The Trauma Of…Immigration and Refugees

This summary sheet was created by the members of the Greater Lowell Trauma Advisory Group, based on a roundtable discussion held on March 6, 2012 in Lowell, Massachusetts.  The purpose of the event was to educate one another through discussion and sharing, so that we may better understand the connection between trauma and immigration and refugees. Our goal was not to develop strategies to “fix the problem” but, rather, to raise awareness among professional about the many layers of trauma and develop ideas to support them. A total of 12 professionals and consumers participated in this event. What follows is a summary of our discussion. 


  • According to the U.N. Refugee Agency, there were 1 million refugees living in the U.S. in 2007. Thirty-eight percent of these individuals were under the age of 18 years.
  • According to a study of Somali youth refugees (ages 11-19), 94% reported exposure to an average of 7 traumatic events (range was 0 to 22 events). Only 7.7% of those exposed to trauma obtained formal support services.
  • According to the International Institute, one-third of Lowell’s population is made up of refugees or derivatives.

The Many Layers of Trauma in Immigration

Migration stages at which there is a potential for trauma/serious psychological distress:
1)  Events experienced prior to migration that were the reasons for relocation,
2)  Events experienced during transit to new country (“the escape experience”),
3)  Events experienced while seeking asylum and resettlement (e.g., violence and abuse occurs in the refugee camps), and
4)  Substandard living conditions in the host country due to unemployment, inadequate supports and minority persecution/isolation.

Challenges Faced by Immigrants and Refugees

  • Children’s experiences of trauma are often minimized. Children do not always have their parents’ physical or emotional availability to support them during the transition.
  • Parents are “starting over” with their children in a foreign land, with food, traditions, laws, people, norms, and often climate that is dramatically different than what they are used to.
  • Teenagers feel they need to protect themselves because they are different than their peers.
  • Varying levels of education cause more stress and difficulty acculturating.
  • Discrepancies between parents’ values and those of the U.S. culture.
  • Providers involved with these families are sometimes not knowledgeable about the culture (act on stereotypes).
  • Families feel they are a burden (drain on the system), which leads to feelings of further isolation.
  • Families experience prejudice, which can lead to hate crimes.
  • They are often taken advantage of because they are not aware of their legal rights or cannot communicate their version of issues.
  • Parents sometimes have low self-esteem, as they are not able to get a job that matches their education level.

Challenges Faced by Providers

  • Not understanding cultural rituals, traditions, and norms or assumptions made about families’ needs.
  • Difficulties bridging the gap between what the families need and culturally-sensitive services that are available.
  • Lack of understanding of communities who are in conflict with one another and trying to put individuals from those communities in contact for support.
  • Agency rules that don’t meet families current needs (the challenge of “negotiating systems”).
  • Shortage of translators and using children as translators (creates boundary violations as children are privy to information they would normally not be exposed to).
  • Providers need time to build trust with these families, but the system doesn’t always allow for this to happen. Staff turnover often forces families to keep “starting over.”

Challenges Faced within Systems

  • Lack of access to services (language capability within the agency, lack of transportation).
  • Place families into poor living conditions due to the shortage of affordable, quality housing.
  • Refugees have to re-tell their trauma stories multiple times and justify their choices to providers, which can feel like they are being interrogated.
  • Families are not given any choice regarding where they live when they are placed in the host country.