The Mental Health of Refugees: Ecological Approaches to Healing and Adaptation

The Mental Health of Refugees: Ecological Approaches to Healing and Adaptation

The Mental Health of Refugees: Ecological Approaches to Healing and Adaptation

The Mental Health of Refugees: Ecological Approaches to Healing and Adaptation

Synopsis

It is estimated that at least 33 million people around the world have been displaced from their homes by war or persecution. Numerous studies have documented high rates of psychological distress among these survivors of extreme violence and forced migration, yet very few have access to clinic-based mental health care. In any case, clinic-based services cannot adequately address the constellation of displacement-related stressors that affect refugees daily, whether in a new region of their homeland or a new country--stressors such as social isolation, the loss of previously valued social roles, poverty and a lack of employment opportunities, and difficulties obtaining education and medical care. Additionally, many refugees from non-western societies find western methods of psychiatric and psychological healing culturally alien or stigmatizing, and therefore underutilize such services. This book brings together an international group of experts on the mental health of refugees who have pioneered a new approach to healing the psychological wounds of war and forced migration. Their work is guided by an ecological model, which, in contrast to the prevailing medical model of psychiatry and clinical psychology, emphasizes the development of culturally grounded mental health interventions in non-stigmatized community settings. The ecological model also prioritizes synergy with natural community resources to promote adaptation, prevention over treatment, the active involvement of community members in all phases of the intervention process, and the empowerment of marginalized communities to address their own mental health needs. Drawing on their expertise in community psychology, preventionscience, anthropology, social psychology, social psychiatry, public health and child development, the authors present a variety of highly innovative, culturally grounded interventions designed to improve the mental health and psy

Excerpt

At the dawn of the 21 century, we are living in a time of remarkable technological achievement, of extraordinary advancements in our ability to treat and prevent an ever-widening range of disease, and of an expanding global economy that links together the most geographically distant communities. Against this backdrop of impressive development, it is disheartening to observe how little distance we have traveled toward the creation of a more socially, economically, and environmentally just world community. Repressive regimes flourish, often with the covert aid of industrialized nations who profess a deep commitment to democratic ideals. the disparity in wealth between nations of the southern and northern hemispheres continues to worsen, with hundreds of millions of people in developing countries living on the equivalent of a dollar a day, and millions dying of preventable and treatable diseases. Multinational corporate profit is frequently prioritized over the basic human and civil rights of impoverished communities that provide inexpensive labor under conditions of exploitation and stark repression; and extreme ethnic violence, at times reaching the level of genocide, is allowed to proceed essentially unopposed while politicians offer moving speeches honoring the victims of the Nazi Holocaust and promise that such horrors will never again be allowed to occur.

Violent conflict, ethnic and political persecution, and state sanctioned repression continue to drive millions of people into exile or internal displacement, forcing them to leave behind their homes, their communities, and for many, their homelands. Many are forced to flee with little time to prepare for the journey of exile, and carry with them only their most essential and portable possessions. They leave behind houses, plots of land passed down through generations, family members and friends unable or unwilling to go into exile; proximity to the graves of ancestors; and the sense of belonging that comes with living in one's own culture, as a member of one's own community, a citizen of one's own country. They flee after having witnessed the death of loved ones, the destruction of their property, and the humiliation of family members, friends, and neighbors at the hands of sadistic armed combatants; and they flee after enduring their own experiences of physical and sexual violence, arbitrary detention, and prolonged fear and vulnerability. They leave not in search of a better life, but simply to survive, because survival in their own homes and communities has become tenuous if not altogether impossible. They seek safe haven, and many hold tightly to the dream of an eventual return home. History has demonstrated repeatedly, however, that the . . .

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