Tag: refugee mental health

Bhutanese refugees in Ohio need more costly mental health care due to high suicide rate

~ Ann Corcoran ~ Leave a comment

There is nothing new in this story from the The Columbus Dispatch.  We have reported ad nauseum about the high suicide rate among Bhutanese (really Nepali) refugees first admitted during the Bush Administration.  Even before Bush’s Asst. Secretary of State for Population Refugees and Migration, Ellen Sauerbrey, gave the go-ahead to resettle 60,000 from UN camps (the UN wanted to close the camps so we said sure! and now we are up to over 80,000 Bhutanese scattered across America) we learned that the Bhutanese really preferred to live in their own culture in their part of the world.

The “Bhutanese” are really Nepali people who had lived in Bhutan. Bhutan expelled them and Nepal didn’t want them back. So, why was it in our national interest to bring over 80,000 to America? It was a Bush Administration decision. Did the Republicans want to import more cheap labor?

See our huge archive on the Bhutanese (mostly Hindu) migration to America by clicking here.   It goes back nearly eight years to a time when the Bhutanese did not want to be “scattered to the four winds.”
For all of you contemplating ‘welcoming’ refugees to your towns and cities, remember that health care/mental health care costs will be borne by state and local taxpayers.
From The Columbus Dispatch  (hat tip: Julie).  What is going on in Ohio that there is so much immigration and refugee news coming out of the state (see our Ohio archive)?  A suspicious person might think that Ohio was somehow being targeted for colonization!

So they recently surveyed 200 members of the Nepali-speaking Hindu minority who had fled the Himalayan mountain kingdom of Bhutan a quarter-century ago during an ethnic cleansing led by the Buddhist elite.

What they discovered shocked them.

Bhutanese refugees in central Ohio are twice as likely to report thinking about suicide as are those elsewhere in the U.S. They have high rates of anxiety, depression and post-traumatic stress and report that they smoke and use alcohol more frequently than other Bhutanese refugees.
“It’s a serious wake-up call,” said Surendra Bir Adhikari, an administrator for the Ohio Department of Mental Health and Addiction Services who led the research project.

[….]

Between October 2008 and September 2014, 5,654 Bhutanese were resettled in Ohio, including 1,738 in Franklin County. The total population is larger because of the family members and others who have arrived in the state from other parts of the U.S.

Local leaders of the Bhutanese community estimate the total population at close to 20,000, but state officials think it is lower. In 2012, the federal Centers for Disease Control and Prevention found that the suicide rate among Bhutanese refugees resettled in America was 20.3 per 100,000 people. That’s nearly twice the rate among the general U.S. population and higher than the global suicide rate of 16.9 percent.

No jobs and yet we keep the refugee flow coming!  Look at the Ohio numbers on this map!

Besides facing language and religious barriers, refugees worry about loved ones and friends left behind. And there’s often a disconnect between their idyllic views of life in America and the difficulties they encounter finding jobs that pay well.

[….]

Much more needs to be done to address the social isolation, substance abuse and trauma experienced by refugees and immigrants, local and state officials say.

They want “mental-health first-aid training” offered to help identify, understand and respond to signs of addiction and mental illnesses in refugees. They’d like to see more health-care systems provide both medical and mental-health services under one roof to lessen the stigma.

There is more, continue reading here.

U. of Vermont psychologists helping Bhutanese refugees with mental problems; send more refugees to Vermont!

~ Ann Corcoran ~ Leave a comment

There really isn’t much new and exciting in this story, but I’m posting it because I was interested in the small number of refugees going to Vermont, after all, Vermont’s senior Senator Patrick Leahy has, over the years, been a big pusher for more refugees and more stuff for them.

UVM psychology professor Karen Fondacaro will be busy with her Bhutanese torture victims. Here with co-founder of NESTT (New England Survivors of Torture and Trauma). http://www.uvm.edu/~psych/?Page=news/NESTT_walk_2010.html

We have had many many reports of Bhutanese (really Nepali people) who were living in UN camps on the edge of Nepal until we took 80,000 of them to America in the last 6 years or so and who are now in the US in need of mental health programs.  See our Bhutanese archive with many posts on the high suicide rate among this group of refugees, some want to go home. (BTW, Reader CW recently suggested a the creation of a ‘Repatriation Fund’ for any refugee, unhappy with America, to be allowed to go home.)

From Kentucky.com (I wondered if a Kentucky publication reported this story as a hint to start mental health counseling in KY for its burgeoning refugee population):

BURLINGTON, Vt. — The scars Ajuda Thapa carries today are emotional — the product of years living in fear, being forced from her home in Bhutan and enduring the murder of her husband during 19 stateless years before she arrived in Vermont as a refugee.

Like many others like her here, she’s helping ease the emotional trauma she suffered through a special program at the University of Vermont for the region’s refugees.

[….]

But the safety she has now didn’t do anything for the anxiety, depression and lingering emotional scars that threatened to turn her into a recluse hiding in her home. So her doctor referred her to Connecting Cultures, a program at the University of Vermont that has helped ease the emotional trauma of hundreds of others like her.

