Immigrants and refugees are vulnerable in health care perspectives. This is due to numerous economic, cultural, psychological, and social barriers. Most immigrants and refugees seek asylum in destitute state where they cannot make sound decisions. In most cases, they are evicted from their places of residence. In the process of resettling, they are faced with numerous challenges that include homelessness, unemployment, substandard living conditions, and destitution. Immigrants and refugees who resettle from overseas have a feeling of insecurity. Consequently, their state of lack of permanent accommodation decreases access to health care services. It is, therefore, important to formulate programs that would cater for the immigrants and refugees by ensuring that they have access to medical care.
Most immigrants and refugees who seek protection from other countries have no legal access to public funds because they are not eligible for local authority accommodation or health care benefits. Again, immigrants and refugees have no access to relevant information on health care services available to them in a host country. Still, most of them are suffering from mental illness due to the stigma they faced when being displaced. Immigrants and refugees are prone to numerous barriers, so eventually there is the need to develop a suitable medical program that should ensure that less protected have access to medical care. The program should break these barriers by creating a platform for the vulnerable community to exercise their right of accessing medical services.
Immigrants and refugees have several health service needs. Since these people have poor living conditions that are overcrowded in most cases, there is a need of developing a program that would minimize the spreading of communicable diseases. The program should also be focused on improving the overall health status of the refugees. The program should ensure that there is proper screening for diseases in the refugee camps. Vaccines and treatment on preventive diseases should be administered in time to ensure that people are not infected. The program should aim at preventing mental illness and improving the general mental health of the community. It must also facilitate special service and support for individuals with mental health problem. Special service support is essential in ensuring that the adult recover from the condition while children and youths maximize their mental wellness as they go through different stages of development.
According to statistics, most refugees and asylum seekers are vulnerable to self-harm and suicide due to the negative impact on their self-esteem, defective self-image, insufficient sense of belonging, and increased sense of insecurity. Unfortunately, these people do not access specialized mental health care to reassure them of safety and security. There is increased rate of depression, anxiety, and post traumatic stress disorder.
A survey conducted in Cambodian the largest community of refugees in US. Analytical sample of 339 persons who qualified a one year criteria for post-traumatic stress disorder, alcohol use disorder, and major depression disorder was used to represent the entire community. The survey reported high rates of contact with both medical care givers and mental health providers with 70% and 46% respectively. The rate of asylum seekers with PTSD is 62% while those reported to have major depression was 51%. These rates are excessive high as compared to those of general population, which is 3.5% with PTSD and 6.7% with major depression.
Despite the high rates of mental problems among the refugees, very few of this vulnerable group seek medical services. Only 9% of the victims receive mental health care. Socio-demographic aspect plays a role in seeking health medical care. For example, women are likely to seek mental health care services as opposed to men. Again, the chances of young adults seeking mental health care are higher than that of older adults.
Having understood the importance of providing mental health care for the asylum seekers, the community should take responsibility of ensuring that this vulnerable group has access to medical care. I would recommend introduction of a friendly forum that would encourage the asylum to have a sense of belonging. I urge the government and non-governmental organizations to ensure that the refugees and immigrants are assured of safety and are offered a better living condition. The program should be directed on that all the asylum seekers are screened of both physical and mental illness. Preventive measures should be taken to ensure that communicable diseases are eliminated from refugee camps. When individuals are diagnosed with mental disorder, therapy should be started immediately.
Individuals with post-traumatic stress disorder (PTSD) should be taken through psychotherapy (talk therapy) and medication. Psychotherapy for PTSD can be conducted on an individual basis or as a group. The reasonable for psychotherapy period ranges between six to twelve weeks, but the duration can be extended depending on the damage caused by the trauma. The treatment should be offered by a mental health caregiver who has experience with PTSD. If the patient is on an ongoing trauma, the issue needs to be addressed to avoid further damage and development of other mental disorders such as depression, panic disorder, feeling suicidal, and substance abuse. Family and friends support plays a significant role in this therapy.
