Index

Acculturation, and identity,

90, 100

ADAPT model,

12

Adolescents, clinical interviews and assessment of,

89. See also Children

Advocacy, for human rights,

152–154

Affirmative applications, of asylum seekers,

4–5, 105, 106–111

Affordable Care Act,

3

Afghanistan, refugees from,

92

Africa, refugees from,

27, 64, 78, 115. See also Ethiopia; Somalia

African Americans

in case example,

55

ethnopharmacology and,

152

racial stereotyping and,

95

Age, and risk factors for poor refugee mental health,

7. See also Adolescents; Children; Geriatric population

Alcohol use disorder,

64, 78

Alpha₂-agonist agents, and posttraumatic stress disorder,

60

Ambiguous loss,

149–150

American College of Psychiatrists,

78

American Psychiatric Association,

78

Amitriptyline,

66

Amygdala, and neurobiology of posttraumatic stress disorder,

61–62

Antidepressants, CRP levels and response to,

69. See also Selective serotonin reuptake inhibitors; Tricyclic antidepressants

Anxiety disorders, and female genital mutilation,

114

Aripiprazole,

68

Asian Americans, and ethnopharmacology,

152

Assessment, of refugee mental health in clinical setting,

8–11, 89. See also Diagnosis

Asylum seekers

. See also Immigrants and immigration; Refugees

affirmative application process,

4–5, 105, 106–111

definition of,

2

detention centers and retraumatization of,

xvii–xviii, 164–167

dual role of psychiatrists in treatment of,

26, 167

ethics and responsibilities of psychiatrists in response to policies of deterrence,

164–167

female genital mutilation and,

114

legal process in U.S.,

104–105

literature review of psychotherapy for,

36–38

premigration and postmigration exposure to trauma,

138–139

as torture victims,

111–114

U.S. policy and attitudes toward,

xviii, 132, 136–139

Attention-deficit/hyperactivity disorder (ADHD),

98–99

Atypical antipsychotics, for posttraumatic stress disorder,

67–68

Australia

immigration policy and confinement of asylum seekers in detention centers,

165–167

mental health issues in Holocaust survivors,

119–120

Australian Human Rights Commission,

166

Avoidance, as symptom of posttraumatic stress disorder,

110

Barriers, to health care and mental health treatment for refugees,

11, 178

“Bio-psycho-social-spiritual” assessment,

33–34

Bipolar disorder,

94–95

Bosnia, refugees from,

50, 51, 54, 64, 67, 68, 75, 78, 80

Brief psychotherapeutic interventions, for demoralization,

148

Bullying, and schools,

93

Burma, refugees from,

75

Cambodia, refugees from,

21–24, 27–28, 59, 63, 65, 67, 74, 75, 78, 80

Cameroon, refugees from,

144

Canada, and transcultural psychiatry for refugees,

166

Case examples

of advocacy for human rights,

153–154

of ambiguous loss,

149, 150

of asylum seekers as torture victims,

112–114

of children as refugees,

92–97, 98, 99–100, 134–135

of cultural humility in psychotherapy,

40–41

of cultural issues in mental health care for refugees,

169–170

of demoralization,

148–149

of diagnostic interview,

21–24, 27–28

of ethnopharmacology,

152

of family-centered psychiatric care,

151

of female genital mutilation,

115

of geriatric population,

123, 124–125, 126–127

of Intercultural Psychiatric Program,

49–50, 51, 52, 54–55, 79–81

of loss of identity,

150–151

of medical needs of refugees,

178, 179

of mental health assessment and treatment for refugees,

14–15

of narrative exposure therapy,

39–40

of pharmacotherapy for posttraumatic stress disorder,

65, 67, 68, 181

of pharmacotherapy for schizophrenia,

182

of social needs of refugees,

177–178

of strengthening resilience in treatment of refugees,

144

of U.S. immigration policy in U.S.-Mexico border region,

134–136

Case management, by counselors in Intercultural Psychiatric Program,

76

Castillo Udiarte, Roberto,

131

Celecoxib,

69

Central America, and countries of origin of refugees and asylum seekers,

3, 4–5, 132. See also El Salvador; Guatemala; Honduras; Nicaragua

Central nervous system (CNS), changes of in patients with PTSD,

60–62

Child protective services,

91

Children, as refugees

. See also Family

challenge of working with,

86–87

discriminatory and deleterious treatment of in U.S. border facilities,

xv

gang violence in Central America and,

4–5

identification issues and,

89–91

numbers of,

85

overview of issues in working with,

87–89

separation of from parents,

86

Chronic pain, and outcome of comorbid depression and posttraumatic stress disorder,

