Skip to main content
SpringerLink
Log in

Mental Health Problems and Risks in Refugees During Migration Processes and Experiences: Literature Overview and Interventions

  • Chapter
  • First Online:
European Psychiatric/Mental Health Nursing in the 21st Century

Part of the book series: Principles of Specialty Nursing ((PSN))

Abstract

This chapter focuses on the mental health problems and risks that are associated with refugees and migrants. As a result, subsequent to a review of the relevant theoretical and empirical literature, the chapter highlights concepts, phenomena, and propositions that could serve as the basis for a theoretical framework of risk factors, mediation, and protective factors involved in the possible onset and development of mental health problems among refugee populations during their migration experience. The review will also take into account the risk factors attributable to the three phases (e.g., premigration, migration, post-migration) of the migration process according to a conventional time perspective. The potential protective factors on refugees’ mental health will be identified on different levels: the personal level (i.e., skills, strategies, demographic characteristics), the community level (i.e., support from the community or from family members on the territory), and the cultural level (i.e., cultural meaning systems and beliefs). Also clinical practices will be put in question as well as their probable ethnocentrism trend. Interventions treating symptoms of mental health problems among refugees population will be reviewed, and preventive measures will be discussed. In so doing, the chapter seeks to support and strengthen clinical knowledge on existing responses and treatments that could actually prove to be useful and effective response to the emergency to provide adequate care to a risk population as that of refugees and asylum seekers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Acarturk C, Konuk E, Cetinkaya M, Senay I, Sijbrandij M, Cuijpers P, Aker T (2015) EMDR for Syrian refugees with posttraumatic stress disorder symptoms: results of a pilot randomized controlled trial. Eur J Psychotraumatol 18(6):27414

    Article  Google Scholar 

  • Ajdukovic D, Ajdukovic D, Bogic M, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, SchĂĽtzwohl M, Priebe S (2013) Recovery from posttraumatic stress symptoms: a qualitative study of attributions in survivors of war. PLoS One 8(8):e70579

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Aldwin CM, Tracey R (1987) Does coping help? A re-examination of the relation between coping and mental health. J Pers Soc Psychol 53(2):337–348

    Article  CAS  PubMed  Google Scholar 

  • Antonovsky A (1979) Health, stress and coping. Jossey-Bass, San Francisco

    Google Scholar 

  • Beiser M (2006) Longitudinal research to promote effective refugee resettlement. Transcult Psychiatry 43(1):56–71

    Article  PubMed  Google Scholar 

  • Bhugra D (2004) Migration and mental health. Acta Psychiatr Scand 109(4):243–258

    Article  CAS  PubMed  Google Scholar 

  • Bhugra D (2014) All medicine is social. J R Soc Med 107(5):183–186

    Article  PubMed Central  PubMed  Google Scholar 

  • Bhugra D, Gupta S (2011) Migration in mental health. Cambridge University Press, Cambridge

    Google Scholar 

  • Birman D, Beehler S, Harris EM, Everson ML, Batia K, Liautaud J, Frazier S, Atkins M, Blanton S, Buwalda J, Fogg L, Cappella E (2008) International family, adult, and child enhancement services (FACES): a community-based comprehensive services model for refugee children in resettlement. Am J Orthopsychiatry 78(1):121–132

    Article  PubMed  Google Scholar 

  • Bogic M, Ajdukovic D, Bremner S, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, SchĂĽtzwohl M, Wang D, Priebe S (2003) Factors associated with mental disorders in long-settled war refugees: refugees from the former Yugoslavia in Germany, Italy and the UK. Br J Psychiatry 200(3):216–223

    Article  Google Scholar 

  • Bogic M, Njoku A, Priebe S (2015) Long-term mental health of war-refugees: a systematic literature review. BMC 15:29

    Google Scholar 

  • Bolton P, Lee C, Haroz EE, Murray L, Dorsey S, Robinson C, Ugueto AM, Bass J (2014) A transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand. PLoS Med 11(11):e1001757

    Article  PubMed Central  PubMed  Google Scholar 

  • Bower RD, Pahl L, Bernstein MA (2004) Case presentation of a tattoo-mutilated, Bosnian torture survivor. Torture 14(1):16–24

    Google Scholar 

  • Buhmann CB (2014) Traumatized refugees: morbidity, treatment and predictors of outcome. Dan Med J 61(8):B4871