A continuum of health care level should also be offered. A continuum of care involves a complete range of programs and services that are offered to a mentally ill patient by the community. The continuum of care for children and adolescents should begin with the caregiver concern on the child’s behavior and emotions. When there are signs of mental illness, the concerned party should involve the services of a qualified mental health professional to evaluate the condition of the child. When the professional evaluates the situation, he/she recommends the suitable program.
- Outpatient clinics which takes between 30-60 minutes per session. However, the number of sessions depends on individual needs.
- Intensive care management where specially trained personnel coordinate to ensure that the child lives successfully when at home or in the society.
- Home-based treatment services where a team of trained staff visit their patient at home and develop a treatment program that is suitable for the child and entire family.
- Therapeutic group where 6-10 children are linked with a treatment program that will suit their needs.
- Residential treatment facilities program where seriously distressed patients receive comprehensive and intensive psychiatric treatment on long-term basis.
Using psychotherapy to treat asylum seekers with mental problems such as PTSD has a great impact not only to the patient, but to entire community. As the patient expresses him/herself, the psychiatric can be able to identify the major issues that affect the refugees in from their initial residential places. Since psychotherapy involves friends and family members, it is easy to protect more cases of mental disorder from developing. The use of continuum of care program especially for children and adolescents ensures that the problem is identified at an early stage. This helps in curbing the impact in old age hence ensures that the community has fewer cases of mentally sick persons. Psychotherapy and continuum of care program will help the asylum seekers to overcome the trauma faster thus overcoming the impact that causes PTSD and major depression.
Implementing the proposed program will help the asylum seekers to gain most of the social and cultural norms. To begin with, the asylum seekers will be educated on how to adapt to different cultures. They will be educated on how to overcome some cultural practices that are against their social growth and development. Again, implementing medical care for mentally distressed person will help to curb the effect of PTSD and major depression.
To realize the benefits of the proposed program, I must work with other bodies that can assist in financing and also offering physical assistance. I would partner with Community Health Outreach (CHO). CHO is a body that is committed to providing medical care to underserved populations. They teach medical people on how to provide high quality care to the patients. CHO would help in implementing the program by educating caregivers and also offering medical services to affected asylum seekers. Also, I would partner with charity village organization. Charity village organization is a body that offers various health care programs that fit different categories of people. Charity village organization are familiar with such programs, therefore, they can easily incorporate it in their program, which helps the asylum seeker to realize its benefit faster.
The program needs a lot of finances, therefore I will look for different bodies to fund it. The first organization that I will approach for funding the program is Office of Immigration and Refugee Affairs (OIRA). This is a governmental organization that was instituted to help refugee families to attain economic independence and also to help them adjust to the new culture. The other body that can fund the program is Department of Social and Health Services (DSHS). DSHS is a federal organization that is responsible of formulating programs to help in refugee resettlement program. National Catholic Fund for Migration and Refugee service is one more variant as a business source. This is a private organization that has been given the mandate to collect funds from the public in order to assist the asylum seekers. The other organization that can fund the program is Local Voluntary Resettlement Agencies (VOLGAS). This is a body that works together with state department to distribute funds to aid the refugees by creating employment, educating them, and helping in adjustment to cultural differences. In order to receive funds from the above mentioned institutions, the program must prove to yield positive influence in the lives of immigrants and refugees.
In conclusion, immigrants and refugees are vulnerable population that is exposed to numerous challenges especially in accessing health care. Most of them suffer PTSD and major depression that need to be treated; however, the majority do not have access to such services. It is essential to have a program that would consider their health and administer it in a most friendly way that will reassure them of better life. A program that takes the victims through psychotherapy and also screens for communicable disease would work best for them. Working for such a program would need to work with different organizations. The program must be funded by relevant bodies to ensure that immigrants are well served and benefit from such programs.