Influx of Refugees: State Challenges and Opportunities

January, 2020

Authors: Kristina McGuire & Sandra Donnay

Contributors: Abigail Akande, Lisseth Roja-Flores, Kelli Hughes & Kee Straits

Refugees face structural and cultural barriers associated with higher physical and mental health disparities, poverty, and uncertainty about their rights and legal status.


  • Community members may not have access to accurate and up to date policy-related information (e.g., misconception on the permanent resident or citizenship process).

  • Refugee uncertainty about healthcare benefit qualification (e.g., Federal reductions in Affordable Care Act outreach).

  • Refugee reluctance/avoidance of benefit programs for mental and physical health care (e.g., fear of deportation, cultural misunderstandings, service systems biases).

  • K-12 personnel may not recognize trauma symptoms in refugee children.

  • Lack of cultural competency in organizations serving refugees (e.g. mental and physical health, schools).


Possible Responses

  • Disseminating accurate and objective information by investing in collaborative, multi-agency and community- based partnerships interacting with refugee families (e.g., faith based groups, grassroots, schools, other immigrant service organizations).

  • Providing accurate (multilingual) information using reputable social media sources such as those associated with professional organizations, subject matter experts, and certain celebrities.

  • Expanding State healthcare multilingual outreach as Federal healthcare outreach declines,

  • Ensuring refugee mental and physical care outreach includes “no threat of deportation” status communication.

  • Use Trauma Informed Care (TIC) approaches to recognize and treat trauma in refugee children. For example,

    recognizing the signs of trauma and mental illness.

  • Enforcing culturally conscious services for refugees. Some examples may include: Promoting cultural

    competency training in schools, community agencies, tailoring culturally responsive mental health services, and

    requiring cultural competency training in higher education curriculum.

  • Cultural conscious programming also includes cultural humility, country of origin political/social climate

    awareness, developmental, gender, and language needs.

Key Resources​