Primary Care Management of Non–English-Speaking Refugees Who Have Experienced Trauma: A Clinical Review

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Tuesday, July 7th to Wednesday, September 30th

Please join us in an online, open forum on telehealth. NCB is providing an opportunity for clinicians to ask each other questions, share observations and adapted telehealth protocols for the SoT population via an online forum and technical exchange. This conversation will be a forum for peer-led informational exchange. NCB staff will assist in facilitating and monitoring the conversation.

Directions: Please watch Eugene Augusterfer’s presentation and interview Telemedicine in Mental Health first. Then feel free to join us in this open forum. All are welcome to join this forum, whether you have an account on Healtorture.org or not. For more information on using the forum, please read the directions on the first post. Please keep your comments respectful, relevant, factual, and do not share identifying information about clients per client privacy and HIPAA regulations. This forum will be open from July 6, 2020 through September 30, 2020.

This article, by Sandra Crosby, MD, is attached, or available for subscribers through JAMA.

Importance  Refugees are a vulnerable class of immigrants who have fled their countries, typically following war, violence, or natural disaster, and who have frequently experienced trauma. In primary care, engaging refugees to develop a positive therapeutic relationship is challenging. Relative to care of other primary care patients, there are important differences in symptom evaluation and developing treatment plans.

Objectives  To discuss the importance of and methods for obtaining refugee trauma histories, to recognize the psychological and physical manifestations of trauma characteristic of refugees, and to explore how cultural differences and limited English proficiency affect the refugee patient–clinician relationship and how to best use interpreters.

Evidence Review  MEDLINE and the Cochrane Library were searched from 1984 to 2012. Additional citations were obtained from lists of references from select research and review articles on this topic.

Findings  Engagement with a refugee patient who has experienced trauma requires an understanding of the trauma history and the trauma-related symptoms. Mental health symptoms and chronic pain are commonly experienced by refugee patients. Successful treatment requires a multidisciplinary approach that is culturally acceptable to the refugee.

Conclusions and Relevance  Refugee patients frequently have experienced trauma requiring a directed history and physical examination, facilitated by an interpreter if necessary. Intervention should be sensitive to the refugee’s cultural mores.

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