Thapa regularly attends meetings where she talks about what she experienced.

“It helps a lot to get relief from that kind of mental pain,” said Thapa, an ethnic Nepali who became stateless after leaving Bhutan in 1992.

Here are some numbers for Vermont:

Connecting Cultures organizers have found that about 65 percent of the estimated 7,000 refugees living in greater Burlington from more than two dozen countries had suffered some form of torture. [Dr. Fondacaro will be very busy!]

[….]

Thapa has struggled to deal with the emotional trauma that comes with the nearly two decades of fear and loss she experienced after being forced from her home. She is one of an estimated 1,300 Bhutanese refugees who have been resettled in Vermont, the largest single refugee nationality in the state.

Those are paltry numbers compared to many other states…

There surely needs to be a national campaign to persuade Vermonters to be more “welcoming” and to accept more refugees there, after all that would only be fair!

See our Vermont archive by clicking here.

More on refugee mental health issues from Pittsburgh

~ Ann Corcoran ~ Leave a comment

Translation services are going to cost your “welcoming” community a bundle going forward (not to mention the cost itself of mental health treatment for immigrants).

This is another in a series of articles written by reporter Erika Beras and published here at the local NPR station.  We have mentioned previously two of Ms. Beras’s excellent investigative reports, here and here.

From WESA (Pittsburgh’s NPR station).  Emphasis below is mine:

Barbara Murock, Immigrants and International Initiative Manager for Allegheny County’s Department of Human Services. Does your county have such a position?

Pittsburgh was once an immigrant foothold. European and Middle Eastern immigrants and black migrants from the Jim Crow American South built the city into what it is. But when industry began to shutter in the ’70s, people started moving away in droves. And for a long time, people didn’t move in.

It’s only been in the last few years that census numbers have ticked upward. Some of that is young people moving to Pittsburgh from other cities, but it’s also refugees. Several thousand have been resettled here in the last few years by four resettlement agencies, and others move here after being resettled elsewhere.

In some ways it’s a perfect fit: There is ample employment and affordable housing stock. But in some critical ways, it’s not a good fit at all.  [What is the ample employment in Pittsburgh?—ed]

“Pittsburgh is about 20 years behind the rest of the country when it comes to immigrants,” said Barbara Murock, the Immigrants and International Initiative Manager for Allegheny County’s Department of Human Services, a relatively new initiative. “We’re still learning and we’re at a tipping point in terms of having enough immigrants that we need to start developing systems and programs and pathways for people to obtain services that they need.”  [What is that going to cost the taxpayers of the county?—ed]

Those services include everything from having interpreters in a slew of languages in the courts and schools and drug and alcohol treatment centers.

However, making services available is more than just language. For refugees, a lot of what they don’t understand is cultural.

What follows is a section worth reading about how in some cultures it is taboo to seek any mental health treatment.  Note one star of the story has “situational depression.”  I guess that means he has become disenchanted with life in America.  One proposal for reform I’ve mentioned previously is for the resettlement contractors to set aside money (preferably theirs!) for an airfare fund to send refugees back to their home country who are not cutting-it in the US.  Some want to go home but are trapped here in nasty jobs at low wages and can’t afford the airfare.

Federally mandated translation services could bust your city or county budget!

Those services are expensive and not always easily accessible. The cost of an interpreter, even on the phone, can be high. The translation services the center uses averages $5,000 a month. They also use in-person interpreters, staff who speak a variety of languages.

[….]

By law, health care providers that receive federal monies such as UPMC have to provide interpreter services, and they do in more than 200 languages. That number is only expected to grow as the number of refugees in the community grows and changes.

Readers should try to find out what translation services are costing your local government.  It isn’t just health care services that must provide an interpreter, but the court system as well.   Even when some refugee has a minor traffic problem and ends up in local court—he or she must have a translator!

Pittsburgh: Language barriers complicate refugee mental health treatment

~ Ann Corcoran ~ Leave a comment

A radio station reporter has discovered that Pittsburgh, PA has taken a lot of refugees in need of health treatment (including mental health treatment) that they may not be getting.  I’ll bet it’s happening where you live too, and partly because no one is available to translate for the mental health provider.

Esar Met was not normal in the camp. If a reporter figured that out, surely the US State Dept. knew.

The issue of cities and counties being responsible for appropriate interpreters came up the other day when we wrote about the Utah murder case where the Salt Lake City police must have figured any Burmese person would do to communicate with the newly arrested Esar Met.  Met is a Muslim, probably a Rohingya.  If he is Rohingya he speaks a Bengali dialect.

So, think about it, according to federal law, local governments are required to provide interpreters, not just in law enforcement cases, but when helping refugees get the appropriate medical treatment and in the hundreds of languages and dialects spoken by refugees.

Increasingly, we are hearing of mental health problems in the refugee community going unattended.  Add the cost of all this (treatment and translators) when determining if yours is to be a “welcoming” community for refugees.

The US State Department resettles refugees with mental problems as they surely knew Esar Met was not normal.

