ArticlePDF Available

COVID-19 and Refugee and Immigrant Youth: A Community-Based Mental Health Perspective

Authors:

Abstract

In this article, we comment on the experience of the Kovler Center Child Trauma Program (KCCTP) following the March 21, 2020, shelter at home order in Chicago due to COVID-19. The KCCTP is a program of Heartland Alliance International that was founded in 2018 to provide community-based mental health and social services to immigrant and refugee youth and families who have experienced trauma. COVID-19 temporarily closed the doors of the center, suspending provision of in-person services in the community, and the program was forced to become remote overnight. The KCCTP rapidly transitioned to providing accessible information, active outreach, extensive case management, and flexible delivery of teletherapy and online psychosocial support, finding that attending to structural barriers and basic needs was crucial to family engagement and therapeutic success. Ongoing challenges include technological proficiency and access to computers, Internet, and private spaces.
 
   
   
   
 
  

      
    
 
 r 

 
  
 
   
 

    

     

     
   
 
 
   
          
        
            
      

              
          
           

   
  
       
    

  
      
  
          
        
     
  
       
 
    
        
 


       
        


    
 

        
       
        

      
       
     
       
     
        
    
        
     

         
   
     
      
 

 
  
       

  
       

    
      
        
        
     
    

    
2   
         
  
         
          
      
  
       

       

         
 
    
      
    
   


         
        
  
   


    
      
    
         
        
         
       

  



       
          
  
      
 
 
         
  v     
      
         
         
 

 
 
       

 
  
       
         
 
 
   
  
 
         
 
         
       
          
     

  
   

 
          
 
         
 
         

          
     
    
    
       
          
    
    
 

       
 

  
1.,        
     

   

          
          
  
 

     
    
  
 
      

   3
 
       
    
           
       
      
   


  
          
     

          
     
    

              
       
      
    

 
   
       
      

  
   