    PubMed  Google Scholar 

  • Buhmann C, Andersen I, Mortensen EL, Ryberg J, Nordentoft M, Ekstrøm M (2015) Cognitive behavioral psychotherapeutic treatment at a psychiatric trauma clinic for refugees: description and evaluation. Torture 25(1):17–32

    PubMed  Google Scholar 

  • Carta, M.G. & Moro, M.F. (2014) Conflicts and mental health in the Mediterranean, Conference: XVI World Congress of Psychiatry. Madrid 2014, At Madrid, Volume 2. Abstracts Regular Symposia, Conference Paper January 2014

    Google Scholar 

  • Carta MG, Hardoy MC, Pilu A, Sorba M, Floris AL, Mannu FA, Baum A, Cappai A, Velluti C, Salvi M (2008) Improving physical quality of life with group physical activity in the adjunctive treatment of major depressive disorder. Clin Pract Epidemiol Ment Health 26(4):1

    Article  Google Scholar 

  • Carta MG, Wallet Oumar F, Moro MF, Moro D, Preti A, Mereu A, Bhugra D (2013) Trauma and stressor related disorders in the tuareg refugees of a camp in Burkina Faso. Clin Pract EpidemiolMental Health 9:189–195

    Article  CAS  Google Scholar 

  • Carta MG, Moro MF, Bass J (2015) War traumas in the Mediterranean area. Int J Soc Psychiatry 61(1):33–38

    Article  PubMed  Google Scholar 

  • Carver CS, Scheier MF, Weintraub JK (1989) Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 56(2):267–283

    Article  CAS  PubMed  Google Scholar 

  • Davydov DM, Stewart R, Ritchie K, Chaudieu I (2010) Resilience and mental health. Clin Psychol Rev 30(5):479–495

    Article  PubMed  Google Scholar 

  • Dinh TQ, Yamada AM, Yee BW (2009) A culturally relevant conceptualization of depression: an empirical examination of the factorial structure of the Vietnamese depression scale. Int J Soc Psychiatry 55(6):496–505

    Article  PubMed  Google Scholar 

  • Drožđek B, Bolwerk N (2010) Group therapy with traumatized asylum seekers and refugees: for whom it works and for whom it does not? Traumatology 16(4):160–167

    Article  Google Scholar 

  • Drozdek B, Wilson JP (2007) Voices of trauma: treating psychological across cultures. Springer

    Google Scholar 

  • Dura-Vila G, Klasen H, Makatini Z, Rahimi Z, Hodes M (2013) Mental health problems of young refugees: duration of settlement, risk factors and community-based interventions. Clin Child Psychol Psychiatry 18:604–623

    Article  PubMed  Google Scholar 

  • Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365:1309–1314

    Article  PubMed  Google Scholar 

  • Ginzburg ES (2010) Comorbidity of posttraumatic stress disorder, anxiety and depression: a 20-years longitudinal study of war veterans. J Affect Disord 123(1-3):249–257

    Article  PubMed  Google Scholar 

  • Goodman JH (2004) Coping with trauma and hardship among unaccompanied refugee youths from Sudan. Quant Health Res 14(9):1177–1196

    Article  Google Scholar 

  • Gwozdziewycz N, Mehl-Madrona L (2013) Meta-analysis of the use of narrative exposure therapy for the effects of trauma among refugee populations. Perm J 17(1):70–76

    PubMed  PubMed Central  Google Scholar 

  • Gyllensten AL, Ekdahl C, Hansson L (2009) Long-term effectiveness of basic body awareness therapy in psychiatric outpatient care. A randomized controlled study. Adv Physiother 11(1):2–12

    Article  Google Scholar 

  • Hadgkiss EJ, Renzaho AM (2014) The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature. Aust Health Rev 38(2):142–159

    PubMed  Google Scholar 

  • HalcĂłn LL, Robertson CL, Savik K, Johnson DR, Spring MA, Butcher JN, Westermeyer JJ, Jaranson JM (2004) Trauma and coping in Somali and Oromo refugee youth. J Adolesc Health 35(1):17–25

    Article  PubMed  Google Scholar 

  • Harpham T, Few R (2002) The Dar Es Salaam urban health project, Tanzania: a multi-dimensional evaluation. J Public Health Med 24(2):112–119

