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KPBS Midday Edition

Helping San Diego-Resettled Refugees Overcome Trauma

Nile Sisters Development Initiative Senior Program Manager Rebecca Paida, who also chairs the San Diego Refugee Forum, speaks at a news conference announcing a refugee mental health toolkit, Oct. 10, 2017.
Nicholas McVicker
Nile Sisters Development Initiative Senior Program Manager Rebecca Paida, who also chairs the San Diego Refugee Forum, speaks at a news conference announcing a refugee mental health toolkit, Oct. 10, 2017.

A City Heights-based nonprofit drew attention to refugee mental health needs to mark World Mental Health Day in San Diego. Nile Sisters Development Initiative touted on Tuesday its grassroots effort called MIND, Matters Involving Neuro-Disorders, to assess behavioral health resources for newcomers and brainstorm improvements to services.

Many of the thousands of refugees who land in San Diego each year may be fleeing violent situations in their home countries, which can leave physical but also emotional scars.

Helping San Diego-Resettled Refugees Overcome Trauma
Helping San Diego-Resettled Refugees Overcome Trauma GUESTS: Elizabeth Lou, Nile Sisters Development Initiative Alfredo Aguirre, San Diego County, Behavioral Health Services

This is KPBS Midday Edition. Refugees in San Diego have left the war of their homelands behind them. Not always the mental and emotional words best cars. Research shows that many may be at risk of long-term emotional disorders. Some traumatic experiences affecting the Somali refugee community may impact their U.S. or in children. To mark world mental health day, Karen mentor spoke with Elizabeth Lou. Of refugee who developed an initiative to assist refugees in San Diego.Here's that interview.What sort of trauma might refugees be overcoming?They are trying to overcome trauma from leaving their home country. They need to go to neighboring countries and from neighboring countries go to camps. They stayed in camps for more than 10 years or they have waited a very long time in camps. Finally, when they are cleared to come to the United States and start life over, it is very challenging and it can be stressful and traumatic. Refugees are struggling with those issues.I want to ask Alfredo, what kinds of mental health issues are we seeing among the refugee population?I think what we are seeing are things like posttraumatic stress and extreme bouts of anxiety. That may look like a panic attack. We can have individuals who are so paralyzed that they cannot continue with a task at hand. We have young students in East County, we have a program designed to do an early intervention in the classroom. We can see how this impacts the child's ability to concentrate and learn. There may be bouts of tearfulness and detachment. They may not be able to connect with the rest of the students or the teacher.Elizabeth, there is a Sigma attached to addressing mental health needs. Does it extend to the refugee community as well? Is this idea familiar with refugees?It may not be in all languages. The services are great. The number of refugees in San Diego County is very large. We have about 150,000 refugees in San Diego. San Diego is the largest county in California that re-settles refugees. In the city -- in city heights, we have about 2000 refugees from East Africa. The number is very highSome providers may not cover all these people and the language is a huge barrier. Not everybody speaks Arabic or Swahili. We have more than 25, one said 30,000 different language and dialects in San Diego and in city heights alone. The barriers are there. That is why we have taken the initiative to come up with these programs. 57 individuals and 29 organizations from ethic community-based organizations and faith based including behavioral health that is a part of this initiative. We really want to be able to encompass every need out there and we need to address the mental health and need in refugee communities collectively, not individually.Summarize what services are available to refugees.We serve and are responsible for the Medi-Cal population we are a specialty mental health provider. They need something more than general -- counseling. We are the safety net. We do serve individuals that may not have coverage but are experiencing a mental health issue or crisis. We are responsible to ensure we meet those individuals needs. The challenging piece with our refugee community is that they bring an assortment of issues. Not all of our services necessarily meet or are as responsive as we would like. We don't have all the languages. There is a. Of languages that come here. We are responsible as a Medi-Cal provider to provide services and have material in our threshold languages so for some of the African communities, there is Arabic spoken. They have access and they are entitled to those services. However, anybody who speaks another language, we have a language bank and our providers can prove -- access that. It is a challenge. We do have some specialized services for serving newcomers. We have a survivors of torture program here that has been long-standing. They serve 100 individuals yearly. They're very resourceful. They get other funding. They serve more than 500 people total per year. This is a combination of refugees and people who have been residents of this country for a while but are still experiencing trauma. We have another program to serve other communities. They have been around for a while. We need to have this be part of a fertile -- barter health network of resources. It is often more, better received. You get a better picture when you look at the social service needs as Elizabeth alluded to and some of the health issues that may be going on.As we are talking about this thing a problem. Community members might want to know how they can help. What role can the public play if they are not immediately attached to the refugee community?They can go to our website and read that information. They can see our work. They can provide volunteer services and also other resources that can help us move forward. As you know, for organizations to develop programs like we have just done, it takes investment. Takes financial support.Is there room for the public to play a role in this from the county's perspective?Absolutely. There may be individuals out there that are professionals from the country of origin and are fluid in more than one language. We would love to hear from those people. Perhaps they could be a part of our interpreter program. They can share their interest. That is one of the areas where we could use support.That was the health director --Alfredo Aguirre.

A July 2017 report from UC San Diego showed some traumatic experiences affecting Somali refugees may even impact their U.S.-born children, and preliminary survey results shared at a June conference in San Diego found high rates of anxiety among Syrian refugee kids.

Nile Sisters launched MIND to unite community and government stakeholders to better serve these kinds of behavioral health needs among refugees. The organization facilitated a series of roundtable discussions that found challenges to care include language and cultural barriers.

"The term anxiety may not be in all refugee languages," Nile Sisters founder Elizabeth Lou said, noting that while services do exist, providers may not be able to meet the needs of the region's large refugee population.

San Diego County Behavioral Health Director Alfredo Aguirre, who has worked with the MIND coalition, said the county offers specialized programs for refugees but acknowledged hurdles exist.

"The challenging piece with our refugee community is they bring in an assortment of issues and not all of our resources are as culturally competent or as responsive as we would like," Aguirre said. "We don't have all the languages — there's a myriad of languages that come to our country."

As a Medi-Cal provider, Aguirre said the county is required to offer services in five "threshold" languages, which include Arabic, Farsi, Spanish, Tagolog and Vietnamese, but said there are interpretation options for other languages.

On World Mental Health Day, KPBS Midday Edition spoke with Lou and Aguirre about the resources available to refugees and the efforts to bridge any gaps.