“If you don’t ask … you don’t tell”: Refugee women’s perspectives on perinatal mental health screening

ProblemNational guidelines recommending mental health screening in pregnancy have not been implemented well in routine maternity care. Women of refugee background are likely to have experienced traumatic events and resettlement stressors, yet are not often identified with mental health issues in the perinatal period.BackgroundGlobally, perinatal mental health conditions affect up to 20% of women. Many difficulties in accessing mental health care in pregnancy exist for women of refugee background including stigma, and cultural and language barriers. Technology can provide an efficient and effective method to overcome some of these barriers.AimTo determine if a digital perinatal mental health screening program is feasible and acceptable for women of refugee background.MethodsThis qualitative evaluation study used focus group and semi-structured telephone interviews with refugee and migrant women from four communities. Interpreters were used with women who spoke little or no English. Data were analysed using both an inductive and deductive approach to thematic analysis.FindingsUnder the three key themes: ‘Women’s experiences of perinatal mental health screening in pregnancy’; ‘Barriers and enablers to accessing ongoing mental health care’ and ‘Improvements to the program: the development of audio versions’, women found the program feasible and acceptable.DiscussionScreening using a mobile device offered women more privacy and opened up discussions with midwives on emotional health. Improvements in service coordination and access to further mental health management for women is required.ConclusionPerinatal mental health screening is an acceptable and feasible option for women of refugee background. Integrated models of care, case management, and patient navigators are options for improvements in uptake of referral and treatment services.     

Preparation and transition planning for unaccompanied asylum-seeking and refugee young people: A review of evidence in England

Most unaccompanied asylum-seeking young people arrive in the UK in their mid teen years. Preparation and planning for transition to adulthood should therefore be at the forefront of the minds of care-givers and social workers. This paper reviews current research evidence on the response of social work services to this group of young people in England, with a particular focus on what is known about the circumstances in which young people may be best prepared for adult life, how they fare in comparison to other young people in public care, and on the challenges presented for pathway planning that arise at the intersection between social work and the asylum determination process. The evidence for England is situated, wherever possible, against evidence drawn from international literature in this field and the need for a broader research agenda (incorporating more longitudinal work on care and leaving care pathways) is highlighted in order to strengthen the evidence base to support policy and practice in this field.     

Children's comprehension of war

The purpose of this paper is to show how pre-school children, both from Zagreb and refugees, experienced and comprehended the war during 1992. The study included 98 children from Zagreb kindergartens (pre-school nurseries). The children were asked five questions about the war in Croatia. Each was interviewed individually. A content analysis of the answers revealed that the children, in defining the warring parties and the causes of the war, besides using much information obtained through the media, based their concepts of the war on personal experience. The worst war-related experience for Zagreb children was the air-raid alarms, while the displaced or refugee children felt worst when there were bombardments, destruction and shooting—mostly personally experienced events. Generally, the children's answers suggest more mature comprehension of war than usually expected and found at the pre-school age.     

韩国《难民法》述评--兼论对我国难民立法的启示

韩国《难民法》在形式上属独立于《出入境管理法》的专门法,其内容体现了正当程序和人权保护的价值理念。韩国《难民法》为我国正在进行的难民立法活动提供了可供借鉴的经验。鉴于一般的出入境管理事务与难民事务在目的和性质上的不同,我国应借鉴韩国《难民法》的立法经验,制定一部以难民的人权保护为主要目的、在内容设计上注重体现正当程序要求的独立的难民法。     

Grounds for Cautious Optimism

Humanitarian assistance organizations have made considerable strides in addressing gender issues. These efforts have fallen short, however, as organizations fail to adapt and apply a gender perspective consistently and to integrate local and international women into decision-making positions. This comment on Chris Corrin's report on humanitarian assistance in Kosova outlines the reasons for this partial failure, some of which are gender related and others of which are endemic to the humanitarian field. It concludes that the emergence of women activists in conflict areas provides grounds for cautious optimism for future transformative change.     

Bridge Builders: A Qualitative Study Exploring the Experiences of Former Refugees Working as Caseworkers in the United States

ABSTRACT.