    Article  PubMed  Google Scholar 

  • Hijazi AM, Lumley MA, Ziadni MS, Haddad L, Rapport LJ, Arnetz BB (2014) Brief narrative exposure therapy for post-traumatic stress in Iraqi refugees: a preliminary randomized clinical trial. J Trauam Stress 27(3):314–322

    Article  Google Scholar 

  • Hinton DE, Pich VH, Stefan G, Otto MW (2013) Acceptance and mindfulness techniques as applied to refugee and ethnic minority populations with PTSD: examples from “culturally adapted CBT”. Cogn Behav Pract 20(1):33–46

    Article  Google Scholar 

  • Hofstede G (2011) Dimensionalizing cultures: the hofstede model in context. Online Read Psychol Culture 2(1):8

    Google Scholar 

  • Jackie June ter Heide F, Mooren GTM, Kleijn W, de Jongh A, Kleber RJ (2011) EMDR versus stabilisation in traumatised asylum seekers and refugees: results of a pilot RCT. Eur J Psychotraumatol 2:5881

    Article  Google Scholar 

  • Kamperman AM, Komproe IH, de Jong JT (2007) Migrant mental health: a model for indicators of mental health and health care consumption. Health Psychol 26(1):96–104

    Article  CAS  PubMed  Google Scholar 

  • Karam EG, Fayyad J, Nasser Karam A, Cordahi TC, Melhem N, Mneimneh Z, Dimassi H (2008) Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon. World Psychiatry 7:103–109

    Article  PubMed Central  PubMed  Google Scholar 

  • Khaawaja NG, White KM, Schweiter R, Greenslade J (2008) Difficulties and coping strategies of Sudanese refugees: a qualitative approach. Transcult Psychaitry 45(3):489–512

    Article  Google Scholar 

  • Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K (2011) Canadian collaboration for immigrant and refugee health (CCIRH): common mental health problems in immigrants and refugees: general approach in primary care. CMAJ 183(12):E959–E967

    Article  PubMed Central  PubMed  Google Scholar 

  • Lambert JE, Alhassoon OM (2015) Trauma-focused therapy for refugees: meta-analytic findings. J Couns Psychol 62(1):28–37

    Article  PubMed  Google Scholar 

  • Liedl A, MĂĽller J, Morina N, Karl A, Denke C, Knaevelsrud C (2011) Physical activity within a CBT intervention improves coping with pain in traumatized refugees: results of a randomized controlled design. Pain Med 12(2):234–245

    Article  PubMed  Google Scholar 

  • Lindert J, Ehrenstein OS, Priebe S, Mielck A, Brähler E (2009) Depression and anxiety in labor migrants and refugees--a systematic review and meta-analysis. Soc Sci Med 69(2):246–257

    Article  PubMed  Google Scholar 

  • MacDuff S, Grodin MA, Gardiner P (2011) The use of complementary and alternative medicine among refugees: a systematic review. J Immigr Minor Health 13(3):585–599

    Article  PubMed  Google Scholar 

  • Manger TA, Motta RW (2005) The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. Int J Emerg Ment Health 7(1):49–57

    PubMed  Google Scholar 

  • Marsella AJ (2010) Ethnocultural aspects of PTSD: an overview of concepts, issues, and treatments. Traumatology 16(4):17–26

    Article  Google Scholar 

  • 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):17–26

    Article  Google Scholar 

  • Meffert SM, Abdo AO, Alla OA, Elmakki YO, Omer AA, Yousif S, Metzler TJ, Marmar CR (2014) Pilot randomized controlled trial of interpersonal psychotherapy for Sudanese refugees in Cairo, Egypt. Psychol Trauma 6(3):240–249

    Article  Google Scholar 

  • Mollica RF (2011) Medical best practices for the treatment of torture survivors. Torture 21(1):8–17

    PubMed  Google Scholar 

  • Mollica RF, McInnes K, Sarajlic N, Lavelle J, Sarajlic I, Massagli MP (1999) Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. JAMA 282(5):433–439

    Article  CAS  PubMed  Google Scholar 

  • Mollica RF, Caridad KR, Massagli MP (2007) Longitudinal study of posttraumatic stress disorder, depression, and changes in traumatic memories over time in Bosnian refugees. J Nerv Ment Dis 195(7):572–579

