Leveraging Community-Based Mental Health Services to Reduce Inequities for Children and Families Living in United States Who Have Experienced Migration-Related Trauma

• Published in: Psychological trauma 2024-08, Vol.16 (S2), p.S426-S434
• Main Authors: Miller, Alisa B., Davis, Seetha H., Mulder, Luna A., Winer, Jeffrey P., Issa, Osob M., Cardeli, Emma, Ellis, B. Heidi
• Format: Article
• Language: English
• Subjects: Child; Community Mental Health Services; Community-Based Participatory Research; Culturally Competent Care; Emigrants and Immigrants - psychology; Evidence Based Practice; Family; Family - ethnology; Family - psychology; Female; Healthcare Disparities - ethnology; Human; Human Migration; Humans; Immigration; Mental Health Services; Policy Making; Psychological Trauma - ethnology; Psychological Trauma - therapy; Refugees; Refugees - psychology; Trauma; United States
• ISSN: 1942-9681; 1942-969X; 1942-969X
• DOI: 10.1037/tra0001392

Objective: Trauma systems therapy for refugees (TST-R) is a trauma-focused, culturally responsive mental health prevention and intervention model designed to meet the needs of children and families who are fleeing their home countries and seeking humanitarian refuge. TST-R provides trauma-focused mental health treatment and addresses problems in part exacerbated by harsh U.S. immigration policies (e.g., poor mental health, stigma, fear) that have implications for the psychosocial well-being of immigrant children and families, especially those who have experienced migration-related trauma. Method: Informed by a community-based participatory research approach, TST-R was developed as an adaptation of trauma systems therapy to address common barriers to care experienced by those of refugee and immigrant backgrounds, including mental health stigma, distrust of service systems, and cultural and linguistic barriers. Results: TST-R is a multitiered and phase-based intervention that strategically addresses stressors and needs across levels of the social ecology. Most TST-R services are delivered in easily accessible, nonstigmatizing settings (e.g., school) by a cultural broker and a clinician who work in partnership. TST-R has been disseminated and implemented with multiple cultural groups (e.g., Somali, Bhutanese) across the United States and Canada. Conclusions: Given the unique stressors, strengths, and needs of immigrant children and their families, mental health services must be equitable, community based, and sustainable. TST-R demonstrates promise as a prevention and intervention model especially for those experiencing immigration policy-related stressors and may serve as a guide for developing child mental health policies and immigration policies that promote mental well-being for immigrant families. Clinical Impact Statement Federal immigration policy can uniquely affect the mental health of immigrant children and families, both directly and indirectly. Trauma systems therapy for refugees (TST-R) is a trauma-focused, culturally responsive mental health intervention for immigrant children and families designed to address stressors, challenges, and strengths commonly experienced in their community. TST-R allows intervention focus to shift to the most significant issues for children, which include policy-related stressors when those are most salient. TST-R demonstrates promise as a sustainable, scalable, and equitable mental health model that is well suited t