7–8

Climate change, and refugees,

176, 177

Clonidine, and posttraumatic stress disorder,

13, 60, 65, 66, 67, 109, 122, 180

Cochrane review,

36, 181

Cognitive-behavioral therapy (CBT)

efficacy of for refugees and asylum seekers,

36

overview of mental health care for refugees and,

12–13

Cognitive disorders, in refugee population,

5–6

Collaborative Problem Solving (CPS),

88

Community agencies, and services for refugee families and children,

91–100

Comorbidity, of posttraumatic stress disorder and depression,

7–8, 48, 59

Compliance, with medication for posttraumatic stress disorder,

63

Comprehensive assessment, of refugee mental health,

8

Confidentiality, and mental health care for refugees,

161–162

Conserved transcriptional response to adversity (CTRA),

179–180

Consistency

of psychotherapy for postmigration stress,

52–53

of testimony in asylum hearings,

110–111

Cortisol, and posttraumatic stress disorder,

61

Counselors

care of geriatric patients and,

122, 127

role of in Intercultural Psychiatric Program,

74, 76–77

Countertransference

Intercultural Psychiatric Program and,

53–55

need of psychiatrists for self care,

26

C-reactive protein (CRP), and posttraumatic stress disorder,

68–69

Critical psychiatry,

168

Cultural Formulation Interview Supplementary Module for Refugees,

10

Culture, and cultural issues

. See also Ethnic groups; Identity; Language; Religion

adaptation of psychotherapy for refugee populations and,

12–13

assessment of refugee mental health in clinical setting,

9

children from immigrant families and,

86–87

concept of cultural humility in psychotherapy for refugees,

40–41

confidentiality and privacy in refugee mental health care and,

162

ethical controversy in global mental health movement and,

167–170

European Association for Psychotherapy and definition of,

38

intercultural compromise and family work with immigrant parents,

88

pharmacological treatment for posttraumatic stress disorder and,

63–64

Cytochrome P450 system,

152

Deep brain stimulation, and posttraumatic stress disorder,

180

Defensive asylum process,

105

Dehumanization, psychotherapy for,

147

Dementia, in geriatric refugee population,

120, 121, 121–124

Demoralization, treatment of in refugee patients,

148–149

Deportation

advocacy for human rights and,

153–154

of parents of refugee children,

86

Depression

. See also Major depressive disorder

comorbidity of with posttraumatic stress disorder,

7–8, 48, 59

demoralization as distinct from,

148

Intercultural Psychiatric Program for Vietnamese geriatric population and,

121

prevalence of in geriatric population,

119

role of inflammation in,

68–69

tricyclic antidepressants for treatment-resistant,

66

Detention centers

children as refugees and,

86, 92

immigration policy and confinement of asylum seekers in,

xvii–xviii, 164–167

Diagnosis

. See also Assessment

affirmative asylum applications and,

107–109

main clinical approaches to for refugee patients,

24–26

process of interviews for,

21–24, 25–28, 33–36, 145–147

Diet, and pharmacology,

152

Dissociative states, and torture victims,

113

Distress

training of psychiatrists in diagnostic and treatment methods for,

148–151

psychiatric assessment and cultural idioms of,

9

Documentation, and affirmative asylum application,

106–107

Domestic violence

affirmative asylum applications and,

104

mental health care for refugee patients and,

163

social needs of refugees and,

178

Do no harm (primum non nocere) principle,

164

Doxazosin,

60–61

Doxepin,

66, 67

Drug trade, and U.S.-Mexico border region,

131

DSM-5, and cross-cultural assessment,

89

“Dual-role” dilemma, for psychiatrists working with asylum seekers,

25–26, 167

Dyslexia,

97

Education

. See also Psychoeducation; Schools

compliance with medication and,

64

for patient and family as important part of mental health care for refugees,

