Working Towards Collaborative, Migrant-Centered, and Trauma-Informed Care: a Mental Health Needs Assessment for Forced Migrant Communities in the DC Metropolitan Area of the United States

Although there are growing numbers of forced migrants in the United States (US), a gap exists in our understanding of their mental health needs, and of how best to build on existing services to provide migrants with good care. To address these gaps, we undertook a qualitative needs assessment exploring (1) perceived mental health needs of forced migrants, (2) barriers to accessing services and achieving positive health outcomes, and (3) effective models and possibilities for improving services across disciplines within healthcare and social service settings. We conducted three focus groups separately engaging 20 (18 women, 2 men) key informants with expert insights into forced migrant health services (researchers, health/mental healthcare providers, lawyers, policy makers, representatives from local social service and government agencies, and advocates) and 9 (3 women, 6 men) forced migrants. We analyzed responses for each group of participants using an iterative thematic analysis process. Results indicated significant overlap in key informant and forced migrant perceptions across multiple themes: mental health–related stressors of migration, changes in mental health status and health concerns once in the US, ways forced migrants cope with health and mental health concerns, ideals for good health, barriers to accessing mental healthcare, limitations of existing services, and characteristics of good health models. Our results point to the need for more accessible, collaborative, and trauma-informed and culturally informed mental healthcare approaches. Based on our findings, we recommend possible components of an effective interdisciplinary, collaborative care model for forced migrants. Public Policy Relevance The growing forced migrant population in the US may face significant mental health needs as a result of the traumas of their migration journey. Drawing on the perspectives of both migrants and mental health service experts, this study helps to illuminate strengths and limitations of existing services available to forced migrants, and points to key elements of a collaborative care model that could more efficiently and effectively address mental health concerns and decrease disparities.