Refugees

Refugees are people who flee their native countries to seek sanctuary in another country as a means of escaping persecution or oppression. Typically, refugee populations are especially active in times of war, though many also leave their countries of origin to escape an oppressive government. The traditional countries that accept refugees are Australia, Canada, Denmark, Finland, the Netherlands, New Zealand, Norway, Sweden, and the United States. In certain political eras in history, the criteria for receiving refugee status and the countries that the United States aided by accepting refugees fluctuated. During World War II, when thousands of people were fleeing violence and persecution, the United States and many other countries turned away refugees because their numbers were much higher than the immigration quotas instituted at the time. The U.S. Department of State refused to increase the quotas and to relax the limits on immigration. In response to the overall failure of countries to respond to the needs of World War II refugees, the United Nations High Commissioner for Refugees (UNHCR) was created, and the 1951 Convention Relating to the Status of Refugees delineated the international obligation, which the United States accepted, to shelter people who faced death and persecution in their own countries.

In contrast to the response to refugees during World War II, during the cold war, people from Southeast Asia, the Soviet Union, and Cuba were accepted into the United States as refugees although they did not meet the criteria for being a refugee. This illustrates how the political atmosphere—in this case, the need to “liberate” people from communism—influences which nationality groups of refugees are allowed into the country. More recently, the United States has focused on smaller refugee groups, such as Sudanese refugees, who have been victims of repression in Egypt, Ethiopia, and Kenya, and refugees from Bosnia and Kosovo who were fleeing religious persecution.

The United States traditionally has accepted more refugees than the other countries of resettlement combined. However, after the terrorist attacks on September 11, the number of refugees admitted has declined. For persons to be declared refugees in the United States, they are generally interviewed by an officer from the UNHCR and an officer of the U.S. Citizenship and Immigration Services to assess if the person is considered a refugee under U.S. law. Despite these procedures, there are still ways to allow refugees into the country who do not fit the profile of a refugee. For example, under the Widows and Orphans Act, (a) women who fear they will be harmed because of their sex and (b) children under 18 whose parents cannot provide adequate care can be admitted into the United States as refugees. Although the United States does not admit as many refugees as in the past, there is still a significant refugee population in the United States that continues to grow.

Refugees are known to suffer extensive psychological distress as a result of war experiences, flight from their native country, residence or incarceration in foreign refugee camps, and their involuntary immigration to a host country. At present, posttraumatic stress disorder (PTSD) and major affective disorders are known to be common symptom patterns within refugee populations, and there has recently been a rise in the prevalence of PTSD. However, despite the known association between refugee status and the likelihood of mental illness, diagnoses may go undetected due, in part, to culture-related presentations (e.g., somatization) and assessment biases of mental health practitioners. Thus, the combination of cultural factors in mental health presentations and new refugee groups in the United States demonstrates a need for research to better understand the problems of refugee populations and to propose effective treatment that is culturally sensitive.

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