Prevention of mental disorder among hmong refugees in the U.S. Lessons from the period 1976-1986

Scientifically valid, well controlled studies on the prevention of mental disorders are sparse. Nonetheless, much quasi-experimental and descriptive work does exist. Published findings permit an evaluation of the mental health effects of policies, procedures and programs designed for refugees. The federal government assigns legal status to refugees and is paramount in matters of refugee relocation and readjustment within its borders. In matters of social adjustment and prevention of mental disorder, agents of the federal government must consider the accumulation and distribution of knowledge, skills and expertise on refugee social and mental health issues; policies and procedures for relocation; premigration education, training, assessment, and orientation; postmigration support and acculturation; and the development of treatment resources to meet the mental health needs. Once refugees arrive in the United States of America, much of the actual implementation of policy and procedures has been left to state governments. At this level there have been neither the resources nor the expertise to develop programs for the mental health of refugees. Limited resources have been wasted and the mental health of refugees has been neglected or made worse by some state initiated programs.