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Unformatted text preview: American Journal of Orthopsychiatry, 71(2), April 2001 2001 American Orthopsychiatric Association, Inc. Theory & Review When Immigration Is Trauma: Guidelines for the Individual and Family Clinician RoseMarie Perez Foster, Ph.D. This paper considers two pertinent strands in the contemporary immigrant mental health literature: 1) the distinction made between stressors that are endemic to most immigrant experiences vs. those migration stressors that precipitate trauma per se; and 2) clinical guidelines that continue to refine the assessment of immigrants' presenting mental health problems, given the provision of services in institutions that are foreign to both the language and idioms of distress of the populations being served. Case vignettes highlight the research findings and practice recommendations. E migrations of human groups have taken place since the dawn of time, and they are recorded in ancient texts. Seeking safety, shelter, food, farmable lands, and human freedom, people have sought to escape hunger, incarcera- tion, torture, and oppression of the spirit. However, the two decades immediately preceding this mil- lennium have witnessed the largest migratory pat- terns ever recorded in history. Civil wars in Africa uprooted centuries-old tribal communities. The fall of the Soviet Union unearthed genocidal aggres- sions in Western Europe. And struggling econo- mies in the Latin American world failed to enhance the lives of a large underclass. Natural and human- made disasters also moved people to seek safety, as droughts in Haiti, floods in Guatemala and Mex- ico, and nuclear accidents in the former Soviet Union caused the relocation of several million refugees in the last 20 years, either to areas within their own countries or outside of their borders. According to the United Nations High Commis- sion of Refugees (1993), there are upward of 20 million people in the world today who are desig- nated refugees. These are people who fled to an- other country either because of war or scarcity of food. Another 70 million have relocated around the world outside their native countries, primarily in search of work. A large number of these immi- grants are known to be at significant risk for poor living conditions, economic exploitation, and racist or prejudicial treatment from their host locations. Many countries have come to serve as a safe haven in the diaspora for many of these people. The United States has traditionally assumed such a role; however, the tremendous influx of immi- grants to this country in the last decade has forced the American social service and mental health sys- tems to generate new services, new sensitivities, and new interventions for large groups of people who are recognizably needy, but unrecognizably foreign. As a result, clinicians and researchers are now pressed to understand how best to serve the nation's new immigrantsand have been led to in- vestigate questions such as: How compromised are people who have been forced to leave behind all...
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- The Land