... by the ongoing COVID-19 pandemic have been shown to increase immigrants/refugees' risk of experiencing mental and emotional distress (Choi et al., 2020;Endale et al., 2020;Rothman et al., 2020;Serafini et al., 2021). The literature on how this population searches and makes meaning of stressful life events is sparse. ...
... Almost all the participants reported high stress, anxiety, and/or depression. Research showed that migrants are more vulnerable to mental health risks in pandemics than the host population (Endale et al., 2020), with an estimated prevalence of up to 44% for anxiety, 44% for depression, and 36% for PTSD (Júnior et al., 2020). It is not surprising that the pandemic worsened the existing mental health issues of the participants who might have been grappling with pre-migration stressors such as war, violence, losses due to health and infections, and starvation and post-migration stressors, including discrimination poor housing, and language difficulties. ...
Article
This study explored how the COVID-19 pandemic affected the Karen, Latinx, and Somali immigrants/refugees in the Minneapolis/St. Paul metro area and how they searched and made meaning of the situation. In-depth interviews were conducted with 32 adults drawn from community networks. Results show that the pandemic negatively affected various aspects of immigrant/refugee lives. Participants attempted to reduce the impact of the COVID-19 pandemic by engaging in different meaning-based coping methods. Participants emerged from the pandemic with greater personal growth. Some made positive life changes and accepted the pandemic as the new reality of life. The study implications are discussed.
... Of the total 26.3 million refugees globally, nearly half are children below 18 years of age, a population considered one of the at-risk refugee groups (UNHCR, 2020). Due to COVID-19, school-going refugee children face unique challenges with disruption of their day-to-day lives -changes in schedule, loss of structure, transitioning to remote education, boredom, and isolation from peers (Edmonds & Flahault, lation in addition to other pandemic outcomes contributes to traumatic experiences in young refugees (Endale et al., 2020). ...
Article
Full-text available
With over 80 million persons around the world forcibly displaced from their homes, 26.3 of whom are refugees, recent estimates indicate that the number of forced migrants has reached an all-time high (UNHCR, 2020). Already at a disadvantage, the closures of schools and key community resources aimed at combating the spread of the virus during the early stages of the pandemic contributed to further distress on the well-being of refugees. Recognizing that forced migrants are a vulnerable and underserved population and that the COVID-19 virus and the lockdowns put in place to reduce its spread severely worsened their multidimensional stressors, the authors used a qualitative narrative review with attention to the thematic analysis model to explore the impact of lockdowns on refugees’ mental health by reviewing publications from April 2020 through May 2021. The review findings are categorized under three themes: (a) negative impact on mental health, (b) suggested intervention approaches/strategies, and (c) recommendations. Implications for counseling and research are discussed.
... Since the beginning of the pandemic, social distancing has negatively impacted learning and growth, especially among younger people (Sikali, 2020). Moreover, children and adolescents living in disadvantaged social and economic contexts, those separated from families of origin, and youth with a migrant background may constitute a particularly vulnerable population in the time of COVID-19 (Endale, St Jean, & Birman, 2020;Fore, 2020). Such youth may have a greater risk of experiencing the negative social, emotional, and behavioral consequences of the COVID-19 outbreak due to boredom, language barriers, the digital divide, family violence, and parental job insecurity (Page, Venkataramani, Beyrer, & Polk, 2020;Primdahl et al., 2020;WHO, 2020). ...
Article
This study used a mixed methods approach to explore the experience of mentors involved in the Mentor-UP program during the COVID-19 pandemic in Padova, Italy. In Study 1, a total of 53 mentors completed an online questionnaire at the end of the program. Results of the path analysis showed that mentors’ perceived support from the program staff was associated with lower levels of psycho-physical burnout, which in turn was negatively associated with online communication frequency, and the latter was positively associated with mentoring relationship quality. Study 2 analyzed in more detail the mentor-mentee relationships during the pandemic and specifically how COVID-19 may have affected the program. Two online focus groups were conducted and transcripts analyzed using thematic analysis. Results indicated that online mentoring interactions, although different from face-to-face, were valuable and allowed the establishment of supportive relationships for youth. Findings suggest program staff should provide constant support to mentors.
... In Ohio, COVID-19 caused a disruption of health and social services systems, and a decrease in volunteer availability for volunteer-dependent agencies [12]. Elsewhere, clinicians have reported challenges with the provision of services and care to refugees [13], while some agencies permanently or temporarily closed their doors [14]. Combined, these findings suggest a need to assess and monitor the impact of COVID-19 on US service delivery systems. ...
Article
Full-text available
Background Key to the US refugee resettlement effort is the role of non-governmental organizations (NGOs) who receive, place, and provide transitional programs and referrals to new and recently resettled refugees. Yet only one rapid assessment study thus far examined the impact of COVID-19 on service delivery systems of US refugee resettlement agencies. This exploratory study describes the capability and preparedness of US refugee resettlement agencies to provide services and care to clients during the COVID-19 pandemic. Methods Using both telephone interviews and an internet survey, we assessed the impact of COVID-19 on service delivery, agency capacity, and preparedness of 101 US refugee resettlement agencies. Descriptive statistics were used to describe the dataset, while chi-square (χ²) tests were used to examine relationships by resettlement agency size (number of employees in each agency). Results Despite a temporary pause on refugee admissions, restrictive stay-at-home orders, and refugee travel restrictions, the majority of responding US refugee resettlement agencies continued to provide specialized services and care to resettled refugees and other immigrants. Among the more important findings was that agencies that continued to provide refugee services and care onsite in their existing facilities or office rather than moving such services offsite differed by agency size [χ² (9.494, n = 101), p < 0.05]. Almost all agencies (93.1%) strongly agreed or agreed that staff have timely access to COVID-19 information. Most of the refugee services were provided offsite (n = 72 agencies, some with multiple offices across the US). Conclusions US refugee resettlement agencies continued to perform admirably despite a lack of funding. Future research is underway to obtain a more balanced understanding of the impact of COVID-19 on practice or operations.
