Common Mental Health Problems in Immigrants and Refugees: General Approach in Primary Care
CMAJ
This paper summarizes risk factors and strategies in the approach to mental health assessment, and to prevention and treatment of common mental health problems for immigrants in primary care.

Summary of Clinical Preventive Care Recommendations for Newly Arriving Immigrants and Refugees to Canada
CMAJ
This article (2010) outlines the specific health risks encountered by subgroups of immigrants that are due to different disease exposures and genetic predispositions,  social and cultural determinants, and variation in access to health services. Clinical preventive recommendations covering cervical cancer, depression, contraception, hepatitis B, HIV, iron-deficiency anemia, oral health, pregnancy, tuberculosis and vision health are presented in this article.

Evidence-based Clinical Guidelines for Immigrants and Refugees
CMAJ
This article, prepared by the CCIRH, outlines preventive health care guidelines  for newcomers to Canada in the first 5 years after resettlement. This article discusses clinical preventive care and emphasize the need for informed care based on the person’s region or country of origin as well as migration history (e.g., forced vs. voluntary migration). Health risks are discussed from both physical and psychosocial perspectives that may be unique to immigrants and refugees. These may include limited language proficiency, required vaccination, the need for screening for region-specific disorders, malaria detection, depression, post-traumatic stress disorder, child maltreatment, intimate partner violence, or unmet contraceptive needs.

For guidelines on specific mental health conditions see:

Best Practice Guidelines for Mental Health Promotion Programs: Refugees
Centre for Addiction and Mental Health (CAMH)
This document provides guidelines on the implementation of mental health promotion practices and is intended for service providers working with refugee populations in Canada. It includes reviews of current mental health promotion programs and addresses the experiences of refugees from different countries.

The Refugee Mental Health Online Courses
The Refugee Mental Health Project aims to build health care professionals’ and settlement workers’ knowledge and skills regarding refugee mental health issues. The aim of this initiative is to contribute to an informed, sustainable network of service provision. hese courses are intended to enhance service providers’ knowledge, communication, comfort and cultural competence when working with refugee clients. The self-directed courses are free and are offered to  health care professionals and settlement counselors/social workers/social service providers who work directly with refugees.

WPA Guidance on Mental Health and Mental Health Care in Migrants
This paper reviews current evidence on mental health problems in migrants and presents advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The three phases of the migration process and the relevant implications for mental health are outlined, as well as the specific problems of groups such as women, children and adolescents, the elderly, refugees and asylum seekers, and lesbian, gay, bisexual and transgender individuals. The concepts of cultural bereavement, cultural identity and cultural congruity are discussed.

Refugee Health Technical Assistance Center (RHTAC)
This U.S. Center consists of five organizations dedicated to improving the quality of health services for refugees. The RHTAC aims to improve the well-being of refugees by providing tools, resources, and support for health and mental health providers.Watch a Webinar on Tools and Strategies for Refugee Mental Health Screening.

Cultural Consultation for Refugees
This chapter focuses primarily on the situation of refugee claimants. After presenting the legal definition of a refugee, there is a brief overview of pre-migratory, transit, and postmigratory factors that may affect refugee claimants’ psychosocial status, including a more detailed discussion of two com- mon postmigratory problems: detention and family separation. The next section examines clinical intervention with refugee claimants, particularly the assessment and treatment of posttraumatic symptoms. Finally, there is a discussion of the ways in which clinicians may act upon the social determinants of refugee claimants’ health, including a detailed explanation of how to write a report in the context of refugee status proceedings.

Role of Psychological Evidence in Refugee Decision-making
The following articles from the Trauma and Mental Health Unit, School of Psychiatry, University New South Wales report on findings from a mental health and legal analysis of a series of refugee decisions involving the submission of psychological evidence.

  • Tay K, Frommer N, Hunter J, Silove D, Pearson L, Roque MS, Redman R, Bryant RA, Manicavasagar V, Steel Z. A mixed-method study of expert psychological evidence submitted for a cohort of asylum seekers undergoing refugee status determination in Australia. Social Science & Medicine. 2013;98:106-115.
  • Hunter J, Pearson L, San Roque M, Steel Z. Asylum adjudication, mental health and credibility evaluation. Federal Law Review. 2014;41(3):471-495.

Mental health professionals,  legal representatives, and decision/policy makers can also access detailed guidelines about improving the quality and interpretation of psychological evidence. These guidelines are especially useful for those involved in providing mental health and cultural assessments of asylum seekers as part of the refugee determination procedure. For more information contact:

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