13

El Salvador, refugees from,

4–5

Empathy, and diagnostic interviews with refugee patients,

27

Ethical issues

controversies in global mental health movement,

167–170

in psychiatric assessment and treatment of traumatized refugees,

xvii

psychiatrist-patient relationship in clinical service setting and,

160–164

response of psychiatrists to policies of deterrence of asylum seekers,

164–167

Ethiopia, refugees from,

74, 75, 79, 152

Ethnic groups

. See also Racism

counselors in Intercultural Psychiatric Program,

76

pharmacology and,

152

European Association for Psychotherapy (EAP),

37–38

Evasiveness, appearance of in asylum hearings,

110

Evil, psychotherapy for postmigration stress and problem of,

53

Executive Office for Immigration Review (EOIR),

105

Expectations, about health care by refugees,

11

Expert witness, and affirmative asylum applications,

106

Exposure therapy,

163–164. See also Narrative exposure therapy

Eye movement desensitization and reprocessing (EMDR),

37

Family

. See also Children

confidentiality and privacy in refugee mental health care and,

162

geriatric population and,

125–127

impact of chronic depression and posttraumatic stress disorder on,

14

mental health professionals as liaison between schools and,

91–100

separation from as risk factor for poor refugee mental health,

7

torture and,

113–114

Family history, and assessment of refugee mental health,

9

Family therapy

overview of mental health care for refugees and,

14

training of psychiatric residents in,

151

Far From the Tree (Solomon 2013),

xv, 90

Female genital mutilation, and asylum seekers,

114–115

Fluoxetine,

65–66

Fluphenazine,

68

Food pantry, and clinical interview,

34

Gender

group therapy and,

42

risk factors for poor refugee mental health,

7

Genetics

ethnopharmacology and,

152

posttraumatic stress disorder and,

61, 179–180

Geriatric population

family issues and,

125–127

Intercultural Psychiatric Program and,

120, 121

management of dementia in,

121–124

prevalence of physical and mental health problems in,

119–120

trauma in former members of South Vietnam government forces,

124–125

tricyclic antidepressants and,

67

Global mental health

ethical controversies in,

167–170

traumatization among refugees and,

xx

Greece, and author’s reflections on trauma in refugee camps,

xix–xxii

Grief, and interviews with refugees,

146–147

Group activities, and dementia in geriatric population,

122–123, 127

Group therapy, importance of for refugees,

42

Guatemala, refugees from,

4–5, 15, 65, 132

Hamilton Depression Rating Scale,

147

Harvard Trauma Questionnaire,

146

Hate speech, rise of in U.S.,

xviii, 186–187

Headache, differential diagnosis of,

9

Health care

. See also Medical examinations; Medical symptoms; Public health

expectations of refugees and American system of,

11

Intercultural Psychiatric Program and,

76

medical needs of refugees and,

25–26, 178–179

Health insurance, eligibility of refugees and asylum seekers for,

3, 25

Historical context, of patient’s experience,

34

Honduras, refugees from,

4, 135

Horizontal identity,

90–91

Hospitalization, and Intercultural Psychiatric Program,

78

Housing

prediction of rates of posttraumatic stress disorder and,

7

social service agencies and,

92

Human rights

psychiatrists and advocacy for,

152–154

refugee patient as perpetrator of abuses,

162–163

Identity

as issue in working with refugee parents and children,

89–91, 100

loss of as cause of distress,

150–151

Illegal immigrants, labeling of refugees and asylum seekers as,

xviii, 164

Imipramine,

66, 67

Immigrants and immigration

. See also Asylum seekers; Illegal immigrants; Refugees

current U.S. policies and attitudes toward refugees,

xviii, 55, 131–139

ethical responsibilities of psychiatrists to policies of deterrence applied to asylum seekers,

