Refugee Health Summit addresses communication, whole health for youth

There are about 18 million New American and refugee youth living in the U.S. For health care providers, social workers and others who interact with this population, it’s critical to understand how to speak to them, and how to promote a whole health approach to help them thrive as individuals and in the community.

More than 150 people spent a recent Saturday learning from, and about, each other in an effort to achieve these goals as part of the eighth annual Western New York New American and Refugee Health Summit held at the Jacobs School of Medicine and Biomedical Sciences. Attendees included health care providers, social workers, academics, students and representatives from organizations that work with the New American and refugee population.

“Today’s summit is an opportunity to draw our attention to New Americans and refugees displaced from their peoples and places,” said Alex Judelsohn, programs manager for UB’s Community of Excellence in Global Health Equity, noting that refugees are people who are forced to flee their home country in order to escape persecution. The phrase “New Americans” has been added to this year’s summit in recognition of the fact that some refugees may not be comfortable being defined as such.

“New Americans bring unique perspectives, ideas and energy to their communities,” Judelsohn said during the event welcome. In 2021, Buffalo’s refugee population came from Afghanistan, Burma, Democratic Republic of the Congo, Iraq, Sudan and Ukraine.

A UB alumnus who is currently pursuing doctoral research at the University of Michigan on the readiness of municipal governments to help refugees thrive, Judelsohn outlined some of the challenges young refugees and New Americans face, such as balancing multiple identities, having different experiences compared to older generations, and navigating a completely new school environment.

A whole health approach calls for taking care of both physical and mental health, a sense of cultural and social belonging, connections to people across generations, and opportunities to live a full life, Judelsohn said.

In his keynote speech, Dilli Gautam, president of the Bhutanese Community of Michigan and associate director of community engagement at Bethany Christian Services, spoke about why the communication approach providers take with New American and refugee youth matters and the difference between helping and empowering.

“Helping is patronizing. Helping is making them depend on you,” said Gautam, who spent 16 years in a refugee camp in Nepal from ages 3 to 19 with his parents before immigrating to the U.S., where they resettled in Grand Rapids, Michigan. “Empowering is making them depend on themselves. If you empower them, you will teach them, you will equip them on how to help themselves and their community.”

Gautam talked about the journey of a 10-year-old refugee he worked with in Michigan. The child walked all the way from Eritrea to Yemen, then took a boat to the Ukraine and ultimately came to the U.S.

“He has more experience at 10 then I have as an adult,” Gautam said. “If you as a health care provider talk to them as a youth, they think that you’re patronizing them. Given the responsibility of the journey that the youth took, I would much prefer providers talk to that individual as an adult, because I can’t even imagine that journey.”

Gautam added: “When it comes to New Americans, we have to analyze their journey and the struggle that they had. We have to analyze the responsibility they have. Those youth earn money and send money back to their parents, so they are adults in their household. We have to acknowledge that fact.”

In fact, he said, “The pressure on youth to be youth, be an adult for their parents, be parents to their parents, navigating the cultural tenets in the U.S. — it is huge pressure.”

While one might expect New American and refugee youth to have higher depressive symptoms compared to their non-immigrant peers, Gautam’s research found the opposite, at least during the high school years.

“The perception we have is that refugee youth should have high depressive symptoms, but in high school they are with the same group of friends who have the same trauma and share their same journey. They find that belonging. They find comfort with each other,” he said.

After high school, however, depressive symptoms skyrocket because that sense of belonging is no longer there, Gautam said.

Preventative care is also a new concept for many New American and refugee youth. In a refugee camp, or when fleeing violence in their home country, survival is top priority, not dental or medical care, Gautam said.

“The very reason we became refugees is because we advocated for ourselves in our home country,” he said. “When we immigrate to the U.S., we choose not to advocate for ourselves, knowing what happened was in the past. You are their advocate.”

Several panel sessions were held after Gautam’s talk.

Isok Kim, associate professor in the School of Work, facilitated a discussion on “Shifting focus from stereotypes to reality: Mental health among refugee youth.” Refugee youth are too often misunderstood by mental health professionals due to preconceived notions on refugee identities and perceptions, Kim said. He emphasized the need to put an end to stereotypes and instead focus on the reality of refugee and New American youth mental health and experiences.

Samina Raja, professor in the School of Architecture and Planning and outgoing co-director of the Community for Global Health Equity, co-facilitated a panel on “Whole communities for youth, by youth” co-designed with panelists Caroline Mwamba (Canisius College), Dalia Alsayadi (I Prep Charter School) and Parveen Attai (UB alumnus). Co-facilitators were Neena Hussey, youth education director for the Massachusetts Avenue Project, and UB Food Lab affiliates Insha Akram, Poushali Bhattacharjee, Usman Itoo and Mazhar Shapoo.

Attai, a research coordinator for the U.S. Department of Veterans Affairs who received three degrees from UB, shared a narrative on the treatment of refugee youth and New American communities as a monolith and why it’s important to consider social determinants of health in definitions of wellness.

Panelists also noted that improved diversity of faculty and staff in schools and universities would alleviate many concerns young refugees have in school.

In a panel about culturally responsive health care, Jessica Scates, coordinator of equity, diversity and inclusion initiatives in the School of Dental Medicine, noted that mental health screening tools are not always culturally sensitive and, as a result, may not capture the reality of refugee and New American youth experiences and mental health struggles.

An afternoon workshop on learning from 1.5 generation refugees — those who immigrated to a new country before or during their early teens — featured Fardowsa Nor, clinical outcomes coordinator for Jericho Road. Nor discussed the untapped potential and underappreciated challenges these refugees face, including the role reversal of youth and parent, and having to navigate American systems with which their parents are unfamiliar.

The WNY New American and Refugee Health Summit is co-sponsored and organized by UB’s Community for Global Health Equity, the School of Architecture and Planning, the School of Public Health and Health Professions’ Office of Global Health Initiatives, Providence Farm Collective, Grassroots Gardens of Western New York, HEAL International, Burmese Community Services the Karen Society of Buffalo, the Human Rights Initiative at the Jacobs School, and the Immigrant and Refugee Research Institute at the School of Social Work.