Exploring how to Improve Mental Health Help-Seeking by Refugees

Newly resettled refugees are among the most vulnerable population to physical and mental health disorders (Nazzal et al., 2014), and those from the African Great Lakes Region are not an exception. Although the US serves as a safe place for refugees, many come with their past traumatic and painful experiences from their home countries, which impact their emotional and mental well-being. Due to life-threatening experiences during war, in exile and during the resettlement process, refugees may be at a particularly high risk for mental disorder symptoms (CDC, 2012). Refugees who have been exposed to severe violence in their countries of origin are at risk for trauma-related disorders such as PTSD and major depressions. According to Nazzal et al. (2014), many refugees suffer from mental health issues as they go through the resettlement process in their new host country. Likewise, studies have shown that the prevalence rates of mental disorders increase with time as refugees faces their daily life stressors (Marija, 2012). However, because of numerous barriers to accessing the mental health services, refugees do not always access mental health services when needed.

Thus, in its effort to respond to the growing concern about refugees' mental health, the Center for Disease Control and Prevention has developed a guideline for incorporating mental health screenings for newly arrived refugees into the domestic medical examination process (CDC, 2012). In the same line, during fiscal year 2016, the Office of Refugee Resettlement(ORR) funded a refugee mental health technical assistance project with the aim to offer refugee resettlement providers possibility to provide consultations on mental health screening and referrals, to train and build the capacity of resettlement organizations, to provide culturally appropriate mental health services and to facilitate research and usage of evidence-based mental health interventions (ORR, 2016).

As initiatives on refugee mental health immerge at local, state and federal level, the question remains to know to what extent do refugees can access mental health services (Shannon et al., 2015)? Studies and research have been conducted around mental health and refugees on varied aspects and concepts. Shannon et al. (2015) have explored mental health screening and capacity building through training for health coordinators. Refugee mental health screening is seen as an important step, but which require scrutiny to know the right time to do it. In their review, Murray et al. (2010) have focused their attention to the need for mental health interventions suitable to the different resettlement stages.

During the resettlement process, refugees receive a medical orientation and a physical health check at the Health Department clinic. Therefore, the needs for trauma related mental health for the newly resettled communities have been identified as a challenge to the public health system (Mcdonalds & Sand, 2011). Some researchers argue that during the first physical health check, the health care providers should assess mental health symptoms and trauma related behaviors within refugees (Citation to be inserted). Others consider that the first days of arrival may not be a good timing to assess mental health symptoms in refugees since they are still in the honeymoon stage, and henceforth, the assessment score may be skewed due to the state of mind of refugee at that phase.

Further to what the research has found regarding addressing mental health needs of refugees, it is imperative to acknowledge the role importance In order to address refugee mental health in a holistic way, those who serve them, especially resettlement agencies need to have accurate information to answer the following questions: What are the mental disorders commonly presented by newly resettled refugees? What are the major factors associated with poor mental health outcome in refugees? Do refugees seek help for mental health issues? How do resettlement agencies assist refugees with mental health related issues? What are the strengths and limitations of the resettlement agencies to address trauma related disorders? The following literature review will attempt to answer these questions while providing definitions for key terms as they have been used across different studies. It will also attempt to illustrate available research about the factors that may contribute to newly resettled refugee's mental health help-seeking, and to identify the gap that exist in current research.

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