Refugee Orientation: Culture Shock and Mental Health

July 27, 2016

Many feel relieved, happy, elated even when they step off a plane to safety. Sure, it’s drizzling rain and gray in Portland. But they’re safe from whatever it was that caused them to flee. Whatever it was that gave them the title of ‘refugee.’

For many, however, those feelings change. Life gets hard in a new way. People are isolated and confused.

“If our body gets hurt, we would go see a doctor or try our best to heal it,” said Graziella Loele, an Americorps  Jesuit volunteer, cultural orientation coordinator with Catholic Charities. “Our mind is as important as our body, so think of it that way when you are experiencing a mental health problem. Take care of it as how you would take care of your body.”

Amy Freeman is a clinical case manager with Catholic Charities

In the second of 10 cultural orientation classes, Catholic Charities staff introduced more than a dozen newly arrived refugees to the concept of mental health challenges and the services available to help them cope.

Cultural Adjustment

Amy Freeman, a clinical case manager with Catholic Charities, asked the new residents what they think they gain and lose by coming to the United States.

People talked about education and employment, safety and citizenship. They would be glad to have better healthcare, access to government support through food assistance programs and social security benefits. They looked forward to a more diverse community, to feeling respected, to feeling equality.

But that comes at a price. Half of the students talked about losing family and friends - some they left behind and others had died. They lost traditions. A woman from Nepal said she lost the ability to make herself understood.


Culture Shock

When a refugee finally settles in a new home country, she goes through stages of adjustment. First, there’s the honeymoon. She feels relieved when she steps off the plane. People talked about feeling confident, joyful, hopeful, curious. That’s because they are in a new country and hopeful that their lives will be better.

But after a few weeks people begin to realize how much life has changed. Things are so different than what they dreamed of. People said they felt sad, confused, disappointed. Some were frustrated, depressed and lonely.

Some of the new residents had moved on. They were in what is called the “adjustment” phase. A few weeks or months after the culture shock begins, they begin to feel more comfortable. There is some relief, even peace. The refugees in the orientation classes were all new to the U.S. But they’ll transition, one day, into the final phase: home. That’s when they’ll feel relaxed, healthy and confident in their lives.  


Mental Health

All of that puts stress on a person. And depression, anxiety and other mental health issues often arise.

Freedman asked what people think about mental health. Some people laughed as they tossed out responses. People who have mental health problems are often considered crazy, disabled or scary.People simply don’t talk about it.

Freeman said it’s really normal for refugees to struggle with the cultural changes and the trauma they survived. She encouraged people to talk to someone if they feel like they are experiencing mental health problem. And she listed programs that offer free and low-cost mental health services in Portland, including: Lutheran Community Services, Intercultural Psychiatric Program, Multnomah County Crisis Line, Catholic Charities Preferred Communities Program for Women.

She asked the class what they do to feel better when they’re feeling down. One man said he breaks things. Women talked about spending time with friends and family. Others said they cried, went for a run, cooked, ate, slept or worked.

“I feel like telling clients about mental health is really important, because a lot of people, culturally, they might not have information that’s okay to seek out help for mental health issues,” said Freeman. “It’s fine to reach out and there’s no shame attached in doing that.”