Background: In 2016, the United States resettled 96,900 refugees. In addition to its share of US resettled refugees, New Mexico was among the 10 states with the largest share of undocumented migrants (85,000) in 2014. As a humanitarian effort, refugee resettlement programs give priority to the most vulnerable cases, leading to a community in need of special care. Since there is significant diversity among refugees’ and other migrants’ conditions and backgrounds, optimizing healthcare for each individual can be overwhelming. Each state in the US has different community and refugee support groups and resources. University of New Mexico Hospital (UNMH), does not yet have a comprehensive guide to follow when caring for refugees and migrants.
Purpose: A literature search and available resources in NM and at the University of New Mexico, for challenges associated with caring for refugees, asylees, and other vulnerable migrants was conducted resulting in recommendations relevant to the care of these vulnerable populations at UNMH. Out of the findings from the search a handout was made which covers: vital points to consider during the assessment of refugees; practical strategies to overcome cultural differences and communication barriers; special focus on assessment of refugees’ mental health and fulfillment of social needs.
Description: The results highlighted lack of trust from refugee patients, lack of training of healthcare providers, language, and cultural differences as major barriers hampering the patient – physician relationship, and consequently, quality of care. A handout was developed and provided to care managers, hospitalists, UNMH internal and family medicine residents. We found that there was a need for care givers to understand that some refugees and migrants present to the emergency department for routine care. Also, the following were critical to the caring for refugees: earning the trust of migrants, acquiring cultural knowledge about a displaced patient’s country of origin and a culturally acceptable and qualified medical interpreters. Refugees are more susceptible to mental and psychological health problems as they may have been exposed to variable types of traumatic circumstances hence a careful mental and psychological assessment is necessary. Hospitalists must become familiar with resources availble for displaced individuals in their community. In New Mexico, Catholic Relief Services and Lutheran Family Services offer a variety of free services including case management, community programs assistance with employment, language classes, and housing services. Also, all resettled refugees will have Medicaid for three months after arrival. Success of the handout could encourage its generalization to hospitalists and other health care clinicians in New Mexico.
Conclusions: Prioritizing basic needs of refugees and other vulnerable migrants is key. Designing and maintaining an integrated, culturally appropriate healthcare system that focuses on the interrelationship between physical, mental, social, and cultural aspects of care is critical.