Based on the previous discussion, school-based interventions appear to have many advantages related to access and stigma reduction; however, they might not be suf-ficient to meet the needs of all refugee families and destigmatize seeking help for mental illness. Therefore, interventions targeted at the community level can foster more support for refugee youth and their families.
Refugee communities can be essential partners and allies in engaging refugee youth and helping them access early mental health interventions. Burbage and Walker (2018) suggest developing a community support system through which community leaders serve as liaison between the refugee population and mental health professionals to provide refugee youth with access to services. Often com-munity leaders hold a deep understanding of the needs of their community’s youth, including what would be perceived as helpful services and who (within and beyond the community) should be trusted (Ellis et al., 2010). Integrating community engagement approaches that respect community members—including youth as equal partners—and honour the knowledge and expertise they hold can lead to developing mental health programs that are accessible to refugee youth (Ellis et al., 2020). The approach needs to include a willingness to listen openly and honestly to community members and engage them as partners in developing programs and ser-vices that might diminish any fear and stigma associated with mental health ser-vices; this can be achieved by building trusting relationships between community members and service providers. Additionally, these programs should be developed in ways that are mindful of the cultural perspectives of community members and consistent with their values and approaches to healing (Ellis et al., 2020). Despite this, community mental health programs that include refugee communities in their development of services are rare. Community engagement approaches might take a range of forms; for example, Ellis et al. (2011) posited that mental health clinicians could seek partnerships with community-based organizations that specialize in serving refugee communities and create parent advisory boards to ensure a diversity of perspectives are represented in the development and implementation of refugee youth mental health services. Further, Torres et al. (2018) suggested that clinicians could also seek to build trust and engagement individually by clearly communicating their roles and the fact that they operate separately from child welfare or law enforcement. An example of a community engagement in mental health service is the transcultural psychiatry team developed by Measham et al. (2005) in Montreal, Canada. This program involved psychiatrists, psychologists, anthropologists, and community organizations to pro-vide services to refugee families. The multidisciplinary team is based at Montreal Children’s Hospital where they provide pharmacology and culturally specific ser-vices and interventions to refugee youth and their families, services which include a collective understanding of individual mental health as well as the inclusion of traditional healing ceremonies and interventions. The team has found this approach to be highly effective in engaging refugee youth and their families. Regardless of the form it takes, successful community engagement means being open to learning and listening, respecting differences, and viewing community partners as equal in their work supporting the mental health of refugee youth.
Conclusion
Given the high degree of trauma experienced by many refugee youth, programs that promote early mental health interventions are essential. Discussion in this chapter indicates that mental health programs that target refugee youth need to integrate a comprehensive approach—individual, family, schools, and communities—to improve the mental health care of this group. Service providers who are interested in making their services accessible, acceptable, and appropriate to meet the needs of this group must also ensure their services integrate culturally competent care to effectively engage refugee youth in services. Working across these levels will make mental health services more accessible and offer more comprehensive support to this group.
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