The practitioner’s interest in learning about their client’s culture and religious background, and how the young person relates to their own cultural and religious identity is important (Valibhoy et al., 2015). It is important that professionals understand that young people from migrant and refugee backgrounds are often in the process of developing ‘multi-faceted identities’, “reflecting their exposure to varied environments and ways of life during their refugee or migrant journeys, at critical development stages” (Valibhoy et al. 2015).
Although ‘refugee’ can be a label many young people are keen to discard upon settlement in a new society, young people do want practitioners to understand some of the experiences they have faced, such as exposure to violence and persecution, and having to leave behind family and friends in dangerous environments (Valibhoy et al. 2015). Understanding the impact of their refugee experience is important, although the individual details of the trauma may not need to be discussed.
“A trauma centred approach acknowledges that the trauma is in the room, [the need to] work differently with youth with a trauma history, it’s not about having to talk about the trauma” (Colucci et al., 2015). Young people from refugee backgrounds value certain things from practitioners. This includes: advice, support and advocacy to address their needs as they see them, understanding the interrelationship of their practical problems and underlying psychological needs, and a holistic approach that integrates care for both their health and social wellbeing (Valibhoy et al., 2015).
Trust is central to how and whether young people from refugee backgrounds engage with mental health services. Establishing and building trust takes time; many young people have had their sense of trust in others eroded as a result of the refugee experience. Negative experiences with authorities during their migration journey can mean building trust with professionals is a slow process. Explaining how information collected will be used and ensuring confidentiality are integral parts of developing and maintaining trust (Colucci et al., 2015).
Additionally, using interpreters effectively is also important for young people from migrant and refugee backgrounds. Young people should be consulted at the point of referral about their interpreter preferences (for instance, do they prefer a particular gender, language or background?), as young people from small communities may have fears of confidentiality (Colucci et al., 2015). Using phone interpreters or employing bilingual health workers could also assist with ensuring confidentiality.
Using interpreters when necessary, particularly at the point of assessment, is important. This is a critical moment where both the young person and practitioner need to be able to effectively communicate and understand one another. For further information see CALD 4: How to work with interpreters (Waitemata DHB eCALD® services, 2014b).
Engaging with family and community is also an important aspect of supporting young people’s engagement with mental health services. Young people want mental health practitioners to understand the value of family to them and the way this may differ culturally from other client groups. It is important to seek the young person’s input as to if and how they would like a service to work with their family is important.
Advocacy, or holistically attending to the priorities of the young person should also be part of a mental health approach for young people from refugee backgrounds. Meeting young people’s practical needs builds trust and rapport, particularly if they are unfamiliar or hesitant to use mental health services. Best practice for refugee young people requires professionals who are not stuck in their own professional roles, and should work to address immediate needs, which might involve advocacy on the young person’s behalf (Colucci et al., 2015). It is important that mental health services have the flexibility to provide practical support and advocacy for young people and their families. This builds trust and addresses factors that may be compromising their mental wellbeing (CYM, 2015, pp. 7). Practical support may include assisting with family immigration, housing and income support issues.