Migrant Trauma and the Role of Healthcare Professionals and Systems in Enhancing Wellbeing

Abstract

Millions of children and adults are forcibly displaced from their homes each year, with a significant proportion seeking refuge in the European Union. Before, during and after their migration journey they may experience multiple trauma events that may lead to significant stress and complicate their adjustment to the host country. Physical, emotional and behavioral responses to adversity (the traumatic stress response) vary and are influenced by numerous factors, notably by cultural beliefs and norms. Culturally responsive healthcare professionals who serve migrant patients are in a unique position to recognize signs and symptoms of traumatic stress, and provide basic, practical interventions. Given the large number of migrant individuals at risk for significant behavioral health issues and the relatively limited number of mental health professionals available to treat them, resources are best allocated if the primary healthcare provider is equipped to offer formal or informal “screening” for traumatic stress (e.g., use a culturally adapted and validated clinical tool or ‘screen’ with open- ended questions about the migration experience, current patient wellbeing, and daily stressors). They may then offer a basic intervention for the majority of patients with mild-moderate symptoms of stress, while referring those with severe symptoms to trained mental health specialists. This article reviews the types of trauma often experienced by migrant families and the nature of the traumatic stress response. It explores how culture may impact manifestations of traumatic stress and influence discussions of trauma between patients/caregivers and healthcare professionals. Moreover, it outlines the roles of the primary healthcare professional and their organization in recognizing and responding to the needs of these vulnerable patients. Screening options, basic psychoeducation strategies and the importance of community resources are discussed. The need for clinical protocols and a trauma-informed healthcare facility, as well as staff education regarding migration-related health and behavioral health needs, cultural responsivity, and trauma-informed care is emphasized, and resources are provided.