164–167

role of in American history,

xiii

terrorism and attitudes toward in U.S.,

xiii–xiv

Indonesia, refugees from,

169

Inflammation, role of in depression and posttraumatic stress disorder,

68–69

Insomnia

assessment of refugee mental health and,

9–10

as symptom of posttraumatic stress disorder,

25, 66

treatment of mental health issues in refugees and,

13

Intercultural Psychiatric Program (IPP)

administrative structure of,

77

consistency in,

52–53

counselors and,

74, 76–77

countertransference issues in,

53–55

description of,

48

geriatric population and,

120, 121

outcomes of,

78–81

postmigration factors in,

49–51

problem of evil,

53

psychiatrists and,

74–76

refugees as patients,

73–74

as source for research,

77–78

International Society for Traumatic Stress Studies,

32

Interpersonal psychotherapy (IPT),

48

Interpreters

. See Language

Intramuscular administration, of medication,

68

Iran, asylum seekers from,

112, 113

Iraq war, and displacement of population,

175

Irritability, as symptom of PTSD,

25

Istanbul Protocol,

38, 109

Korea, refugees from,

177–178, 179

Kurdish refugees, and depression,

119

Language

affirmative asylum application and,

107

counselors for Intercultural Psychiatric Program and,

76

diagnostic interview and use of interpreters,

35–36

group therapy and,

42

refugee children and adaptation to new,

91, 97–98

Laos, refugees from,

75

Length of treatment, with medication for posttraumatic stress disorder,

63

Literacy, and compliance with medication,

64

Literature review, of psychotherapy with refugees and asylum seekers,

36–38

López Obrador, Andrés,

132

Loss

diagnostic interviews and,

35, 146–147

interventions for distress due to,

149–150

Major depressive disorder (MDD),

108, 146. See also Depression

Malingering, and asylum hearings,

111

Mania, and bipolar disorder,

95

Marital status, as risk factor for poor refugee mental health,

7

Medicaid, and Medicare,

77

Medical examination, and refugee screening process,

2–3

Medical symptoms

. See also Health care

frequency of among refugees,

25–26

of stress,

9

Melancholic depression,

66

Memories, and consistency of testimony in asylum hearings,

111

Mental disorders, and mental health

. See also Comorbidity; Depression; Diagnosis; Global mental health; Posttraumatic stress disorder; Psychosis; Schizophrenia; Treatment

assessment of refugees in clinical setting,

8–11

overview of psychiatric conditions among refugees to U.S.,

5–8

prevalence of in refugees in initial years of resettlement,

xiv, 6

Mental health professionals, role of in affirmative asylum application process,

106–111. See also Counselors; Psychiatrists

Mexican Americans, and ethnopharmacology,

152

Mexico, border region with U.S. and impact of U.S. immigration policies,

5, 130–139

Migration Policy Institute (MPI),

136–138

Migration trauma, and asylum seekers,

138–139

Misdiagnosis, in immigrants and refugees in primary care clinic,

179

Mood disorders, risk factors for in refugee population,

32–33

Multidisciplinary model, for refugee mental health care,

162

Multiethnic groups, and group therapy,

42

Narrative exposure therapy (NET),

36, 37, 39–40

National Consortium of Torture Treatment Programs (NCTTP),

33

Nauru, and detention centers for asylum seekers,

165

Nepal, refugees from,

75

Neurocircuitry, and posttraumatic stress disorder,

61–62

Nicaragua, and ethnopharmacology,

152

Nightmares

assessment of refugee mental health and,

10

as symptom of posttraumatic stress disorder,

25, 66

treatment of mental health issues in refugees and,

13

Noradrenergic dysregulation, in posttraumatic stress disorder,

60

Norepinephrine, and posttraumatic stress disorder,

61

Normalizing attitude, and treatment of refugees,

144

Nursing homes, and geriatric population,

126

Office of the Chief Immigration Judge,

105

Older adults

. See Geriatric population

Openness, as component of cultural humility,

40

Oregon, and Mental Health Division,

77

Oregon Health & Science University (OHSU)