    Article  PubMed  Google Scholar 

  • Morgan LM (2001) Community participation in health: perpetual allure, persistent challenge. Health Policy Plan 16(3):221–230

    Article  CAS  PubMed  Google Scholar 

  • Muller J, Karl A, Denke C, Mathier F, Dittmann J, Rohleder N, Knaevelsrud C (2009) Biofeedback for pain management in traumatised refugees. Cogn Behav Ther 38(3):184–190

    Article  PubMed  Google Scholar 

  • Mura G, Carta MG (2013) Physical activity in depressed elderly. A systematic review. Clin Pract Epidemiol Ment Health 12(9):125–135

    Article  Google Scholar 

  • Myers SJ (2011) Cross-cultural measurement of posttraumatic stress disorder in post-conflict settings. Am J Public Health 101(4):581–582

    Article  PubMed Central  PubMed  Google Scholar 

  • Naja WJ, Aoun MP, El Khoury EL, Abdallah FJ, Haddad RS (2016) Prevalence of depression in Syrian refugees and the influence of religiosity. Compr Psychiatry 68:78–85

    Article  PubMed  Google Scholar 

  • Neuner F, Onyut PL, Ertl V, Odenwald M, Schauer E, Elbert T (2008) Treatment of post-traumatic stress disorder by trained lay counselors in an African refugee settlement: a randomized controlled trial. J Consult Clin Psychol 76(4):868–694

    Article  Google Scholar 

  • Pearson NJ, Chesney MA (2007) The national center for complementary and alternative medicine. Acad Med 82(10):967

    Article  PubMed  Google Scholar 

  • Piwowarczyk L, Bishop H, Yusuf A, Mudymba F, Raj A (2014) Congolese and Somali beliefs about mental health services. J Nerv Ment Dis 202(3):209–216

    Article  PubMed  Google Scholar 

  • Porter M (2007) Global evidence for a biopsychosocial understanding of refugee adaptation. Transcult Psychiatry 44(3):418–439

    Article  PubMed  Google Scholar 

  • Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294(5):602–612

    Article  CAS  PubMed  Google Scholar 

  • Regel S, Berliner P (2007) Current perspectives on assessment and therapy with survivors of torture: the use of a cognitive behavioural approach. Eur J Psychother Counsel 9(3):289–299

    Article  Google Scholar 

  • Robjant K, Fazel M (2010) The emerging evidence for narrative exposure therapy: a review. Clin Psychol Rev 30(8):1030–1039

    Article  PubMed  Google Scholar 

  • Schomerus G, Auer C, Rhode D, Luppa M, Freyberger HJ, Schmidt S (2012) Personal stigma, problem appraisal and perceived need for professional help in currently untreated depressed persons. J Affect Disord 139(1):94–97

    Article  PubMed  Google Scholar 

  • Schwartz MS, Andrasik F (2015) Biofeedback: a practitioner’s guide, 4th edn. The Guilford press, London

    Google Scholar 

  • Schweitzer R, Greenslade J, Kagee A (2007) Coping and resilience in refugees from the Sudan: a narrative account. Aust N Z J Psychiatry 41(3):282–288

    Article  PubMed  Google Scholar 

  • Shapiro F, Maxfield L (2002) Eye movement desensitization and reprocessing (EMDR): information processing in the treatment of trauma. J Clin Psychol 58(8):933–946

    Article  PubMed  Google Scholar 

  • Siriwardhana C, Shirwa SA, Roberts B, Stewart R (2014) A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants. Confl Heal 8:13

    Article  Google Scholar 

  • Slobodin O, de Jong JT (2015) Mental health interventions for traumatized asylum seekers and refugees: what do we know about their efficacy? Int J Soc Psychiatry 61(1):17–26

    Article  PubMed  Google Scholar 

  • Stade K, Skammeritz S, Hjortkjær C, Carlsson J (2015) “after all the traumas my body has been through, I feel good that it is still working.”--basic body awareness therapy for traumatised refugees. Torture 25(1):33–50

    PubMed  Google Scholar 

  • Stenmark H, Catani C, Neuner F, Elbert T, Holen A (2013) Treating PTSD in refugees and asylum seekers within the general health care system: a randomized controlled multi-center study. Beh Res Ther 51(10):641–647

    Article  Google Scholar 

  • Stone L (1992) Cultural influences in community participation in health. Soc Sci Med 35(4):409–417

