Tuesday, May 22, 2012

Mental Health Form


Alliance for African Assistance
Refugee Mental Health Services
for Family Advocates


Family advocates are sometimes the first to see that a refugee is suffering the emotional or psychological effects of migration, trauma, and personal loss as the challenging reality of resettlement becomes clear. Alliance for African Assistance provides psychological services for refugees.

It is critical that family advocates be respectful of the particular cultural assumptions that refugees may have about admitting to their suffering or to the suffering of members of their family or community. As for many Americans, there is often great stigma around being thought of as “crazy.”

That said, if you recognize that a member of the family you are supporting is suffering emotionally or is displaying a behavior that worries you, you could be a critical advocate to assist them.

First of all, it is fine to express your concern for the refugee. Talking about their suffering will not make it worst but generally better. This is particularly true for statements about wanting to be dead, of wanting to commit suicide, or of wanting to hurt someone else. Just listen to their concerns without feeling like you have to solve their problem. Let them know that Alliance can help them.

Second, talk to Julie or Joelle. They can assist you connect with our psychologist, Dr. Dehnel.

Your conversation with Dr. Dehnel will be confidential and together you and he can figure out the best way to intervene. If the refugee wants you to keep what they have said to you confidential, you can talk to Dr. Dehnel about the concerns you have without revealing the name of the refugee or identifying information. You have the right to be informed, to learn, and to discuss your concerns. That is part of your role as a member of our team. You can call Dr. Dehnel at (619) 402-7305 or stop in his office at Alliance. He is very approachable and is interested in what you have to say.

In general, be respectful, assure the refugee that you will keep their confidence, and let them know that you will assist them find the help they need. Here are some indications that a refugee needs our help.


□  Suicidal Thoughts
□  Homicidal Thoughts
□  Sadness, Crying
□  Depression
□ Difficulty Sleeping
□  Hopelessness
□  Lack of Motivation, Interest
□  Feelings of Worthlessness
□  Loneliness
□  Difficulty Concentrating
□  Nervousness, Fear, Worry
□  Panic Attacks
□  Anger, Violence
□  Hallucinations, Delusions
□  Traumatic Flashbacks
□  Traumatic Memories
□  Emotional Numbness
□  Chronic Physical Pain
□  Alcohol or Drug Abuse
□  Eating Disorder
□  Sexual Problems
□  Personality Change
□  Difficulty Parenting
□  Difficulty Learning

FAM meeting 5/18/12


Family Advocate and Mentor Meeting: May 18, 2012
FAM Updates
§  Andre’a: family from Iran, the father speaks English well, she is helping the mother with hers, the daughter is learning very fast! She has taken them hiking, baked them cookies, joined them for dinner, etc.
§  Erin: family from Russia, has been mentoring them since December, she has taken them to the beach, grocery stores. They are enrolled in all ESL classes offered during the day.
§  Diane: family from Columbia, tutoring kids, teaching the father how to drive, she has also been helping advocate for childcare.
Staff Comments
§  Gerald: FAMs are a blessing, he presented in Washington in regards to the work we’re doing here and how integral volunteers are to our programs. Sees us as transformers, as a way to help refugees forget about the persecution they lived through. It is so important to have people here to help them through the process. He is happy when his mentored families say they don’t need him anymoreJ
Mental Health- Russell Dehnel
§  Refugees are expected to be on their feet in 6-8 months after arrival, yet they don’t always have the support needed to get there.
§  75% suffer from PTSD
o   -civil wars in Africa
o   Iraq/Iran/Afghanistan wars.
o   Dealing with things no human being is wired to deal with
§  On top of that: having to learn English, get jobs, adjust to new culture/environment/way of life, figuring out school systems here for their children, dealing with raising kids; needs of children-health, welfare, schools.
§  Upon Arrival, refugees are focused are resettling. After the first month or so, reality sets in; a whole other set of obstacles arises. They realize the economic and cultural state they are in.
§  FAMs act as community, support network: this is very similar to what a lot of our clients are used to in their home countries where “it takes a village to raise a child”: it takes a community to resettle!
§  Symptoms are listed on the referral sheet-related to trauma
§  If you notice anything, you can let any staff member know.
Questions…
§  If don’t see symptoms and don’t know their history, how do you address mental health?
o   Russell: just ask, ask about their lives. Listen to your gut, follow your heart. Find the right moment to ask and feel out the situation. You may want to let it be. Always feel free to alert me or any staff member to your hunch and we can discreetly handle it from there.
§  What if there is a problem with the wife and the husband doesn’t want her to come in?
o   Russell: in the US, independent health services are a right. Offer for her to come in and talk to a female nurse practitioner, if that’s helpful. Can use poor sleep as a reason for referral, etc. Alert us (Russell, Joelle, Julie, a Case Manager, etc) to the issue, especially if you are worried about losing trust. As a team we can develop a strategy-a way to include the family/husband to make sure the wife receives help. Respect roles, redefine roles so family gets what they need and acknowledge the need to maintain a sense of self worth for the husband. Although, he doesn’t have the right o refuse medical treatment for his wife. There are sensitive ways to address the issue.
Other Comments
§  Gerald: factors for choosing and making matches:
*      They look for open families who want help, giving reserved families more time to adjust and realize they might need help.
*      Language-consider where they are coming from and who can easily communicate with.
*      Tells FAMs to do as much as they can/ feel comfortable with-don’t get burnt out and leave!
§  Erin: her own goal: for the family to become self sufficient. Connect to community, DMV, bank accounts, online banking, stores, government checks, ESL, school, job searching, park-fun!
*      Erin can help clients set up bank accounts, learn online banking if you need help!
§  Andre’a: Use what you’ve got! All family’s needs are different!
§  Gerald: wants the clients he serves to get the best! Volunteers motivate him!