. See Intercultural Psychiatric Program

Outcomes, and Intercultural Psychiatric Program,

78–81

Pakistan, refugees from,

98

Paliperidone,

68

Papua New Guinea, and detention centers for asylum seekers,

165

Paroxetine,

65–66, 180

Patient-physician relationship

. See also Therapeutic alliance

ethical issues in refugee mental health care and,

160–164

importance of in care for refugees,

xvi

Peer group interactions, and assessment of children or adolescents,

89

Perphenazine,68

Persecution, refugee status and fear of,

103–104

Pharmacology

ethnic differences in,

152

Intercultural Psychiatric Program and medication management,

75

for treatment of posttraumatic stress disorder in traumatized refugees,

62–68

Policy

. See Immigrants and immigration; United States

Postmigration stress

. See Intercultural Psychiatric Program

Postmigration trauma,

139

Posttraumatic stress disorder (PTSD)

affirmative asylum application and diagnosis of,

107–109, 110

attention-deficit/hyperactivity disorder and,

98–99

common symptoms of,

25

comorbidity of with depression,

7–8, 48, 59

female genital mutilation and,

114–115

geriatric population and,

121, 122

inflammation and,

68–69

pharmacological treatment of in traumatized refugees,

62–68

prevalence of in Cambodian refugees,

59

psychobiology of,

60–62, 179–180

reactivation of,

25, 28

risk factors for in refugee population,

6, 7, 33, 61

torture and development of,

6, 33

treatment of in refugee patients,

179–182

Prazosin, and posttraumatic stress disorder,

13, 60–61, 65, 109, 122, 180

Prevalence, of mental disorders in refugees,

xiv, 6, 59

Privacy, and mental health care for refugees,

161–162

Psychiatrists

. See also Counselors; Mental health professionals

dual role of in treatment of asylum seekers,

25–26

factors in psychotherapy for postmigration stress,

51–52

importance of self care for,

26, 42

Intercultural Psychiatric Program and role of,

74–76

prevention of burn out,

54, 164

psychiatrist-patient relationship in clinical service setting,

160–164

training of and skills needed to treat refugees,

147–154

Psychobiology, of posttraumatic stress disorder,

60–62

Psychoeducation

. See also Education

diagnostic interviews and,

34–35

for families on care of geriatric patients,

127

family-centered psychiatric care and,

151

Psychological effects, of female genital mutilation,

114–115

Psychosis, and psychotic disorders

. See also Schizophrenia

in asylum seekers,

108

exposure to multiple traumas and,

60

in geriatric population,

122

pharmacology and,

68

torture victims and,

113

Psychotherapy

. See also Cognitive-behavioral therapy; Exposure therapy; Family therapy; Group therapy; Intercultural Psychiatric Program; Interpersonal therapy; Supportive therapy; Treatment

asylum seekers and,

109

concept of cultural humility,

40–41

for dehumanization,

147

flexibility in approach to,

163–164

literature review of benefits for refugees and asylum seekers,

36–38

overview of mental health care for refugees and,

12–13

for posttraumatic stress disorder,

180–181

stigma about mental health care in refugee communities,

38

vicarious traumatization and,

41–42

Public health, and traumatization among refugees as global concern,

xx

Racism, and attitudes toward refugees in U.S.,

xviii, 91, 95, 186–187

Radical hospitality, and diagnostic interview,

33–36

Rating scales, and common problems in diagnosis of refugees,

26–27

Reactivation, of posttraumatic stress disorder,

25, 28

Realism, and symptom reduction for posttraumatic stress disorder,

25

Referral information, for social service agencies,

92

Refugee Act of 1980,

2, 103–104

Refugee Medical Assistance,

3

Refugee psychosocial education, for teachers and school administrators,

91

Refugees

. See also Asylum seekers; Children; Diagnosis; Ethical issues; Geriatric population; Immigrants and immigration; Intercultural Psychiatric Program; Mental disorders; Pharmacology; Psychotherapy; Treatment; United States