Individuals who come to the United States as refugees and work as resettlement caseworkers offer peer support, modeling, and assistance with integration to newly arriving refugees, despite often having limited training or experience in social service provision. A phenomenological approach was utilized to gain understanding about the experiences of refugee caseworkers. Nine caseworkers who came to the United States as refugees completed in-depth interviews. Thematic analysis was used to identify primary themes, including: a) the caseworker's bridge-building role with clients; b) their role in building bridges with others in the community, including the resettlement agency; and c) the caseworkers’ experience as bridge builders, including motivations, perspectives toward their role, and needed supports. Refugee service providers face unique challenges in negotiating boundaries with clients and meeting the expectations of their ethnolinguistic community members. Their strengths in understanding household experiences and in building agency and community understanding highlight their ability to contribute to positive resettlement outcomes. The findings from this study have implications for agencies serving refugees and for other social services that utilize peer-support strategies, particularly in regards to staff training and support. Findings highlight the need for research examining effective resettlement strategies and the perspectives of refugees toward resettlement approaches.     

Implementing innovative evidence-based perinatal mental health screening for women of refugee background

ProblemNational guidelines recommend repeated screening for depression and anxiety for all women in the perinatal period. Routine screening in pregnancy is limited due to service, community and individual barriers.BackgroundPerinatal depression and perinatal anxiety affect up to 20% of all women. Women of refugee background are at even greater risk for perinatal mental health conditions due to refugee experiences and resettlement stressors.AimTo evaluate the acceptability and feasibility of a perinatal mental health screening program for women of refugee background from the perspective of health professionals.MethodsA mixed methods design guided by the Normalization Process Theory was used. Data were collected at a dedicated refugee antenatal clinic in the south-eastern suburbs of Melbourne, Australia. An online survey (n = 38), focus groups (n = 2; 13 participants) and semi-structured interviews (n = 8; 11 participants) with health professionals were conducted.FindingsUnder the four constructs of the Normalization Process Theory, health professionals reported improvements in identifying and referring women with mental health issues, more open and in-depth conversations with women about mental health and valued using an evidenced-based measure. Key issues included professional development, language barriers and time constraints.DiscussionImplementing a perinatal mental health screening program has been positively received. Strategies for sustainability include professional development and the addition of audio versions of the measures.ConclusionThis perinatal mental health screening program is acceptable and a feasible option for health professionals. Health professionals value providing more holistic care and have more open discussion with women about mental health.     

Social support networks,instant messaging,and gender equity in refugee education

ABSTRACT

This paper addresses the role of instant messaging chat groups to support teacher training and gender equity initiatives in Kenyan refugee camps. Our findings are based on survey data with refugee teachers in Dadaab and Kakuma refugee camps (n?=?203), group interviews with refugee teachers in Kakuma (n?=?21), and interviews with international instructors of teacher training programs in Nairobi, Toronto, and Vancouver (n?=?14). In our analysis, we apply amplification theory, feminist science and technology studies paradigms, and considerations of transnational approaches to understand the use of instant messaging among refugee teacher communities. Our framework explores how social and cultural norms are amplified through transnational text and instant messaging related to teacher training and in support of gender equity. Peer-to-peer group chats draw on transnational learning opportunities and expand these engagements through group chats between men and women refugee teachers across camps as well as through community engagement about gender equity initiatives in education. International instructors identify both value and hesitation in navigating the quantity and content of these communications, such as learning more about refugee teachers’ daily lives in the camps and concern about following and managing the amount of communication that can ensue over chat groups. Our work has practical implications for transnational teacher training programs in refugee camps, illuminates how mobile technology and chat groups allow women and men in the community to engage and support girls’ education, and questions how text messaging affects the lived and day-to-day experiences of women refugee teachers.     

Disentangling the role of income in the academic achievement of migrant children

Poverty has a well-established association with poor developmental outcomes in children but is often found to be a weak predictor of outcomes for migrant children. Building on theory focused on the developmental competencies of minority children, the current study used a systematic and novel analytic approach to disentangle the relationship between income and developmental outcomes for different groups of migrant children. Utilizing a population-based cohort of children in British Columbia, Canada (N = 23,154), the study examined whether income differently predicted the kindergarten to Grade 7 (K-7) literacy and numeracy trajectories of migrant children (economic, family, and refugee groups), in comparison to non-migrants. By applying Group-Based Trajectory Modeling (GBTM), the study found that lower income was generally associated with lower K-7 literacy and numeracy achievement trajectories. The relationship between income and achievement did not differ for migrant children in comparison to non-migrant children, with the exception of one sub-group of high-achieving economic class migrant children, which appeared to be less impacted by low income levels. Follow-up binomial logistic regression analysis found that parental education levels at migration and English language ability predicted which migrant children would be high literacy and numeracy achievers despite low income. The results suggest that basic associations between poverty and the outcomes of migrant children mask an underlying complexity: For most migrant children, poverty was just as predictive of detrimental academic outcomes as it was for non-migrant children and being in the exceptional sub-group of high-achieving, low-income migrant children was partly accounted for by other protective factors.