In the COVID-19 pandemic, additional mental wellness challenges are being placed on refugee, immigrant, and migrant (RIM) community members due to increased stigma, isolation, financial stressors, and existing traumas from resettlement. Ensuring equitable barrier-free access to mental health support and resources is especially critical for RIM communities to mitigate the disproportionate impact of COVID-19 on this population and prevent further trauma. It is also important to note that children may be affected, too, and may need mental wellness support.
Engaging with RIM Communities to Support Mental Well-Being
Health departments, resettlement agencies, and community-based organizations (CBOs) are engaging RIM communities and promoting mental health and resiliency during COVID-19. These groups are uniquely positioned to reach communities through COVID-19 hotlines, community health workers, testing and vaccine events, and word-of-mouth. Support interventions focus on strengthening and maintaining social networks, maintaining healthy routines, and screening for “need” areas. When planning programs and events, consider these tips to support mental wellness in the RIM community:
- Validate and normalize feelings; it is normal to experience a wide range of emotions during this time
- Consider how your organization can facilitate Zooms, distanced meetings, support and resource information, hotlines, and videos
- Encourage RIM community members to stay in close contact with loved-ones via phone or internet, or suggest physically distanced porch, balcony, or patio visits
- Encourage setting up physically distanced walking groups or other groups to maintain friendship and support
- Support RIM community members in identifying skills they have used in the past to overcome adversity and encourage coping strategies that fit within their lifestyle
- Facilitate access to the resources they need to put these habits into practice
- Encourage keeping daily routines
- Screen for violence or abuse in the home
- Facilitate virtual access to mental health workers and support them in creating a plan for how and where to seek help if necessary
- Facilitate access to culturally and linguistically appropriate information from reliable resources
- Promote limited exposure to media reporting news about the health crisis
Connecting with the RIM Community in Arizona
To address mental well-being in their elderly RIM population, The Campesinos Sin Fronteras (Farmworkers Without Borders) promotores (community health workers) developed a coloring book with positive messages. The community health workers delivered the coloring books and coloring materials to the doorsteps of community members. The promotores remained in contact with the elder community and conducted follow-up with them to take the place of support groups that were suspended during COVID-19.
Reaching the RIM Community in Eastern Iowa
In Eastern Iowa, the University of Iowa collaborates with the Iowa Bureau of Refugee Services to identify refugees' mental health needs, train healthcare providers on discussing mental health, and support refugees in stress management. The group utilizes a peer-to-peer model developed by the World Health Organization (WHO) called Problem Management Plus (PM+), which community health workers can deliver. The team hired multilingual and multicultural community facilitators to support the program, mainly from Eastern African RIM communities and leaders or influencers. They underwent approximately 16 hours (2 days) of in-person training and 8 hours of virtual training and received ongoing supervision. The program helps RIM participants learn strategies to manage stress, relax their body, address their feelings, respond to problems that arise, find motivation for essential activities, and strengthen social support within a non-clinical community setting.
Reaching the RIM Community in Linn County Iowa
As part of the Linn County Iowa Public Health Department’s effort to address mental health in their community, their mental health branch of the Incident Command Structure partnered with mental health providers throughout the community. The collaboration included providers from the National Alliance on Mental Illness (NAMI) and AbbeHealth, a community mental health clinic. The providers reached out to agencies that work with the RIM community, including schools and employers, to provide handouts and mental health materials in native languages and offer someone to speak to about mental health. The group also offers free mental wellness in-person or telehealth visits and virtual support groups through CARES Act funding.
Supporting the RIM Community in California
AltaMed Health Services is the nation’s largest independent federally-qualified community health center (FQHC) and serves patients in Los Angeles and Orange Counties. It is dedicated to pediatric care in partnership with Children’s Hospital Los Angeles (CHLA) at its sites at CHLA and Westlake. AltaMed has integrated behavioral and mental health services provided by the Family Advocacy and Support Team (FAST). This team includes psychologists, developmental-behavioral pediatricians, social workers, and case managers who offer in-person and online support and resources to families. The FAST team provides on-site consultation, triage, and psychotherapy services to meet the complex behavioral/mental health needs of clinic patients and their families. Besides providing wrap-around services like grocery gift cards and packets on how to access food banks and other supplies, they can triage and coordinate care for behavioral/mental health needs. The team also works to bring awareness around domestic violence and child abuse. In addition to the Family Support team, AltaMed has a regional center parent navigator program for children with autism, intellectual disability, seizures, and cerebral palsy. These parent navigators help families with concerns about their child’s development, giving them access to an Early Intervention program. The Regional Center Parent Navigators help families with children with special needs who need extra support during COVID-19. For example, with online schools, they can apply on the client's behalf to help with online learning in the home by advocating for pandemic relief. The navigators have also helped parents apply for individual education plans (IEP) in English and their native language.