countries of origin and,

3–5

definition of,

1–2, 103–104

developments distinguishing modern era from past,

175–176

experiences of authors with treatment for,

185–187

future needs of,

176

health care needs of,

25–26, 178–179

impact of trauma on,

32–33

mental health care for as specialist field,

161

prevalence rates of mental disorders in,

xiv, 59–60

resettlement process in U.S.,

5

screening process in U.S.,

2–3

skills required to provide mental health care for,

143–144

social needs of,

177–178

stigma about mental health problems and treatment in communities of,

38–40

traumatization among as global mental health concern,

xix–xxii

use of term in pejorative and discriminatory manner,

xvii, 186

Relapse, and medication for posttraumatic stress disorder,

63

Religion

cultural conflicts between families and children,

96

drug treatment of posttraumatic stress disorder and,

63

hate speech and negative attitudes towards immigrants in U.S.,

xviii, 186

Research, Intercultural Psychiatric Program as source for,

77–78

Residencies, and training of psychiatrists in skills needed to work with refugees,

147–154

Resilience

concept of vicarious in psychotherapy,

42

strengthening of while treating symptoms of disorders,

144–145

Resistance, to provider’s advice for treatment in geriatric population,

122

Risperidone,

67–68

Russia, refugees from,

74, 75

Safety, creating sense of in diagnostic interview,

34, 35

Sanctuary program (Scotland),

153

San Diego (California),

130–131

Saudi Arabia, refugees from,

152

Schizophrenia

in geriatric patients,

120, 121, 123–124

pharmacology for,

68, 182

prevalence of in refugees,

60

suicide and,

64, 78

Schools, and refugee families and children,

91–100

Scotland, and Sanctuary program,

153

Selective serotonin reuptake inhibitors (SSRIs), for posttraumatic stress disorder,

65–66, 122, 180

Self-agency, clinical interview and enhancement of,

34

Self-awareness and self-reflection, as components of cultural humility,

40

Self-care, for psychiatrists and therapists,

26, 42

Senegal, and study of female genital mutilation,

115

Serotonin-norepinephrine reuptake inhibitors (SNRIs),

66

Serotonin system, and posttraumatic stress disorder,

61

Sertraline,

65–66, 180

“Seven D’s” (discrimination, detention, dispersal, destitution, denial of health care, delayed decisions, and denial of right to work),

