i needed 2 to 3 pages on check out the yellow part of the sample paper that i have attached I have attached the previous assignment I have attached the guideline for this paper.
Running head: RESEARCH PAPER 1
Research Paper II
Introduction
People with refugee status are individuals who flee their homes due to threats to their safety and well-being. The threats may include war, disaster, or persecution (Baranik, Hurst, & Eby, 2018). People with refugee status also often experience trauma before leaving due to the stress of fleeing their home countries and traveling to unfamiliar countries (Baranik et al., 2018). In 2015, over 54 million people were affected by war, human rights atrocities, and violence. Out of the 54 million people, 14.3 million were people with refugee status along with 1.8 million asylum seekers and 32.2 million internally displaced persons. The refugee resettlement process could present disruptive consequences, such as mental health problems, like depression, impaired interpersonal relationships, and heightened conflict (Utrzan & Northwood, 2016).
Particularly, when women from the Democratic Republic of Congo (DRC) flee to the United States, they deal with several different pre and post migration stressors, such as significant trauma. This could also affect other women with refugee status as well (Wachter, Cook-Heffron, Snyder, Busch-Nsonwu, & Busch-Armendariz, 2016). By 2016, near two million individuals from the DRC were internally displaced and 450,000 were registered as people with refugee status throughout the United States (Wachter & Gulbas, 2018). Since 2015, about 200 people with refugee status from the DRC have entered North Dakota and from 2011 to 2017, about 210 have entered Minnesota (LSS of North Dakota & Minnesota, 2018). Considering their experiences of violence along with cultural and political destabilization, it is essential these women receive a variety of supports, including mental health resources aiding their resettlement.
Literature Review
When people with refugee status leave their home country and resettle in a new place, it can produce significant distress; they are at greater risk to develop a mental illness. The risk factors include exposure to war, torture, refugee camps, and the physical displacement from their home country. Other risks factors are human trafficking, stress of adapting to a new culture, and low socioeconomic status (Espinoza, 2016). Other hardships could include imprisonment, malnutrition, physical and sexual assault, and separation from their family. These traumatic experiences can develop into Posttraumatic Stress Disorder (PTSD), anxiety disorders, and depressive disorders. Even though people with refugee status resettle in a new, safer country, they still might experience major stress, especially with worrying about the well-being of their family and friends who remain in the countries they fled from (Devine, DeCaporale-Ryan, Lim, & Berenvi, 2017). Adjusting into a new culture and learning a new language includes challenges and the possible feelings of isolation, confusion and frustration. Also, people with refugee status are often forced to restart their careers due to different professional degrees required in the United States (Devine et al., 2017).
Many people with refugee status who experience trauma before relocation are specifically vulnerable to stressors upon resettlement. More examples of trauma could include deprivation of basic needs, physical injury, rape, holding in reeducation camps and witnessing traumatic events (Baranik et al., 2018). Particularly, over the past two decades, people from the DRC have experienced a tremendous amount of trauma and violence, especially sexual violence. According to a survey with a representative group from the DRC, 39.7% of women have been exposed to sexual violence during their life (Espinoza, 2016). The sexual violence included molestation, rape, and forced marriage. Other violence present in the survey was human rights abuse, such as being beaten, shot, abducted, and forced displacement. The psychological, physical, and social impacts of sexual violence perpetrated in the DRC on women has been severe. The survivors describe psychological symptoms, such as depression, anxiety, and PTSD (Wachter et al., 2016). Through the different types of violence, mental health illness can occur. Some of the barriers to mental health treatment can include religion, stigma, lack of transportation, language, and culture (Espinoza, 2016). Specifically, in the United States, there has been a lack of appropriate mental health screening and lack of interpretations for the DRC population of people with refugee status; possibly the result of not understanding the education about mental health services in general (Espinoza, 2016).
Between 2014 and 2019, the United States plans to resettle approximately 50,000 people with refugee status from the DRC. At least 20% of the 50,000 are expected to be resettled under the “women-at-risk” category; this category is defined as women who have protection problems particular to their gender (Wachter et al., 2016). For nearly two decades, the DRC has endured war and chronic instability. Hundreds of thousands of women, children, and men have been assaulted, tortured, and sexually terrorized along with millions of individuals dying from disease and malnutrition due to the conflict (Wachter et al., 2016). From these experiences, it is important to evaluate if they, especially women, are able to recreate social support post-resettlement. Support through functioning social networks (social support) is often described in expressions of empathy, love, advice, or trust, which usually involves family members. There is also a strong relationship between social support and health (Wachter & Gulbas, 2018). Besides possibly not having social supports, more possible post-migration stressors could be language, employment, transportation barriers, and loss of status with their education or occupation. There are also pre-migration stressors, such as sudden loss of home and family members, sexual violence (rape), torture, and food insecurity. Also, there is research focusing on how woman with refugee status can increase the chance of experiencing mental health challenges in new countries due to the post-migration stressors discussed (Wachter et al., 2016).