... In addition, immigrant families from Latin America are more likely to access mental health support through community-based programs, schools, and emergency medical services. Many organizations serving immigrant and refugee youth have reported that drastic, rapid changes were needed to continue supporting families, including dissemination of information, active outreach, extensive case management, and creative telehealth communication (Endale et al., 2020). ...
Article
Newcomer Latinx immigrant youths in the United States are currently in a syndemic of increased risk of behavioral health concerns, disparities in access to related services, and are disproportionately impacted by the COVID‐19 pandemic. This study used qualitative inquiry to examine the impact that the transition to telehealth had on a school‐based group prevention program for immigrant youth, Fuerte, within the context of this syndemic. Data included semi‐structured interviews with group leaders, and focus groups with youth program participants. Themes indicated both positive and negative impacts of the transition to telehealth on program component implementation, youth participant engagement, and youth participant social connectedness. Despite the telehealth model, youth participants reported that they felt socially connected to each other through the program. This study's results provide implications for the potential value and drawbacks of a telehealth prevention model for newcomer immigrant youth, as well as deepening understanding of how virtual behavioral health programs may operate in socially isolating contexts around the world.
... Refugees are at a significant health disadvantage compared with non-refugee immigrants due to an intersection of various social and economic inequalities that they face [7,8]. Recent reports indicate that social isolation, lack of information, stigma and language have all negatively impacted refugee mental health during COVID-19 [9][10][11]. ...
Article
Full-text available
Background There is growing evidence that government health information related to COVID-19 has failed to adequately reach culturally and linguistically diverse (CALD) populations in Australia. Refugees are a unique sub-set of the CALD communities and are subject to numerous barriers preventing adequate health care, both pre- and post-migration. The barriers are accentuated during emergencies, such as a pandemic, as a result of an intersection of various social and economic inequalities. The recently resettled Ezidi refugee community in a regional area of Australia is an example of a community sitting at the intersection of various inequities and thus at greater risk from COVID-19. The purpose of this study is to describe the experiences of the Ezidi in a regional area with COVID-19 information and how this has been communicated to and shared within this group; what barriers the community may experience in accessing COVID-19 information; and how the government-led COVID-19 information communication could be improved. Methods This qualitative study was designed to explore the perceptions and views of the Ezidi and service providers regarding COVID-19 messaging. Multicultural and Refugee Health staff facilitated interviews with four local service providers and ten Ezidi community members, including seven influential leaders. Thematic analysis was employed across individual, pair and group data analysis. Similar categories were grouped into themes. Results The main findings of the study are: the refugee experience influences the communication of COVID-19 messages; cultural, social and gender norms influence responses to COVID-19; trusted individuals and service providers are key in communities’ uptake of COVID-19 messages; currently available governmental COVID-19 information resources and sharing strategies were found unhelpful and inappropriate; COVID-19 communiqués and message delivery for this regional minority refugee community can be improved. Conclusion The recently resettled Ezidi community, and likely other similar communities, would benefit from tailored engagement by government organisations, as well as settlement services to improve the communication of COVID-19 health information and reduce related inequities.
Article
Full-text available
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol ( https://osf.io/4dxms/ ). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/ .
Article
Full-text available
Mental health outcomes in refugee youth are diverse, ranging from prolonged difficulties to resiliency. Refugee communities rarely access services, even for those youth who are in need. Barriers include (a) distrust of authority and/or systems, (b) stigma of mental health services, (c) linguistic and cultural barriers, and (d) primacy and prioritization of resettlement stressors. Mental health promotion among refugee youth requires an integrated response to these barriers. This article includes a description of how the previously mentioned barriers may prevent refugee youth from receiving mental health services; approaches to addressing them; and a detailed description of Supporting the Health of Immigrant Families and Adolescents (Project SHIFA), a program developed in collaboration with the Somali community in Boston, Massachusetts.
Article
The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
International Family, Adult, and Child Enhancement Services (FACES): A community-based comprehensive services model for refugee children in resettlement
  • D Birman
  • S Beehler
  • E M Harris
  • M L Everson
  • K Batia
  • . . Liautaud
  • E Cappella
Birman, D., Beehler, S., Harris, E. M., Everson, M. L., Batia, K., Liautaud, 1.,... Cappella, E. (2008). International Family, Adult, and Child Enhancement Services (FACES): A community-based comprehensive services model for refugee children in resettlement. American Journal of Orthopsychiatry, 78, 121-132. hnp://dx.doi.org/10.1037/0002-9432.78 .1.121