TUESDAY, Oct. 1, 2002 (HealthDayNews) -- Women refugees and immigrants fleeing countries rife with war, persecution or disaster may be able to escape potential physical harm by moving to a new country. But that doesn't always guarantee their mental well-being.
They may carry the baggage of post traumatic stress disorder (PTSD) with them to their new countries, says a study of immigrant, refugee and visible minority women in the province of Saskatchewan, Canada.
In some cases, their PTSD may remain hidden just below the surface for years until full-blown symptoms are triggered by a stressful event or situation.
Even the actual immigration process or the challenges of creating a life in a new country and culture can compound a person's distress and mental trauma, says the report by Judy White, a professor of social work at the University of Regina in Saskatchewan.
Often, these women have difficulty getting help for their PTSD in their adopted homelands. The new report emphasizes the need for policy makers, doctors and community workers to improve mental health services for immigrants and refugees.
The study was presented today at a meeting at the University of Winnipeg, in Manitoba.
White interviewed 20 female immigrants and refugees living in different communities across Saskatchewan. The women came from a range of countries and continents, including South Africa, Ethiopia, Bosnia and Latin America. Focus groups with immigrant/refugee women and interviews with a physician and psychiatrists were also part of the study.
One of the most significant findings was that many immigrant and refugee women with PTSD don't use mental health services available to them in Saskatchewan, White says. There are a number of reasons for that trend.
Many of the women aren't aware of what help is available to them, and mental health services aren't doing enough to reach these women, White says.
Culture is another factor. Many of the women come from countries or societies where there's a strong stigma attached to mental health problems, so the women may be reluctant to seek help or discuss their problems, even in a new country.
Language also may be a barrier. Many of the women aren't fluent in English. That can make it difficult for them to explain post traumatic stress symptoms such as flashbacks or anxiety attacks.
"Some of the women mentioned that they didn't feel comfortable about going and talking because they couldn't express themselves," White says.
She offers a number of suggestions on how to improve the situation.
Medical professionals need to pay closer attention to the possibility of PTSD in immigrants and refugees, White says. She says physicians and psychiatrists do seem to have strong theoretical knowledge about PTSD. But that knowledge isn't always translated into practical application.
During initial interviews with refugees and immigrants, doctors often fail to ask the right questions to open up the discussion and enable them to get a sense of whether a person is suffering from PTSD, White says.
In terms of accessibility, mental health services are often tucked inside large, confusing government office buildings. Easy-to-find and less intimidating community-based mental health outlets are a better option, says White.
In some cases, it can take years for PTSD to become apparent. White says one woman in the study was a refugee who witnessed killings and other violence in her home country. But she was in Canada for about 13 years before her PTSD manifested itself after she was assaulted at work.
"She completely fell apart. She couldn't go do groceries, she couldn't sleep," and she was off work for six months, White says.
PTSD is a psychiatric disorder that can occur after witnessing or escaping life-threatening events such as military combat, natural disasters,
terrorist incidents and serious accidents. Victims are often plagued by nightmares and flashbacks of the traumatic events. They also may have difficulty sleeping, and feel "detached or estranged," and these symptoms can be severe enough and last long enough to significantly impair daily life, according to the National Center for PTSD.
PTSD in immigrants and refugees is an important issue for Canada, the United States and other developed countries as they continue taking in people fleeing countries where violence and persecution are common, White says.
What To Do
You can learn more about post traumatic stress disorder at the National Center for PTSD or the U.S. National Institute of Mental Health.