A study done on women with refugee status under the women-at-risk category, from the DRC, explored the concerns, challenges, risk, and strengths faced by these adult women who resettled in the United States. There were five common themes related to the experiences of the women present throughout the study. The themes include: significant trauma, safety and security, feeing alone, lonely, and isolated; disempowered and overwhelmed, and doubtful survival (Watcher et al., 2016). The study found the women had strong feelings of sadness and loneliness from being separated by their family, which triggered the greatest emotional response from many of them. The study identified how pre-migration sexual violence continued to impact these women in their post-migration resettlement. Despite the many challenges among the pre and post migration factors, the women showed a determination along with the will to survive that helped them through the extreme situation of facing war, fleeing from their home country, and seeking refuge for themselves and possibly their children (Watcher et al., 2016).
There are gaps present about social support in forced migration literature. Additionally, the existing literature has overlooked the ways DRC women recreate social support with their post-displacement. Without this focus on factors preventing or enabling their social supports, which to the best of the author’s knowledge, there is no study examining the loss of social support impacting these women in different ways (Watcher & Gulbas, 2018). However, there are other studies done in different countries evaluating social support/social networks for women with refugee status. An example is exploring social capital and refugee resettlement within the social networks of people with refugee status in Canada (Lamba & Krahn, 2003). But, the gap in the literature found for the United States relates to understanding if social support is beneficial as a treatment for women of refugee status and if they have access to utilizing social supports. Another gap in literature is the general lack of material about women with refugee status experiencing mental health issues and not receiving proper mental health treatment, specifically in North Dakota and Minnesota. It would be valuable to assess in different parts of the United States to better understand and evaluate mental health issues and access to mental health treatment regarding women of refugee status. The proposed study is going to explore the question: do women with refugee status from the DRC and other countries have access to the proper kind of mental health treatments or resources they need to help them with their personal experience of a variety of stressors in the United States?
Methods
The proposed study will utilize a qualitative research approach. In addition, it will be exploratory. Specifically, the purpose of qualitative social work approach is to create descriptive data in an individual’s own spoken words. Qualitative social work approach is concerned with understanding the human experience from the individual’s own frame of reference (Thyer, 2001). This qualitative approach will include a process orientated structure, which means to use the natural setting of participants to understand them better. It is also important to mention how the qualitative approach requires researchers to be active and immersed in the natural environment of participants they are interviewing (Thyer, 2001). Overall, the use of a qualitative approach will engender in-depth understanding of the experiences of women with refugee status.
Participant Recruitment
Participants will be recruited from two refugee agencies from two states in the United States, namely, North Dakota and Minnesota, through purposive sampling. Purposive sampling will be used as it incorporates selecting participants based on particular features or characteristics; this helps create a detailed exploration and understanding of the main question previously mentioned (Lewis & Ritchie, 2003). The main participants are going to be women, ages roughly between 20 and 90, with refugee status mainly from the DRC, but other countries are accepted, such as Syria and Iraq. The participants will also need to have experienced a variety of stressors, such as war, sexual or physical violence, or separation from family along with the stress of resettling in North Dakota or Minnesota. Also, a recommendation either from the refugee agency or participants to acquire mental health services and resources will be required as well.
Data Collection
Semi-structured interviews and open-ended questions will be used to collect data from participants. This type of qualitative assessment helps understand and describe what pre and post migration stressors women of refugee status face through their own words and observations (Ballan & Freyer, 2016). Previously formulated set of questions will be used. The purpose of the interviews is gaining a better understanding and entering into the participants perspective. Using open-ended questions allow the opportunity for participants to respond in their own words and to express their own personal perspectives. One main benefit of using semi-structured interviews is it will help specify on what things individuals cannot directly observe; it helps learn the participants feelings, thoughts, and behaviors (Patton, 2002). Some examples of interview questions used are: what kind of stressful or traumatic events did you experience in your home country, what are some post migration stressors you have faced since resettling in the United States, and what kind of feelings are associated with both your pre and post migration stressors? The estimated duration for each interview is approximately one hour and it will be conducted either at the refugee agency or at a location of the participant’s choice and convenience. The interviews will be audio recorded and transcribed for later analysis.
Data Analysis Approach
The interview data will be analyzed using a thematic analysis framework. Thematic analysis framework helps with an in-depth exploration of the data retrieved through the semi-structured interviews. This type of framework will be used because it will help bring together similarities and differences within the responses from participants (Wachter et al., 2016). Within the analytic process, the specific steps will include the coding of the data, the subsequent examination of the data for redundancies in codes, and then placing them into categories. Emergent themes will be identified and reported. This process will be iterative and cyclical; this is necessary to ensure sufficient immersion in and familiarity with the data.
