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The Challenges Facing Mental Health Programs for Post-Conflict and Refugee Communities

Published online by Cambridge University Press:  28 June 2012

Derrick Silove
Derrick Silove*
Affiliation:
Centre for Population Mental Health Research, Southwestern Sydney Area Health Service and School of Psychiatry, University of New South Wales, Sydney, Australia
*
Psychiatry Research and Teaching Unit Level 4, Health Services Building Liverpool Hospital Liverpool, NSW 2170, Australia E-mail: d.silove@unsw.edu.au
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Abstract

The majority of refugees and communities exposed to warfare and oppression live in low-income countries with few resources or special skills. Yet, epidemiological studies have identified high levels of traumatic stress reactions in such populations. These stress reactions can be intensified by harsh policies aimed at deterring survivors from seeking refuge in technologically advanced societies. The scale of the problem of mass violence and displacement creates formidable challenges for mental health professionals in their efforts to develop practical frameworks for responding to the extensive needs of displaced persons. In this article, a model is proposed for low-income, post-conflict countries, based on a two-tiered formulation. At the eco-social level, mental health professionals can play a supportive, but not a lead, role in facilitating recovery of core adaptive systems that hasten natural recovery from stress for the majority of the population. Where small-scale, community mental health services are established, the emphasis should be on assisting persons and their families who are at greatest survival and adaptive risk. Training and promotion of local workers to assume leadership in such programs are essential. In technologically advanced societies in which refugees are in a minority, torture and trauma services can focus more specifically on traumatic stress reactions, acculturation, and resettlement. In a historical epoch in which displaced persons are facing particularly harsh treatment, there is a pressing need for consensus amongst mental health professionals in advocating for their needs.

Keywords

asylum-seekersinternally displaced personsmental health servicespostconflict environmentspost-traumatic stress disorder (PTSD)psychological traumarefugees
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 19 , Special Issue 1: Psychosocial Themes , March 2004 , pp. 90 - 96
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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