Environmental characteristics

Almost nothing is known of those environmental factors that increase the resiliency of refugee survivors. It is accepted as a given that humanitarian aid in the acute phase of the refugee crisis and protection against further violence reduces medical and psychiatric morbidity. However, the natural history of traumatic outcomes and the associated environmental characteristics affecting these outcomes have never been described. Political compromises related to asylum protection in host countries have plunged refugees into years of forced dependency, chronic malnutrition, lack of education and work, and the inability to practice their religion and cultural rituals. Similarly, in resettlement countries, opportunities related to family unification, learning to speak the new country's language, and employment have clearly been shown to be associated with decreased psychiatric morbidity over time. Those who provide psychiatric care for refugees must keep in mind the environmental opportunities that can increase their overall resiliency.

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