Conclusion
From the proposed study, it will hopefully project why women with refugee status from the DRC and other countries do not have access to mental health resources and examine in more detail the variety of pre and post migration stressors they experience. It will help learn about the challenges with access to mental health resources for these women with stressors. It will also help project recommendations to solve the presenting issue of no access to mental health resources. In other words, the proposed study will help anticipate what steps need to be done to offer availability and overall help with mental health issues to women with refugee status. The topic of women with refugee status and proper access to mental health resources is relevant to social work because it examines these women’s availability to mental health resources or treatments. Social workers are usually support systems for helping populations get connected to appropriate resources. Overall, the social work profession challenges the possible social injustice the population faces while respecting their inherent dignity and worth of them as individuals. The social work profession can also use this proposed study to connect women of refugee status to proper and appropriate resources, and improve both their overall well-being and quality of life.
Limitations
One limitation of the proposed study is only focusing on two states in the United States. The availability to proper mental health resources for women with refugee status could vary in the different states throughout the United States. Another limitation is not acquiring enough participants to gain a good understanding of availability of mental health resources; however, a rather small sample size for a qualitative study could be seen as beneficial, especially through purposive sampling. Another limitation could be not fully understanding why these women do not have access to proper mental health resources. In other words, if their culture prohibits them from receiving mental health resources, it might be more difficult to think of effective ways to treat their mental health issues. Also, a limitation of mainly focusing on just the country of the DRC might not be applicable to other countries women with refugee status flee from.
Future Studies
Data gathered from this proposed study can be used as a comparison point for other studies on lack of resources for people with refugee status, such as lack of access to affordable housing. The results from this proposed study can be used for other studies to develop new ways on how to improve access to mental health resources for women with refugee status, particularly women from the DRC. Also, future studies could look further into different reasons women with refugee status do not receive proper mental health resources, such as culture, lack of transportation, or religion. This suggestion for future studies could also be applied in considering recommendations to address or solve the challenges the women face.
References
Ballan, M., & Freyer, M. (2016). Qualitative assessment methods. In C. Jordan & C. Franklin (Eds.), Clinical assessment methods for social workers: Quantitative and qualitative methods (4th ed., pp.121-153). Chicago, IL: Lyceum.
Baranik, L., Hurst, C., & Eby, L. (2018). The stigma of being a refugee: A mixed-method study of refugees’ experiences of vocation stress. Journal of Vocational Behavior, 105, 116-130. doi: 10.1016/j.jvb.2017.09.006
Devine, M., DeCaporale-Ryan, L., Lim, M., & Berenyi, J. (2017). Psychological Issues in Medically Underserved Patients. Primary Care: Clinics in Office Practice, 44(1), 99-112. DOI: 10.1016/j.pop.2016.09.012
Espinoza, S. (2016). Barriers to Mental Health Treatment within the Congolese Population. Retrieved from University of Virginia, School of Medicine website: https://med.virginia.edu/family-medicine/wp-content/uploads/sites/285/2017/02/Stephanie-Espinoza-Congolese-Mental-Health_Web.pdf
Lamba, N. K., & Krahn, H. (2003). Social capital and refugee resettlement: The social networks of refugees in Canada. Journal of International Migration and Integration/Revue de l'integration et de la migration internationale, 4(3), 335-360.
Lewis, J. & Ritchie, J. (Eds.). (2003). Qualitative Research Practice: A Guide for Social Science Students and Researchers. (2nd ed.). Thousand Oaks, CA: Sage Publications, Inc.
Lutheran Social Services (LSS) of Minnesota. Facts & Figures. Retrieved from https://www.lssmn.org/services/refugees/about-refugees/facts-and-figures
Lutheran Social Services (LSS) of North Dakota. Refugee resettlement. Retrieved from https://www.lssnd.org/refugee-resettlement
Patton, M. (2002). Qualitative Research & Evaluation Methods. (3rd ed.). Thousand Oaks, CA: Sage Publications, Inc.
Thyer, B. (Ed.). (2001). The Handbook of Social Work Research methods. Thousand Oaks, CA: Sage Publications, Inc.
Utrzan, D., & Northwood, A. (2016). Broken promises and lost dreams: Navigating asylum in the United States. Journal of Marital and Family Therapy, 43(1), 3-15. doi: 10.1111/jmft.12188
Wachter, K., Cook-Heffron, L., Snyder, S., Busch-Nsonwu, M., & Busch-Armendariz, N. (2016). Unsettled integration: Pre- and post-migration factors in Congolese refugee women’s resettlement experiences in the United States. International Social Work, 59(6), 875-889. doi:10.1177/0020872815580049
Wachter, K. & Gulbas, L. (2018). Social support under siege: An analysis of forced migration among women from the Democratic Republic of Congo. Journal of Social Science and Medicine, 208, 107-116. doi: 10.1016/j.socscimed.2018.04.056
