Melissa Mitchell, PharmD, BCPS, BCGP, BCPP
AAPP Program Committee Member
Assistant Director of Pharmacy
RUHS Medical Center
Moreno Valley , CA
In each practice, patients may present with a variety of cultures, often different than our own. This alone can alter the patient’s care, from the way the patients view their mental health, the treatments they prefer, and their willingness to seek treatment, to the development of a therapeutic relationship with their provider, as well as implicit bias they may face1. The difference in culture alone creates challenges for a clinician, and refugee status only adds to these challenges.
Each year, we watch millions of people become refugees due to a variety of reasons, from conflict, violence, human rights violations, and/or persecution. These individuals are leaving their homes just to protect their safety and survival. According to the UN Refugee Agency, over 1% of the world’s population are refugees, with more than 100 million people as of May 20222. According to the World Health Organization, refugees are one of the most vulnerable subsets of the population. They experience poor working, housing, and living situations, as well as discrimination and inadequate access to healthcare3.
Refugees are exposed to multiple stressors and traumatic events. Due to this, refugees have a higher incidence of post-traumatic stress disorder (PTSD), anxiety, and depression compared to the general population. In addition, refugees can have a more difficult time finding and/or accessing care, as well as ensuring a continuation of care. COVID, and the lockdowns and travel restrictions that ensued, not only were harder on refugees but also brought to light the inequities that were occurring in this patient population.
Each one of our practices may be affected by the refugee crisis, and yet we often do not feel like we might be prepared to do so. Psychiatric pharmacists can plan a key role in helping refugee patients treat their mental health conditions but do need to have an understanding of cultural differences that exist. These differences may affect the way the patient accesses care, as they may have already experienced discrimination, racism, or bias from other healthcare providers.
We are excited to have Dr. Arash Javanbakht, MD speak to us about this very important topic. Dr. Javanbakht is a psychiatrist and the director of the Stress, Trauma, and Anxiety Research Clinic (STARC). He treats civilians, refugees, and first responders, focusing on anxiety, trauma, and PTSD treatment. Several of his studies have researched the impact of trauma in war for both Syrian and Iraqi refugees, in adults and children. In addition, he and his team have researched the genetic and inflammation correlation with trauma. They use a variety of mechanisms to help refugees deal with these stressors, from yoga to mindfulness and dance.
In addition to being a past speaker for AAPP, Dr. Javanbakht’s work has been featured on a variety of media outlets, such as the Washington Post, CNN, NPR, and Aljazeera. At AAPP 2023, Dr. Javanbakht will help increase the knowledge of treating refugees by identifying the opportunities and challenges of caring for this population, while also understanding the cultural considerations. He will talk about how pharmacists can provide culturally sensitive care to meet the needs of refugee populations and will identify key resources providers may utilize to help support best-practice care with the refugee population. This presentation will allow each of us to become better practitioners for all patients experiencing the trauma of being a refugee.