Cultural Consultation for Refugees

Refugees and refugee claimants are faced with the task of rebuilding their lives in an unfamiliar environment, while having to deal with past trauma and multiple ongoing stressors. As part of the clinical intervention with this population, it is important to understand and act on the social determinants of health, which may maintain or exacerbate mental health problems and impede integration. In this chapter, we summarize the legal rights of refugees and refugee claimants, with a strong focus on the criteria that a refugee claimant must meet in order to be accepted as a refugee according to international and Canadian law. We then examine some of the main stressors that refugees and refugee claimants may face during the premigratory, transit and postmigration phase, and discuss in greater depth the impact of immigration detention in the host country and of family separation and reunification. This is followed by a discussion of the clinical assessment and treatment of refugees who have experienced trauma and forced migration. Finally, we provide guidance on writing reports assessing refugee claimants’ mental health in the context of refugee status determination proceedings. To conclude, we briefly examine the relevance for clinicians to engage in advocacy on behalf of this population.