153

Shire, Warsan,

xxi, xxii–xxv

Sister cities, and U.S.-Mexico border region,

130

“Slow metabolizers,” and ethnopharmacology,

152

Smuggling networks, in U.S.-Mexico border region,

137

Social networks

. See also Peer group interactions

dementia in geriatric population and,

122–123, 127

mental health care for refugees and,

12

resettlement of refugees and,

177–178

Social service agencies

. See Community agencies

Solomon, Andrew,

xv, 90

Somalia, refugees from,

38, 49, 74, 96, 108, 115, 187

Spain, and ethnopharmacology,

152

Specialist field, of refugee mental health,

161

Stereotyping, and social service agencies,

91, 95

Stigma, and psychotherapy for refugee patients,

38–40

Stress

. See also Intercultural Psychiatric Program

court hearings for asylum seekers and,

108

physical symptoms and,

9

Substance use disorders,

33, 64. See also Drug trade

medication for PTSD and,

64

risk factors for in refugee population,

33

Suicide

Intercultural Psychiatric Program and,

78

pharmacotherapy for posttraumatic stress disorder and,

64

“Super metabolizers,” and ethnopharmacology,

152

Supportive interaction, as component of cultural humility,

40

Supportive psychotherapy

asylum seekers and,

109

Intercultural Psychiatric Program and,

75

for symptoms of posttraumatic stress disorder and depression,

25

Sympathetic CNS studies, of posttraumatic stress disorder,

61

Syria, refugees from,

74, 75

Teachers, and support for refugee children,

91, 97

Teaching My Mother How to Give Birth (Shire 2011), xxiii

Terrorism, and attitudes toward immigrants in U.S.,

xiii–xiv

Testimony, and role of mental health professional in asylum process,

109–111

Therapeutic alliance

. See also Patient-physician relationship

family-centered psychiatric care and,

151

pharmacotherapy for posttraumatic stress disorder and,

62, 64

Therapists

. See Psychiatrists

Tijuana (Mexico),

130–131, 133

Torture

asylum seekers as victims of,

111–114

reluctance to ask about in diagnostic interview,

35

as risk factor for development of posttraumatic stress disorder,

6, 33

Traditional healing methods,

96

Training, and psychiatry residencies,

147–154

Transportation, and dispersal of refugees population in modern era,

175–176

Trauma

. See also Trauma psychiatry

asylum seekers and premigration or postmigration exposure to,

138–139

avoidance of retraumatizing during diagnostic interview,

34

counselors in Intercultural Psychiatric Program and histories of,

76–77

diagnostic interviews and,

146

geriatric refugee population and,

124–125

impact of on refugees,

32–33

medical and psychiatric definitions of,

112

psychosis and exposure to multiple,

60

reactivation of posttraumatic stress disorder due to triggers,

25

recounting of,

48

“Trauma and Mental Health in Forcibly Displaced Populations” (Nickerson et al. 2017),

32

Trauma psychiatry, and cross-cultural approach to mental health care for refugees,

xix–xxii

Traumatic brain injury

asylum seekers and,

108

comorbidity of with posttraumatic stress disorder,

7

Trazodone,

122

Treatment, of mental disorders in refugees and asylum seekers

. See also Pharmacology; Psychiatrists; Psychotherapy

affirmative asylum application and,

109

dual roles of psychiatrists in,

26, 167

experiences of authors in,

185–187

overview of general issues in,

11–14

of posttraumatic stress disorder in refugee patients,

179–182

psychiatry residencies and skills needed for,

147–154

strengthening resilience during,

144–145

Tricyclic antidepressants,

66, 180

Triggers, for reactivation of posttraumatic stress disorder,

25, 63

Trust

children as refugees and,

89

diagnostic interview and establishment of,

35

2D6 enzyme system, and ethnopharmacology,

152

Uganda, refugees from,

153

United Nations

Charter on sovereign rights and obligations,

133–134

comprehensive refugee response framework and,

176–177

definition of torture,

111–112

United Nations Convention Related to the Status of Refugees,

xviii, 164–165

United Nations High Commissioner for Refugees (UNHCR),

xiv, xv, 2, 176

United Nations Protocol Relating to the Status of Refugees,

2, 103, 104

United States

border region with Mexico,

130–139

countries of origin of refugees,

3–5

current policies of and negative attitudes toward refugees and asylum seekers,

xviii, 55, 131–139, 186–187

legal process of seeking asylum in,

104–105

overview of psychiatric conditions among refugees to,

5–8

policy change reducing numbers of refugees admitted to,

xiv

role of immigration in history of,

xiii

screening process for refugees,

2–3

traumatic results of treatment of children at southern border facilities,

xv

U.S. Citizenship and Immigration Services,

2–3, 4, 104, 105, 106

U.S. Customs and Border Protection,

132

U.S. Department of Health and Human Services,

130

U.S. Department of Homeland Security (DHS),

3, 105

U.S. Department of Justice,

105

U.S. Department of State,

3

U.S.-Mexico border region (UMBR),

130–139

U.S. Office of Refugee Resettlement,

3, 77

U.S. Refugee Admissions Program,

104

Universal Declaration of Human Rights,

xviii, 164

University of New South Wales (Australia),

xvii, 165, 166

Venlafaxine,

66

Ventral medial prefrontal cortex (VMPFC), and posttraumatic stress disorder,

61

Vertical identity,

90–91

“Via Crucis” caravan,

132–134

Vicarious traumatization, and psychotherapy for refugees,

41–42

Vietnam, refugees from,

74, 75, 76, 78, 79–80, 95–96, 120, 121, 121–125

Vietnamese Depression Scale,

77

Wall, and U.S.-Mexico border region,

131, 133

Warfare, and refugees in modern era,

175, 176

White nationalism, in United States,

187

World Health Organization,

114

World Medical Association,

112