Bhutanese refugees suffer from alarming rates of substance misuse, depression, anxiety, and PTSD (Cochran et al., 2013), the latter three at significantly higher rates than the general U.S. Mental health is a public health concern among Bhutanese refugees, and these problems are experienced across generations (Rinker & Khadka, 2018). After their third-country resettlement in the United States, this experience of collective historical trauma is often compounded by post-resettlement challenges including but not limited to adjusting to a new environment, lack of employment and reliable social services, and language barriers, causing Bhutanese refugees to suffer from poor mental health outcomes (Ellis et al., 2016). The majority of Bhutanese refugees in the United States arrived between 20 (Centers for Disease Control and Prevention, n.d.) after two decades of displacement in refugee camps in neighboring Nepal, which denied them citizenship despite their cultural ties to the country (Chase & Sapkota, 2017).īhutanese refugees have a long and painful history of collective historical trauma from forced displacement, separation from family members, and loss of citizenship that continues to affect them on both individual and community levels in places of resettlement (Rinker & Khadka, 2018). An ethnically and linguistically Nepali minority group called Lhotshampas, Bhutanese refugees were forced to flee genocide, torture, and other human rights violations (Tol et al., 2010) in the early 1990s when the Bhutan government enacted policies to exclude and denationalize ethnic and religious minorities (Evans, 2010). Department of State, 2017), one of the largest refugee resettlement programs coordinated by the United Nations High Commissioner for Refugees in recent years (Gurung & Baidya, 2010 Shrestha, 2015). Since 2006, more than 86,000 Bhutanese refugees have resettled in the United States (U.S. Our study also contributes to emerging knowledge on methodological rigor in research among understudied, hard-to-reach, small populations. Findings emphasize the need to understand historical and cultural perspectives in cross-cultural contexts for the development and implementation of culturally responsive services. We argue that recognition of refugees’ conceptualization of mental health and identification of cultural protective factors is paramount to healing. region to understand mental health conceptualization from the Bhutanese refugee perspective by examining the cultural meaning and perception of mental health, describing experiences of mental health problems, and examining cultural protective factors and coping strategies. Guided by historical trauma theory, we gathered data using a two-phase explanatory sequential mixed-methods study (quantitative: n = 40 qualitative: n = 6) in a Midwestern U.S. Despite the rapidly growing need to understand mental health challenges faced by refugee subpopulations, there is a dearth of literature exploring mental health conceptualization through the unique refugee lens.
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