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Protecting vulnerable populations: COVID-19 pandemic, mental health, and refugees and asylees

Jenny Mincin, PhD, MPhil, MPA, Rupa Khetarpal, LCSW, MSW, Jordan Steiner, PhD, LSW, MA


According to the World Health Organization, as of June 2021, there have been over 3.7 million deaths globally and nearly 600,000 Americans who lost their lives from COVID-19 (WHO Coronavirus Disease Dashboard, 2021). The health, mental health, and economic effects are apparent in every household and community. However, the most vulnerable populations tend to be more adversely affected by disasters, and the COVID-19 pandemic is no exception. This article focuses on the mental health effects of COVID-19 on the refugee, asylee, and immigrant (RAI) community, the effects of misinformation and lack of access to the healthcare system, and the results from a small qualitative program evaluation that included exploration of the effects of COVID-19 on refugees and asylees. The authors discuss specific issues reported by the RAI population, intergenerational trauma, and recommendations for health and mental health programming when working with RAI communities during disasters such as pandemics.


COVID-19, refugee, asylee, and immigrant (RAI) community, mental health

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Al-Roubaiy NS: Post-migration stress among adult male Iraqi refugees and its implications for counselling and psychotherapy: A qualitative study. Unpublished paper, University of Leicester, 2014. Available at Accessed on June 9, 2021.

Al-Roubaiy NS, Owen-Pugh V, Wheeler S: The experience of exile-related stress among Iraqi refugee men in Sweden and its implications for counselling and psychotherapy: A qualitative study. Counsel Psychol Rev. 2014; 28(2): 53-67.

American Community Survey: Census. Gov., 2019. Available at Accessed on June 9, 2021.

American Psychological Association: Resilience & recovery after war: Refugee children and families in the United States. Available at Accessed on June 9, 2021.

Ballard J, Wieling E, Solheim C, et al.: Immigrants and Refugee Families, 2nd Ed. University of Minnesota Libraries Publishing, 2019. DOI:10.24926/8668.2901. Available at Accessed on June 9, 2021.

Betancourt TS, Newnham EA, Layne CM, et al.: Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress. December 2012; 25: 682-690.

Bierer LM, Bader HN, Daskalakis NP, et al.: Intergenerational effects of maternal holocaust exposure on FKBP5 methylation. Am J Psychiatry. 2020 Aug 1; 177(8): 744-753. DOI:10.1176/appi.ajp.2019.19060618. Epub 2020 Apr 21. PubMed PMID: 32312110.

Bojic M, Njoku A, Priebe S: Long-term mental health of war-refugees: A systematic literature review. Bio Med Central Int Health Human Rights. 2015; 15(29). Accessed on June 9, 2021.

Bojic M, Njoku A, Priebe S: Long-term mental health of war-refugees: A systematic literature review. Bio Med Central Int Health Human Rights. 2015; 15(29). Accessed on June 9, 2021.

Carlssona J, Sonnea C, Vindbjerga E, et al.: Stress management versus cognitive restructuring in trauma-affected refugees—A pragmatic randomised study. Psychiatry Res. 2018; 266(2018): 116-123.

Chen HT, Rossi P.H: The multi-goal, theory-driven approach to evaluation: A model linking basic and applied social science. Social Forces. 1980 ; 59(1): 106-122. Retrieved from Accessed on June 9, 2021.

Chen A, Hadfield K, Hamoudi A, et al.: Under siege: Cognitive signatures of poverty and trauma in refugee and non-refugee adolescents. Child Develop. November/December 2019; 90(6): 1856-1865.

COVID Emergency, United Nations High Commissioner on Refugees (2021). Available at Accessed on June 9, 2021.

COVID-19 in Newly Resettled Refugee Populations (2019, December 31). Centers for Disease Control. Available at Accessed on June 9, 2021.

Davis EA, Markenson D, Mincin J: Vulnerable populations and public health disaster preparedness. In D. Markenson & M. Reilly (Eds), Healthcare emergency management: Principles and practice. Boston, MA: Jones & Bartlett Publishers, 2010.

Derose KP, Escarce JJ, Lurie N: Immigrants and health care: Sources of vulnerability. Health Affairs. 2007; 26(5): 1258-1268. DOI:10.1377/hlthaff.26.5.1258.

Dillard JV: Cultural diversity: A primer for the human services, 6th Ed. Cengage Publishers, 2019.

Donaldson SI: Program theory-driven evaluation science: Strategies and applications. Mahwah, NJ: Erlbaum.

Gradwohl PN: Granddaughters of the holocaust: Never forgetting what they didn’t experience. ProQuest Ebook Central, 2012. Available at

Green BL, Freidman MJ, de Jong JTVM, et al.: Trauma Interventions in War and Peace: Prevention, Practice and Policy. New York, NY: Kluwer Academic/Plenum Publishers, 2003.

Gushulak B, Weekers J, Macpherson, D: Migrants and emerging public health issues in a globalized world: Threats, risks and challenges, an evidence-based framework. Emerg Health Threats J. 2009; 2: e10. DOI:10.3134/ehtj.09.010. Accessed on June 6, 2021.

Halpern J, Tramontin M: Disaster Mental Health: Theory and Practice. Brooks/Cole, Cengage Learning: Belmont, CA, 2007.

