Refugees from war-torn regions and those seeking political asylum are likely bringing with them memories of events they would rather not recall or discuss. Many experience symptoms that in the U.S. are labeled post-traumatic stress disorder (PTSD). This profound fear and anxiety can influence the ELL student significantly.

PTSD represents the chronic effects of life-threatening experiences.  The persistent, intense anxiety that is symptomatic of PTSD has a direct affect on the student’s ability to concentrate.  Poor sleep patterns due to rumination and nightmares reduce attentiveness and thus, memory.  Difficulty sustaining a full night’s sleep almost always accompanies this disorder.

Families may continue to experience loss and bereavement for relatives who have been left in their native country or killed.  Persistent anxiety contributes, over time, to loss of neural tissue essential to forming memories.

Depression frequently occurs.  Individuals who leave their homeland and face a foreign place, people, customs, and language often become depressed, particularly if they have left loved ones and/or friends behind and if they fear for their safety.  Chronic depression is typically accompanied by cognitive changes such as reduced concentration, memory, and initiative.  Anxiety and depression often co-occur in this population.

Economic hardship, difficulties acquiring citizenship, long waits for U.S. Immigration Services to approve visas for relatives, and family tensions present additional stressors, which make adjustment more difficult. Younger adults often find themselves in conflict with an older generation as well as their American peers as they try to resolve the demands of assimilation versus cultural preservation. It is not easy to deal with a dominant culture if it lacks understanding or respect for differences.

Securing appropriate and accepted treatment for immigrants with a need for mental health services is difficult, even for more long-tenured refugees such as those from Southeast Asia, Mexico, and Central and South America. Health services are available with certain translators at several locations, but mental health services are still provided almost exclusively in English, and there are strong cultural barriers to seeking treatment.

For more information about mental health cultural views, go to the Echo Minnesota website at:  For more information about mental health of refugees, the Refugee Health Technical Assistance Center website offers helpful content.