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Protecting the mental health of refugee children

SCOTT DETROW, HOST:

Millions of children worldwide have fled violent conflict to relocate to safer places like the United States. Studies show that refugee kids in this country experience high levels of anxiety, depression and post-traumatic stress. But research also shows that supporting the families of refugee kids in specific ways can prevent some of these problems. NPR's Rhitu Chatterjee went to Maine to see how it works.

RHITU CHATTERJEE, BYLINE: It's mid-afternoon, and Shabana Siddiqui (ph) has just hopped into an Uber.

SHABANA SIDDIQUI: The address is 177...

CHATTERJEE: Siddiqui is from Afghanistan and moved to the U.S. with her husband in 2022. And for the past couple of years, she's worked in the Lewiston-Auburn area in Maine with a project helping refugee families. It's an effort run jointly by Boston College and the local nonprofit Maine Immigrant and Refugee Services on this day. Siddiqui is visiting a family she's been working with for a few months.

SIDDIQUI: There's a two-caregiver family, a mom and a dad, and they have two sons here.

CHATTERJEE: A 19-year-old and a 12-year-old. The family arrived in the U.S. in January this year after more than two years of living in fear under the Taliban.

SIDDIQUI: When the government collapsed, and Taliban took over, they were really scared for their lives.

CHATTERJEE: The 12-year-old boy has struggled with symptoms of anxiety and post-traumatic stress.

SIDDIQUI: One day, he was at school, and he got pushed by a bully. But then it triggered him so much that he started crying, and he had an even panic attack. Here. Yeah. We're here.

CHATTERJEE: The Uber drops us off in a wide, tree-lined street with big houses on either side. Siddiqui walks up to a house and knocks on the front door.

(SOUNDBITE OF KNOCKING)

SIDDIQUI: Yeah. Somebody is coming.

CHATTERJEE: A lanky boy with big eyes and thick black hair opens the door.

SIDDIQUI: Hi, (inaudible)...

CHATTERJEE: This is Mujib ur-Rahman (ph), the 12-year-old Siddiqui told me about. His parents, Khadija and Mohamad Rahmani, are waiting upstairs outside their first-floor apartment. They greet Siddiqui in their mother tongue, Dari. Later, sitting in her own one-bedroom apartment, Siddiqi explains that the program relies on people like her with the same background to be community health workers.

SIDDIQUI: You go as a friend, and you build rapport so they can easily share everything with you.

CHATTERJEE: She says newly resettled refugees are overwhelmed by the stress of building a new life in a new country.

SIDDIQUI: Initially, language barrier is the biggest obstacle you face in this - in the country, and the next would be financial restraint.

CHATTERJEE: It can take a long time for refugees to find a job, even if they're fluent in English, as Siddiqui was when she arrived.

SIDDIQUI: I applied for like three, four jobs at a time. I was applying for this website, that website, called here and called there and called career center.

CHATTERJEE: But nothing came through for a while.

SIDDIQUI: That takes a really big toll on mental health. I was so anxious. I was diagnosed with anxiety because my mind was running a hundred miles per hour, like here, there, here, there in order to just get a job.

CHATTERJEE: Siddiqui says it also took months for her and her husband to find an apartment they could rent because they had no credit history. All this stress, she says, takes a toll on families.

SIDDIQUI: I can even tell you from my own experience that the lack of getting a job or unemployment, it really strains your relationship.

CHATTERJEE: Strains relationships and creates conflict. Theresa Betancourt directs the Research Program on Children and Adversity at Boston College.

THERESA BETANCOURT: There can sometimes be an elevated risk for violence within the home.

CHATTERJEE: Especially because parents are also struggling with their past traumas.

BETANCOURT: We know this from military families, that when parents are exposed to significant violence in other settings, then they come back to rejoin their family environments, we can see elevated problems with emotion regulation, sometimes more harsh disciplinary practices or harsh interactions between parent and children.

CHATTERJEE: And that worsens the risk of mental health problems in kids. But when parents are doing well, they can buffer their kids from the long-term impacts of past trauma and stresses. And so Betancourt developed this program to prevent long-term mental health problems in refugee kids.

BETANCOURT: We're really trying to work with the family a lot earlier with a prevention focus and a mental health promotion focus.

CHATTERJEE: Parents learn positive parenting skills, as well as ways to better manage their own stress, say, by using mindfulness strategies. It also helps parents navigate everyday stresses. Betancourt and her team piloted the effort in Lewiston's Somali and Bhutanese communities. Families who participated reported fewer family arguments and a reduction in symptoms of depression and traumatic stress in their kids. Khadija Rahmani tells me how Siddiqui has supported her, for example, when she was struggling with learning English.

KHADIJA RAHMANI: (Through interpreter) She motivated me, saying it's not hard. At least you are educated. You can read and write, which will help you learn English.

CHATTERJEE: Siddiqui also helped Khadija find a job.

RAHMANI: (Through interpreter) She guided me to a place where women work, and all of them are Afghan women at FedEx.

CHATTERJEE: And she says Siddiqui has had a huge impact on her youngest son, Mujib, who's struggled the most.

RAHMANI: (Through interpreter) Shabana sat with him, told him good stories, talked about safety and security. She said this place is safe, and you don't need to stress.

CHATTERJEE: She encouraged him to engage more at school, which had been a big source of anxiety for him. Khadija says Mujib loves it when Siddiqui visits and talks to her a lot about his life. Mujib confirms that.

MUJIB UR-RAHMAN: (Through interpreter) We talk about English. We talk about my school. We talk about everything.

CHATTERJEE: And it's helping him start to move past the shadow of old traumas and towards building a hopeful future in this country. Rhitu Chatterjee, NPR News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.

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