In the Utah rape/murder case an article in the Salt Lake Tribune in 2008 tells us this about the accused murderer (below).  Interestingly his mother did not want to come to America, but the US State Department figured Met would make a good addition to a multicultural America—help diversify Utah!

A challenged son » About a mile away, people at Mae La knew Esar Met was not normal. He often sat alone, talking and laughing to himself in the Muslim section of the camp where his family lived. Or he played with children years younger, shooting rubber bands in the camp’s narrow lanes, flicking marbles across the rocky, dirt patches that were his neighbors’ yards.

He was the eldest of eight children, but when he argued with his younger brothers, he was the one to cry.

As a boy, he could not remember what he learned in class. His mother, Ra He Mar, knew her son was not very smart and worried he might become even slower as he grew older. After he had to repeat second grade, she let him drop out of school.

Friends told her the family should find someone to “check his brain,” but Esar’s parents thought they couldn’t afford to have him tested.

I’m surprised there is no insanity plea in the case yet, maybe it is still coming.

Reporter Erika Beras: no system in place when refugees are new to the town.

Back to Pittsburgh where there is NO SYSTEM IN PLACE for dealing with mental health issues and language barriers.

From 90.5 WESA (NPR in Pittsburgh), thanks to reader Joanne:

Refugees to the region face a number of challenges, unfamiliarity with a different language is even more complicated when trying to obtain health care.

90.5 WESA Behavioral Health Reporter Erika Beras is embarking on a month-long series on the challenges refugees face in the Pittsburgh area to obtain health care. She says her interest in the topic was sparked by the high population of refugees in Pittsburgh.

“The refugee community here has grown and grown. And in that time I’d been talking to providers and I’d been in different situations at specialty courts and I keep hearing stories about different refugees who have come in with different issues and how people are struggling to meet their needs. They don’t quite have a system in place after the first few months a refugee is in town.”

Mental health challenges throughout the US:

As Project Editor for the Reporting on Health Collaborative, William Heisel also finds the system to be often unprepared or overwhelmed by immigrant mental health cases.

“When you’re talking about refugees, they’re coming with acute needs…Refugees are coming from conflicts that most of us will never experience and so they, in addition to having the trauma they need to get over, they have language barriers that make it difficult for them to access health care, many of them have low income status, they’re disconnected from their communities and so we are seeing this throughout the U.S. as a pretty big challenge.”

So who is responsible for refugees when they first arrive in Pittsburgh?   Catholic Charities, Jewish Family & Children Services and AJAPO (Acculturation for Justice, Access & Peace Outreach) (here).   Ms. Beras needs to start her investigation right here—with these three federal contractors.

For ambitious readers, this is our 190th post on health problems and refugees.  See Health issues category here.

Sacramento Iraqis have mental problems; no psychiatric treatment readily available

~ Ann Corcoran ~ Leave a comment

This is not the first time that we have written about Iraqi refugee mental health problems (and I suspect it won’t be the last).

So far, this fiscal year (2013) we have “welcomed” 11,066 Iraqis.  If the Sacramento percentages of suffering delicate Iraqis is representative then we have just admitted:

6,528 cases of insomnia

4,869 depressed people

4,537 people with headaches

4,205 fearful people

…all in need of mental health professionals to help them cope, so that they can find jobs.

LOL!  I bet the percentages of Americans reading this post who are experiencing sleeplessness, depression, headaches and fear are at about the same percentage as the Iraqis as we contemplate what the US State Department and the resettlement contractors are doing to America and how the heck we are going to pay for all of this!

Here is the story from California Health Line:

Many of the 2,700 Iraqi refugees living in the Sacramento area have experienced symptoms of post-traumatic stress disorder but struggle to obtain mental health care services, according to a report by the UC-Davis Health System Clinical and Translational Science Center, the Sacramento Bee reports.

The report was conducted with the help of Opening Doors,* a refugee resettlement agency, and the Mesopotamia Organization, an Iraqi self-help agency.

Report Findings

The report analyzed the number of Iraqi refugees experiencing PTSD symptoms and found that:

59% of refugees reported experiencing insomnia;
44% of refugees reported experiencing depression;
41% of refugees reported experiencing headaches; and
38% of refugees reported experiencing fear (Magagnini, Sacramento Bee, 6/3).

Obamacare to the rescue?  Don’t count on it!

According to the report:

65% of refugees reported experiencing long waits for treatment of symptoms;
74% of refugees said needed services were not covered by their health insurance; and
82% of refugees said that the U.S. health care system moved too slowly (UC-Davis report, May 2013).

The Iraqi unemployment rate in the US is at about 67%.   Who knew it was because they have so many mental health problems.

He ( Sarmed Ibrahim) added that the lack of medical treatment is affecting Iraqi refugees’ ability to obtain jobs.

Just a reminder, California takes the most refugees of any state, so its only going to get worse for Medi-Cal.

* Opening Doors is a Sacramento refugee resettlement agency.  Its most recent Form 990 is here.  Out of a revenue stream of $636,186, government grants (taxpayer dollars) supplied $595,700 of their income.