Hameed S, Sadiq A, Din AU: The increased vulnerability of refugee population to mental health disorders. Kansas J Med. 2018; 11(1): 1-12.

Harvard Humanitarian Initiative (HHI): Assessment of health care access and programs for resettled refugees in the United States. (U.S. Health Assessment, HHI/IRC USP). Boston, MA: Harvard Humanitarian Initiative, 2009.

Healey J (ed.): Stolen Generations and the Way Ahead. ProQuest Ebook Central, 2019. Available at

Herman J: Trauma and Recovery: The Aftermath of Violence –From Domestic Violence to Political Terror. New York, NY: Basic Books, 1997.

Hassan G, Kirmayer LJ, MekkiBerrada A, et al.: Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians: A Review for Mental Health and Psychosocial Support Staff Working with Syrians Affected by Armed Conflict. Geneva: UNHCR, 2015.

Jamil H, Farrag M, Hakim-Larson J, et al.: Mental symptoms in Iraqi refugees: Posttraumatic stress disorder, anxiety, and depression. J Cult Divers. 2007; 14(1): 19-25.

Jamil H, Hakim-Larson J, Farrag M, et al.: A retrospective study of Arab American mental health clients: Trauma and the Iraqi refugees. Am J Orthopsychiatry. 2002; 72(3): 355-361.

Keyes EF: Mental health status in refugees: An integrative review of current research. Issues in Mental Health Nursing, 2009; 21(4): 397-410.

Kim I: Beyond trauma: Post-resettlement factors and mental health outcomes among Latino and Asian refugees in the United States. J Immigr Minor Health. 2016; 18: 740-748. DOI:10.1007/s10903-015-0251-8.

Kirişci K, Denney S: Order from chaos: COVID-19 and the chance to reform US refugee policy. Brooking Institution, 2020. Available at Accessed on June 6, 2021.

Marceca M: Migration and health from a public health perspective. Chapter 6 in People’s Movements in the 21st Century - Risks, Challenges and Benefits, Muenstermann L (ed.), 2017. Available at DOI:10.5772/67013. Accessed on June 6, 2021.

Mincin J: Emergency management: special populations in Encyclopedia of Security and Emergency Management. Springer Publishing: New York, 2019.

Mincin J, Phillips B: International and humanitarian disaster relief. In Phillips, B. (Eds), Introduction to Emergency Management, 2nd Ed. Boca Raton, FL: CRC Press. 2017.

Miller JL: Psychosocial Capacity Building in Response to Disasters. New York, NY: Columbia University Press, 2012.

Nisson JE, Jorgenson KC: Refugees in resettlement: Processes, policies, and mental health in the United States. The Counseling Psychologist. 2021; 49(2): 178-195.

Page KR, Venkataramani M, Beyrer C, et al.: Undocumented US immigrants and Covid-19. N Engl J Med. 2020; 382: e62. DOI:10.1056/NEJMp2005953. Available at Accessed on June 6, 2021.

Pember MA: Intergenerational trauma: Understanding natives’ inherited pain. 2016 Indian Country Today Media Network, LLC, 2016. Available at Accessed on June 6, 2021.

Sandera R, Laugesena H, Skammeritza S, et al.: Interpretermediated psychotherapy with trauma-affected refugees – A retrospective cohort study. Psychiatry Res. 2019; 684-692.

Silove D, Ventevogel P, Rees S: The contemporary refugee crisis: An overview of mental health challenges. World Psychiatry. 2017 Jun; 16(2): 130-139.

Stebnicki, MA: Disaster Mental Health Counseling: Responding to Trauma in a Multicultural Context. Spring Publishing Company: New York, NY, 2017.

Taylor EM, Yanni EA, Pezzi C et al.: Physical and Mental Health Status of Iraqi Refugees Resettled in the United States. J Immigrant Minority Health. 2014; 16: 1130-1137. DOI:10.1007/s10903-013-9893-6. Accessed on June 9, 2021.

Teodorescu DS, Heir T, Hauff E, et al.: Mental health problems and post-migration stress among multitraumatized refugees attending outpatient clinics upon resettlement in Norway. Scand J Psychol. 2012; 53: 316-332. DOI:10.1093/acprof:oso/9780195187250.001.0001.

Truman BI, Tinker T, Vaughan E, et al.: Influenza preparedness and response. Am J Public Health. 2009; 99(Supplement 2): S2.

United Nations High Commission on Refugees. (n.d..) Who We Help. Retrieved from Accessed on June 9, 2021.

Volkin S: How are refugees affected by COVID-19? 2020. Available at Accessed on June 6, 2021.

Weiss CH: Evaluation, 2nd Ed. New Jersey: Prentice Hall, 1998.

What is the impact of the COVID-19 pandemic on immigrants and their children? (2020). OECD Policy Responses to Coronavirus (COVID-19), 19 October 2020. Available at Accessed on June 6, 2021.

World Health Organization (WHO): Coronavirus Disease Dashboard 2021. Available at Accessed on June 6, 2021.

Yako RM, Biswas B: We came to this country for the future of our children. We have no future: Acculturative stress among Iraqi refugees in the United States. International Journal of Intercultural Relations. 2014; 38: 113-141.



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