplan I (2009) Effects of trauma and the refugee experience on psychological assessment processes and interpretation. Aust Psychol 44(1):6–15CrossRefGoogle Scholar
  43. Lacroix M, Sabbah C (2011) Posttraumatic psychological distress and resettlement: the need for a different practice in assisting refugee families. J Fam Soc Work 14(1):45–53Google Scholar
  44. Lejukole JW-KL (2008) ‘We will do it our own ways’: a perspective of southern Sudanese refugees resettlement experiences in Australian Society. School of Social Sciences: Anthropology. Adelaide, The University of Adelaide. Doctor of PhilosophyGoogle Scholar
  45. Lenette C (2014) ‘I am a widow, mother and refugee’: narratives of two refugee widows resettled to Australia. J Refug Stud 27(3):403–421CrossRefGoogle Scholar
  46. Lenette C (2019) Mental health and critical multicultural practice: an arts-based approach. In: Nipperess S, Williams C (eds) Critical Multicultural practice in social work: new perspectives and practices. Allen & Unwin, Crows NestGoogle Scholar
  47. Leuder I et al (2008) Hostility themes in media, community and refugee narratives. Discourse Soc 19(2):187–221CrossRefGoogle Scholar
  48. Losoncz I (2011) Blocked opportunity and threatened identity: understanding experiences of disrespect in South Sudanese Australians. Australas Rev Afr Stud 32(2):118–142Google Scholar
  49. Martin SS (2009) Illness of the mind or illness of the spirit? Mental health-related conceptualization and practices of older Iranian immigrants. Health Soc Work 34(2):117–126CrossRefGoogle Scholar
  50. Martinez O et al (2015) Evaluating the impact of immigration policies on health status among undocumented immigrants: a systematic review. J Immigr Minor Health 17(3):947–970CrossRefGoogle Scholar
  51. McKeary M, Newbold B (2010) Barriers to care: the challenges for Canadian refugees and their health care providers. J Refug Stud 23(4):523–545CrossRefGoogle Scholar
  52. McPherson J (2012) Does narrative exposure therapy reduce PTSD in survivors of mass violence? Res Soc Work Pract 22(1):29–42CrossRefGoogle Scholar
  53. Milos D (2011) South Sudanese communities and Australian family law: a clash of systems. Australas Rev Afr Stud 32(2):143–159Google Scholar
  54. Minas H et al (2013) Mental health research and evaluation in multicultural Australia: developing a culture of inclusion. Int J Ment Heal Syst 7(1):23CrossRefGoogle Scholar
  55. Mitschke DB et al (2016) Listening to refugees: how traditional mental health interventions may miss the mark. Int Soc Work 60(3):588–600CrossRefGoogle Scholar
  56. Muchoki S (2013) ‘[In Australia] what comes first are the women, then children, cats, dogs, followed by men’: exploring accounts of gender relations by men from the Horn of Africa. Australas Rev Afr Stud 34(2):78–98Google Scholar
  57. Nadan Y et al (2015) The political dimension of multicultural social work education. J Soc Work 16(3):362–379CrossRefGoogle Scholar
  58. Ochala Y, Mungai NW (2016) The challenges facing single female parents of African background in regional Australia. Aust Soc Work 69(3):311–322CrossRefGoogle Scholar
  59. Olliff L (2010) Finding the right time and place: exploring post-compulsory education and training pathways for young people from refugee backgrounds in NSW. Retrieved 28 Apr 2019, from https://www.nswtf.org.au/files/finding_the_right_time_and_place.pdf
  60. Pavlish CL et al (2010) Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med 71:353–361CrossRefGoogle Scholar
  61. Poon AWC, Lee J-S (2019) Carers of people with mental illness from culturally and linguistically diverse communities. Aust Soc Work 72(3):312–324CrossRefGoogle Scholar
  62. Pupavac V (2008) Refugee advocacy, traumatic representations and political disenchantment. Gov Oppos 43(2):270–292CrossRefGoogle Scholar
  63. RCOA (2010) Economic, civic and social contributions of refugees and humanitarian entrants: a literature review. http://www.refugeecouncil.org.au/docs/resources/Contributions_of_refugees.pdf
  64. RCOA (2011) Australia’s refugee program: services for refugees. http://www.refugeecouncil.org.au/arp/ihss.html
  65. Renzaho AMN, Vignjevic S (2011) The impact of a parenting intervention in Australia among refugees and migrants from Sierra Leone, Congo, and Burundi: results from the African Migrant Parenting Program. J Fam Stud 17(1):71–79CrossRefGoogle Scholar
  66. Saechao F et al (2012) Stressors and barriers to using mental health services among diverse groups of first-generation immigrants to the United States. Community Ment Health J 48:98–106CrossRefGoogle Scholar
  67. Seah E et al (2002) Cultural awareness tool: understanding cultural diversity in mental health. Multicultural Mental Health Australia, ParramattaGoogle Scholar
  68. Shannon P et al (2012) Screening for war trauma, torture, and mental health symptoms among newly arrived refugees: a national survey of U.S. refugee health coordinators. J Immigr Refug Stud 10(4):380–394CrossRefGoogle Scholar
  69. Shier ML et al (2011) International migration and social work: a review of the literature. J Immigr Refug Stud 9(1):38–56CrossRefGoogle Scholar
  70. Sleijpen M et al (2016) Between power and powerlessness: a meta-ethnography of sources of resilience in young refugees. Ethn Health 21(2):158–180CrossRefGoogle Scholar
  71. Teodorescu DS et al (2012) Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway. Scand J Psychol 53:316–332CrossRefGoogle Scholar
  72. Thomson MS et al (2015) Improving immigrant populations’ access to mental health services in Canada: a review of barriers and recommendations. J Immigr Minor Health 17:1895–1905CrossRefGoogle Scholar
  73. Tinghög P et al (2010) The association of immigrant- and non-immigrant-specific factors with mental ill health among immigrants in Sweden. Int J Soc Psychiatry 56(1):74–93CrossRefGoogle Scholar
  74. Turrini G et al (2019) Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiol Psychiatr Sci 384–385Google Scholar
  75. UNHCR (2016) UNHCR viewpoint: ‘refugee’ or ‘migrant’ – which is right? https://www.unhcr.org/news/latest/2016/7/55df0e556/unhcr-viewpoint-refugee-migrant-right.html
  76. UNHCR (2019a) Figures at a glance. Retrieved 28 Apr 2019, from https://www.unhcr.org/en-au/figures-at-a-glance.html
  77. Westoby P, Ingamells A (2010) A critically informed perspective of working with resettling refugee groups in Australia. Br J Soc Work 40(1):1759–1776CrossRefGoogle Scholar
  78. World Health Organisation (2014) Mental health: a state of wellbeing. Retrieved 28 Apr 2019, from https://www.who.int/features/factfiles/mental_health/en/
  79. Ziersch A, Due C (2018) A mixed methods systematic review of studies examining the relationship between housing and health for people from refugee and asylum seeking backgrounds. Soc Sci Med 213:199–219CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.School of Social SciencesUNSW SydneySydneyAustralia

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