The Scope of Work:
The Transforming Refugee Mental Health (TRMH) project is working to develop a culturally-sensitive, gender-sensitive intersectional framework for diagnosing trauma among refugees and vulnerable groups in Arab countries. We attempt to decolonize our understanding of trauma, through exploring the ways, in which trauma is conceptualized in the Arab region and the relationship between the person, family, and community in order to ground understanding trauma among refugees in the region.
With the gendered and cultural framework, the TRMH project team plans to develop a training program in refugee mental health, telemedicine, health informatics, and mobile health for primary care doctors and nurses, psychiatrists, psychologists, counselors, medical, nursing, and public health students, refugee community health workers, and refugees.
Launched in 2017, by Suad Joseph, TRMH is a project of the University of California Arab Region Consortium (UCDAR), research collaboration that includes the American University of Beirut, the American University in Cairo, the Lebanese American University, Birzeit University, and the American University of Sharjah, http://sjoseph.ucdavis.edu :
The Problem:
According to the UN Refugee Agency (UNHCR), the Syrian refugee crisis has displaced more than 5 million people, and the Arab region in general is the largest producer of refugees, globally. Many of these refugees have fled to neighboring countries including Lebanon, Turkey, and Jordan. Syrian refugees struggle with the violence and trauma that they have experienced, and the extreme poverty they confront in host countries. In addition to the Syrian refugees, are the long-standing Palestinian refugees, housed in Palestine, Lebanon, Jordan, and Egypt. In Lebanon, there are upwards of 500,000 Palestinian refugees, some of whom have been there since 1948, others since 1967 and others at various wars and dislocations. Palestinians, like Syrians and Iraqis have also been dislocated numerous times within their own country. Hundreds of thousands of Iraqi refugees are also stretched among the countries of the Arab regions. They are living alongside other vulnerable populations in host countries. Depleted resources, the high cost of living and restricted livelihood opportunities due to lack of access to employment and legal residency are making it difficult for these families to meet their basic needs. The overall situation is exacerbated by weak economic growth in host countries, and overstretched resources and services.
Where we are at now? June 2023 updates
Since the end of 2020 the team has been working on a scoping review of the literature on trauma. The team posed the review question “Does the current literature on refugee trauma in the Arab Region challenge the Western conceptualization of a traumatized individual self?” The team has submitted a systematic scoping review manuscript addressing this question for publication. Currently we are working on finalizing a manuscript of a critical narrative review of conceptual models of Arab trauma and a cultural and gendered framework, to re-conceptualize Arab trauma. Followed by field projects on trauma in Egypt, Lebanon, and Palestine, all in collaboration with our partner universities. Utilizing the findings of our review, and future work we plan to incorporate cultural and gender understanding and sensitivity throughout the research and data collection, certificate training programs, and monitoring and evaluation.
Dr. Joseph, presented a summary of the proposed framework to trauma conceptualization, and the TRMH work, with other team members participating the discussion, in the Gender and Politics in the MENA workshop, University of Gothenburg, at the Arab World Health Summit, and at keynote addresses for the Relief Center, the American University of Beirut, and the American University in Cairo between 2021-2023 and various other conferences.
Findings of our scoping review were presented separately by other team members in conferences of the American Public Health Association and Lancet Palestine Health Alliance in 2022.
Additional Research Emerging from the TRMH Project:
UC Davis Refugee Law-Mental Health Intersection Forum 2018
Bridging the Scientific-Legal Divide in the Adjudication of Trauma in Immigration Proceedings.
This project brings together legal and mental health academic faculty, and clinical practitioners working with immigrants and trauma to improve how immigration forensic assessments are conducted. Forensic assessments provide a meaningful point within the legal process where legal and health professionals can collaborate to 1) significantly improve the odds that immigration petitioners succeed in their claims, and 2) seize the opportunity to educate decision-makers about science-informed best practices to document trauma. The project is a continuation of an ongoing collaboration between the UC Davis law and medical schools in a project titled Transforming Refugee Mental Health: Improving Legal Assessment of Credibility through Science. Following two interdisciplinary symposiums, which brought together over seventy professionals, including lawyers, mental health providers, researchers and academics, refugee resettlement specialists, and medical professionals, from over twenty countries, this project led to the publication of a report titled Stakeholder Perspectives Report: Focus Group Findings on Migrant Legal-Mental Health Intersectionality. We seek to implement some of the most important recommendations from the findings. Click here to learn more about our project.