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Things to Consider:

The mental health of those providing treatment in direct conjunction with that of the
refugees.
The cultural contexts of the refugee/patient.
Adopting a more culturally contextual approach to mental health services (as opposed to
implementing more Westernized systems and ideals).
The challenge of providing any kind of universal protocol or standards for mental health
treatment.
The socioeconomic accessibility of mental health care in nations and areas marked by
conflict.
Social stigma of mental health (BUT DO NOT assert that this can be attributed to a
backwards propensity of an atavistic, nonwhite culture.
Kleinman et al set of questions to ask the patient. The patient-centered therapeutic nature
can help attain a sense of cultural understanding (10).
Remember that, to breach cross-cultural boundaries, one must effectively collaborate
with the impacted culture.
Consider the social stigma surrounding the seeking of mental health care.
Cultural connections, in conjunction with familial ties, are both part and parcel to the
mental wellbeing of the refugee.
Remember, too, sometimes overpathologizing a refugees plight can have a reverse effect
on their treatment.
Harvards Study for Refugee Trauma Thing categorizes trauma into three varying
magnitudes:
o 1. Ordinary Human Suffering (OHS): This is the most typical response to crises.
Based on the assertion that suffering is not always a pathological condition,
adversity is merely a facet of life. Therefore, it is unnecessary to medicalize it or
pathologize it.
o Distressful Psychological Reaction (DPR): This does not always warrant certified
attention. Average human resilience can sufficiently address this phenomenon.
o Psychiatric Disorder (PD): This manifests itself primarily in PTSD, and thus
necessitates the aid of a specialist.
STRUCTURAL NOTE: Entertain the thought of devoting an entire paragraph to Western
forms of psychological treatment as a kind of default. Given that, from the onset of the
UNHCR, it has been implemented as such.
STRUCTURAL NOTE: For the examples, use the implementation of different systems in
camps specified in some the articles.
It seems that, generally speaking, a community-based approach is one of the most
universal remedies of mental health issues.

For the burden(ish) of the host government, the respective culture and mental health
service may or may not be conducive to those of the refugees.
Additionally, the host governments current services, such as psychiatric and mental
hospitals, may be unfit to accommodate an influx of mentally unstable refugees.
PROPOSITIONAL NOTE: Have a kind of consultation panel comprising of a respected
role of the refugee society (religious figure), a trained regional professional, etc.
Basically, try to conceive of a fusion between the lay approach, as documented by Ken
Miller, and the institutionalized UNHCR.
PROPOSITIONAL NOTE: Given that this panel could be assembled quickly, and under
extenuating circumstances and fast-growing conflict, there should be immediate
background research as soon as individuals seek refuge.
PROPOSITIONAL NOTE: A downfall to this is, admittedly, the fact that the rushed
nature of such an assembly very well might employ misguided and insufficient persons to
the task.
PROPOSITIONAL NOTE: A system and protocol that is manufactured to the culture
rather than the inverse.
COUNTER-PROPOSITIONAL NOTE: The one administering treatment, if they do
originate from the community, must be deemed healthy enough to properly provide it.
One of the most pressing factors to stress is that most psychotic symptoms displayed by
refugees can be attributed to their current state of exile and limbo, rather than trauma
endured by the previous conflict.
Every context of the refugee must be considered, rather than making therapy being based
solely on emotional or theoretical frameworks.
PROPOSITIONAL NOTE: As is often the case with psychology, it may be erroneous to
polarize these different schools of thought. Rather, mediation may be reached, given that
WHO does recognize symptoms that manifest themselves in other ways.
PROPOSITIONAL NOTE: There should be a framework-within-a-framework. That is to
say, the UNHCR may have a general, flexible framework for mental health treatment.
This is based on (generally) universal findings from refugee camps (such as the need for
family, self-help groups that empower, etc.) Enclosed therein is the bandwidth for an
individualized treatment plan and protocol for both collective and individual relief. This
individualized treatment plan will be catered to the culture and persons of the refugees,
and can alter the additional framework if needed.
PROPOSITIONAL NOTE: Some Western attempts at more universal psychological
treatment, such as international psychiatry, are recommended as being selectively
implemented. Some psychopharmacological treatments are, unfortunately, statistically
more readily available in developed countries.

-Caring and Nuclear Family: Need for unconditional love and support.

-Self-Help Groups That Empower: A shared and mutual misery, yet a collective strength that's
attained from it.

-Possibility to Work or Generate Income: Purpose and preemptive protection against rumination
over endured trauma.

-The ability to participate in cultural ceremonies or religious rituals: Again, the dire need to
retain one's culture and religion-perhaps as a means of maintaining connection with one's selfimage. This carries a multitude of implications. It could be that the individual's resilience, in
response to the oppression and persecution presumably endured as a result of their culture,
ennobles them in their resistance. Additionally, it could be that they feel validated, as the
oppression endured because of their culture and identity can still be protected and practiced. The
complication is, naturally, the displaced state of being that they live under.