Rabbani, H.A., Sainte Anne Universitary Hospital, France
This paper is a preliminary statement based on our psychiatric study and psycho-medico social research over the past two decades on immigrants and refugees in the communities of mental health centers and hospitals and on our experiences and observations in France, other European countries, Canada, the USA and particularly in the Eastern Countries (Iran, etc.). During the past century, specially after the second world war and the socio- political events in some Eastern countries (Iran, Lebanon, Afghanistan, etc.) the increase in the number of immigrants and refugees has become a world wide phenomenon facing all societies. Consequently, this poses increasing problems in hospitals and mental health centers. Part of this study offers a brief clinical consultation with psycho-social analyses on a group of 100 immigrants and refugees (men and women) considered as patients. We observed different psychiatric problems : paranoid reaction, delusion, obsessional thinking, anxiety and depression and some psycho- somatic disorders. The common environmental end psycho-social problems and behavioural reactions of these patients (from different countries) have also been analysed. This was followed by clinical discussions and interviewing in which we attempted to observe and interpret the psychological factors on an outline of the psycho-social dynamic and mobility of immigrants and refugees with the two principal references, as well known : horizontal and vertical aspects. In one part of this study- research, we will also discuss older adults and displaced persons from different nationalities who were interviewed individually, in some cases during home visits by the social worker or personnel responsible for their care. From these studies and observations we perceived that some elements and acts: loss of homeland and resources (salary, etc.) slowing cultural adjustment to new conditions and in some cases, previous experiences of often severe persecution, physical injury (in extreme cases) and general social isolation and loneliness, the influence of previous stress on the present stress, etc. as we discussed elsewhere (Rabbani H., Stockholm 2000, San Francisco 1998), are the principal determining factors that can be responsible for an increased susceptibility to mental disorders in displaced persons : trauma, ambivalence, insecurity, psychosis, dementia, personality disorders, etc. Therefore, what type of special care and treatment for these rootless migrants and refugees? Firstly, the health (mental and physical) of these people must be protected form depression or maladjustment by giving them suitable work, occupation and pay with which they can occupy themselves and rebuild a satisfying circle of life and personal relationships. In any case, the treatment and appropriate therapy for the displaced persons and refugees must be prompt. In this way, they will be able to handle their affairs to compensate for their lack of security and finally to adjust themselves to their new environment. Reconstructing ones daily life anew is a slow and often difficult process for many immigrants and refugees. It is clear that psycho-social and mental health problems of the refugees and immigrants cannot be solved and treated by psychotherapeutic attention alone.