Learning from Our Patients: Training Psychiatry Residents in Refugee Mental Health

Acad Psychiatry. 2019 Oct;43(5):471-479. doi: 10.1007/s40596-019-01053-7. Epub 2019 Mar 29.


Objective: Psychiatric residents are increasingly called upon to work cross-culturally, serving diverse populations including refugees. This study aims to (1) understand the training experience of psychiatry residents working with refugees and (2) assess the level of satisfaction of refugees, most of whom are Iraqi, who seek psychological treatment at the University of Colorado Hospital (UCH)'s Refugee Mental Health Program of Colorado (RMHPC).

Methods: Using qualitative methodology, over a 1-year period, independent evaluators interviewed a group of nine residents who chose to participate in an RMHPC elective and also interviewed ten Iraqi refugee patients who sought services at the clinic. Recordings of the interviews were transcribed and analyzed using thematic analysis. Emerging themes were identified for both resident and refugee patient interviews.

Results: Five major themes emerged summarizing residents' experiences: (1) adapting practices to meet refugee needs, (2) value of supervision, (3) cultural barriers, (4) need for extra resources, and (5) effect on future practice. Four major themes emerged summarizing Iraqi refugees' experiences: (1) reasons for seeking treatment, (2) barriers to treatment, (3) residents' knowledge of culture and needs, and (4) quality of treatment.

Conclusions: This study's findings highlight the complexities of effectively treating refugee patients and suggest ideas for training residents. Additionally, they offer important frameworks for developing, implementing, and evaluating culturally responsive practices in the context of training psychiatry residents and other mental health professionals. An essential key to this process was giving voice to refugees who accessed and engaged our services.

Keywords: Culture; Mental health; Psychiatry; Refugee; Training.

MeSH terms

  • Adult
  • Cultural Competency*
  • Education, Medical, Graduate
  • Female
  • Health Services Accessibility
  • Humans
  • Internship and Residency*
  • Interviews as Topic
  • Iraq / ethnology
  • Male
  • Mental Disorders / ethnology
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Middle Aged
  • Psychiatry / education*
  • Refugees / psychology*
  • United States