Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community-based interventions are discussed, along with future opportunities for research in intervention development and evaluation.

/pdf/cultural-considerations-in-adolescent-suicide-prevention-and-20rb2786lg.pdf

Cultural considerations in adolescent suicide prevention and psychosocial treatment

Trained counselors interviewed 192 women who had been trafficked and sexually exploited about abuse and evaluated their physical and mental health status within 14 days of entry into posttrafficking services. Most reported physical or sexual violence while trafficked (95%), pre-trafficking abuse (59%), and multiple posttrafficking physical and psychological problems.Newly identified trafficked women require immediate attention to address posttrauma symptoms and adequate recovery time before making decisions about participating in prosecutorial or immigration proceedings or returning home.

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.2006.108357

The health of trafficked women: a survey of women entering posttrafficking services in Europe.

https://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1085&context=psychfacpub

Understanding mental health needs of Southeast Asian refugees: Historical, cultural, and contextual challenges

The number of North Korean defectors entering South Korea has been increasing rapidly since 1994. Two hundred North Korean defectors in South Korea were studied to identify their experiences of traumatic events in North Korea and during defection, and the correlation with Posttraumatic Stress Disorder (PTSD). Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, the Traumatic Experiences Scale for North Korean Defectors, and the PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: Physical Trauma, Political-Ideological Trauma, and Family-Related Trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: Physical Trauma, Detection and Capture-Related Trauma, Family-Related Trauma, and Betrayal-Related Trauma. In multifactorial logistic regression analysis, Family-Related Trauma in North Korea had a significant odds ratio.

Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea

This paper examines with a somewhat critical eye the primary role that psychotherapy and other clinic-based services currently play in addressing the mental health needs of political refugees in the industrialized countries. Two factors are considered which suggest that refugee mental health needs might be better served by complementing clinic-based treatments with a variety of community-based interventions. The first factor concerns the pervasiveness of psychological distress within refugee communities, coupled with the reluctance of many refugees to utilize formal psychological and psychiatric services. This calls into question both the adequacy and appropriateness of clinical-based services as cornerstones of our response to the mental health needs of refugees. More precisely, it suggests the need to complement such services with a variety of culturally grounded, community-based strategies that do not require attendance in formal mental health settings. Second, recent findings have shown consistently that a considerable amount of the distress reported by refugees is related not to prior exposure to violent events, but to a constellation of exile-related stressors such as the loss of one's community and social network, the loss of important life projects, changes in socioeconomic status and related concerns about economic survival, the loss of meaningful structure and activity in daily life, and the loss of meaningful social roles. It is suggested that while psychotherapy can play an important adjunctive role in helping people confront these exile-related stressors, they may most effectively be addressed through targeted community-based interventions. Examples of such community-based approaches are briefly described, and suggestions are offered for community-level strategies that might be explored. The paper concludes by emphasizing the complementary nature of clinical and community-based programs, and by suggesting that psychotherapy might best be conceptualized as one component of a more comprehensive approach to addressing the mental health needs of refugee communities.

http://www.drkenmiller.org/Ken_Miller,_Ph.D./CV_files/Rethinking%20a%20Familiar%20Model.pdf

Rethinking a Familiar Model: Psychotherapy and the Mental Health of Refugees

most painful of these is experienced by an immigrant who has grown up in one culture and finds it necessary to move to another. This separation involves transitional processes which enable persons to cope with personal and material losses and to learn social, economic and psychological skills necessary for functioning in a new culture. The literature refers to these processes as acculturation and depicts them as occurring in the following three sequential stages: (1) four months following arrival in which refugees appear to be focusing on their present environment by availing themselves of the concrete services provided by various agencies; (2) four months to one year after arrival in which they appear to be realizing their past losses and present difficulties and to be manifesting psychological distress (Tyhurst, 1951); and (3) one to two and a half years later in which their psychological distress has been reported to be reduced and their acculturation adjustment has been facilitated by the interpersonal social support provided by their families, communities and established agencies (Tyhurst, 1951; Nguyen, 1984). The rise of the Khmer Rouge in Cambodia in 1975 led to an influx

Susan B. Strober

Papers

Social work interventions to alleviate Cambodian refugee psychological distress