    Article  CAS  PubMed  Google Scholar 

  • Stuart S, Robertson M (2012) Interpersonal psychotherapy: a clinician’s guide, 2nd edn. Edward Arnold, London

    Book  Google Scholar 

  • Swartz HA, Grote NK, Graham P (2014) Brief interpersonal psychotherapy (IPT-B): overview and review of evidence. Am J Psychother 68(4):443–462

    Article  PubMed Central  PubMed  Google Scholar 

  • Taylor SE, Stanton AL (2007) Coping resources, coping processes and mental health. Annu Rev. Clin Psychol 3:377–401

    Article  PubMed  Google Scholar 

  • Tyrer RA, Fazel M (2014) School and community-based interventions for refugee and asylum seeking children: a systematic review. PLoS One 9(2):e89359

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • UNHCR’s annual Global Trends Report (2015), 20 JUNE 2016

    Google Scholar 

  • Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85(3):317–332

    Article  CAS  PubMed  Google Scholar 

  • Voulgaridou M, Papadopoulos R, Tomaras V (2006) Working with refugee families in Greece: systemic considerations. J Fam Ther 28:200–220

    Article  Google Scholar 

  • Weine S (2008) Family roles in refugee youth resettlement from a prevention perspective. Child Adolesc Psychiatr Clin N Am 17(3):515–518

    Article  PubMed Central  PubMed  Google Scholar 

  • Weine S (2011) Developing preventive mental health interventions for refugee families in resettlement. Fam Process 50(3):410–430

    Article  PubMed Central  PubMed  Google Scholar 

  • Weine SM, Kulauzovic Y, Besic S, Lezic A, Mujagic A, Muzurovic J et al (2006) A family beliefs framework for developing socially and culturally specific preventive interventions for refugee families and youth. Am J Orthopsychiatry 76:1–9

    Article  PubMed  Google Scholar 

  • Weine S, Kulauzovic Y, Klebic A, Besic S, Mujagic A, Muzurovic J, Spahovic D, Sclove S, Pavkovic I, Feetham S, Rolland J (2008) Evaluating a multiple-family group access intervention for refugees with PTSD. J Marital Fam Ther 34(2):149–164

    Article  PubMed  Google Scholar 

  • WHO/Europe (2015) Mental health and psychological support for refugees, asylum seekers and migrants on the move in Europe: a multi-agency guidance note

    Google Scholar 

  • Williams ME, Thompson SC (2011) The use of community-based interventions in reducing morbidity from the psychological impact of conflict-related trauma among refugee populations: a systematic review of the literature. J Immigr Minor Health 13(4):780–794

    Article  PubMed  Google Scholar 

  • Wilson JP, So-Kum Tang C (2007) Cross-cultural assessment of psychological trauma and PTSD. Springer, New York

    Book  Google Scholar 

  • World Health Organization (2015) Policy brief on migration and health: mental health care for refugees. http://www.euro.who.int/__data/assets/pdf_file/0006/293271/Policy-Brief-Migration-Health-Mental-Health-Care-Refugees.pdf?4a=1

  • Ying YW, Akutsu PD (1997) Psychological adjustment of southeast Asian refugees: the contribution of sense of coherence. J Commun Phychol 25(2):125–139

    Article  Google Scholar 

  • Ying YW, Akutsu PD, Zhang X et al (1997) Psychological dysfunction in southeast Asian refugees as mediated by sense of coherence. Am J Community Psychol 25:839

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy

    Cossu Giulia, Maura Galletta & Carta Mauro Giovanni

Authors
  1. Cossu Giulia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maura Galletta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carta Mauro Giovanni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carta Mauro Giovanni .

Editor information

Editors and Affiliations

  1. Escola Superior de Enfermagem de Coimbra, Nursing School of Coimbra, Coimbra, Portugal

    José Carlos Santos

  2. Cutcliffe Consulting, Kingston, Canada

    John R. Cutcliffe

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Giulia, C., Galletta, M., Giovanni, C.M. (2018). Mental Health Problems and Risks in Refugees During Migration Processes and Experiences: Literature Overview and Interventions. In: Santos, J., Cutcliffe, J. (eds) European Psychiatric/Mental Health Nursing in the 21st Century. Principles of Specialty Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-31772-4_41

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31772-4_41

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31771-7

  • Online ISBN: 978-3-319-31772-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation