DETROIT — Their home is warm and full of richly spiced aromas, a vast improvement from the chaotic tent cities where they lived while fleeing war in Sudan. Refugee advocates have spent months helping them get settled, signing them up for Medicaid and food stamps and dental care.
Maryam Hassan Yahqub is grateful. But she also says this: “We feel lost.”
Her six children and her baby grandson live in a rough stretch of Detroit, next to several boarded-up and burned-out houses. President Trump’s temporary ban on immigration from Sudan and six other predominantly Muslim nations doesn’t enter their conversations. They don’t have time to think about politics.
About the Author Reprints
We have recently completed one of the largest prospective studies of stress, resilience, mental health and biological reactions in newly arrived refugees as compared to immigrants. In this NIMH/NIH-funded, 5 year study, we were able to demonstrate that most refugees managed tho cope with most forms of war trauma, if conditions in the US were supportive, low stress. However, with conditional stress in the US, e g socioeconomic strain, mental and somatic health worsened, obesity increased as did healthcare utilization. We also noted changes in how genes expressed themselves, especially gens related to regulations the stress system, inflammatory system, and obesity regulation. In work with our WSU colleague Professor Mark Lumley and colleagues, we demonstrated the efficacy of new and briefer forms of therapy to treat post teaumatic stress disorder. Intersting, in this first study with a truely random sample of refugees, the prevalence of PTSD was low as was depression. However, after coming to the US, rates increased especially if exposed to sustained stress. We are now working with many community based organizations, including ACCESS, Samaritas and others to evaluate effective community driven strategies to enhance wellbeing and integration of refugees. We also now know from this study that resilience strategy is a critical tool to manage post displacement challenges and complements the focus on only assessing stress. We now have several community engaged projects planned with research colleagues at MSU and WSU in order to move the refugee research beyond describing recognized problems to focusing on solutions. This is a critical,y important area and it is great to see the growing interest among communities and researchers to determine strategies to optimize post migration health and well being among refugees.
Bengt Arnetz, MD, PhD
My first question is why is someone spending an undisclosed amount of money to quantify the amount of stress refugees are under instead of just acknowledging that IT’S REALLY HIGH and spending that money actually helping? Because I can see grant money being “spent on refugee services” that actually pays doctors and researchers and data crunchers and analysts and front office phone answerers to study refugees, but refugees are like – we’re still stressed. And hungry. And depressed. And suicidal. And some agency just spent $750,000 to look at us and write a bunch of reports and get paid and how did that help us exactly?
I just have had some bad experiences with federal grants and how money is allocated – enormous sums are awarded for programs and like 20% gets spent on actual direct services, while the other 80% pays for 27 layers of bureaucracy and cost-inflated supplies and equipment to measure and analyze data.
I mean, I guess a lot of people don’t understand that refugees are stressed. And I guess some people need a fat spiral bound report complete with powerpoint and panel discussion to even entertain the notion that people who have been living in camps and shot at and raped and starved MIGHT HAVE PTSD FOR THE LOVE OF GOD. But seriously? Genetic testing to prove they are depressed and have night sweats and can’t navigate the US medical system? And a “gosh, oh darn” about the vermin-infested living conditions they’re subjected to once they arrive in DETROIT? It boggles my mind that this isn’t obvious to people.
I hope there is a clear picture of what can be done to help refugees who are undeniably stressed, depressed, anxious, and bewildered by the medical and social services systems. But America’s track record when helping AMERICANS who are experiencing all of the above is pretty atrocious. I would love to see any money given to programs like these spent on direct services, not research or equipment or genetic testing.
Dear Stacey,
I am the principal investigator on this study. I understand your passionate concerns, and here are a few comments:
– This work is solely on the WSU department of psychiatry internal funds, no funding specific to care of refugees is used.
– Majority of the staff on this work, are helping selflessly as volunteers.
– Establishing and determining the “need” is the first step in any form of meaningful intervention. Prevalence range has been very wide in previous studies based on the type of trauma, environment, and the population. If the prevalence of PTSD is 2% in a population of 1000 people, then there would be need for treatment of 20 people. If the prevalence is 30%, then there is need for treatment of 300 people. The amount of resources needed for these scenarios is different. The data produced from this volunteer based work, will provide valuable insight for the authorities, and also helps advocating for seeking resources to help.
– Medical care of the population is provided by the clinic where they are seen, and is separate in funding from the university research study.
– The genetic and biological components of the study, are again funded by the WSU, and the results, along with other genetic studies, can help with providing more sophisticated prevention and treatment of such conditions in the future. Like any other area in the medical field, we need a full biological understanding of the disease to be able to improve our treatment methods.
– Having established the need, we are working on using our funds, and seek external funds to provide interventions for those identified in high need for evidence based treatments for PTSD and depression.
Once again, thank you for your concern and care.