By: Rosalind Ghafar Rogers, PhD, LMHC, Clinical Behavioral Health Subject Matter Expert
with USCRI’s Refugee Health Services in Arlington, VA
February 20 marks the World Day of Social Justice – a day that recognizes that social justice is inextricably linked to human rights and fundamental freedoms, which in turn are indispensable for the achievement of peace and security.
As a mental health counselor and international psychologist, I have dedicated my professional life to individual, family, and community mental health and well-being. As a profession, whether psychiatrists, psychologists, mental health counselors, or clinical social workers, we must also be invested in social justice, as it is inextricably linked to the work we do. Mental health and well-being cannot exist without justice because individuals and communities cannot be well in the absence of opportunities and resources that promote safety, connection, dignity, and growth. Our work cannot be to help clients adjust to oppressive and unjust circumstances, but rather we must work to identify the root causes of our clients’ distress and advocate to change the contextual factors that contribute to their problems and the systemic barriers that stand in the way of our clients’ achieving optimal psychological health.
Social justice is critical to the professional field of mental health because it aligns with our various codes of ethics. Promoting social justice is a core professional value and principle in the American Counseling Association’s (ACA) code of ethics which states that “Counselors are expected to advocate to promote changes at the individual, group, institutional, and societal levels that improve the quality of life for individuals and groups and remove potential barriers to the provision or access of appropriate services being offered” (ACA, 2014). The general principles of justice and respect for people’s rights and dignity are part of the American Psychological Association’s (APA) code of ethics, as well as respecting and protecting civil and human rights (APA, 2017). The core values of social justice and people’s dignity and worth and the ethical standards of social welfare, public participation, and social and political action are enshrined in the National Association of Social Worker’s (NASW) code of ethics which states that “Social workers should promote social, economic, political, and cultural values and institutions that are compatible with the realization of social justice” (NASW, 2021).
At a time of unprecedented rates of forced displacement due to war, conflict, and climate change, rising nationalist and xenophobic sentiments, and increasingly punitive and restrictive national immigration policies, the plight of migrants and refugees has never been greater. By mid-2023, more than 110 million people were forcibly displaced worldwide as a result of persecution, war, violence, human rights violations, and climate-related crises (UNHCR, 2023). As of 2021, there were approximately 45.3 million immigrants, with close to 20% of all global migrants residing in the U.S. (Ward & Batalova, 2023).
We know that people forced to flee their homes and make perilous journeys in the hope of finding safety and refuge in other countries are at an increased risk for mental health problems, including depression and anxiety disorders, and posttraumatic stress disorder (PTSD). Migrants and refugees face multiple traumatic experiences pre-, during, and post-migration that impact their mental health. While war, conflict, persecution, and severe food shortages are major causes of pre-migration trauma and forced displacement, we must also acknowledge the fact that immigration and asylum policies of countries around the world also significantly contribute to trauma of those seeking to resettle in another country. Moreover, migrants and refugees are faced with environmental, economic, and sociopolitical challenges in the process of adjusting to life in the U.S., including limited material resources, legal challenges, unstable or inadequate housing, acculturation stressors, barriers to health care, education, and social services, limited social support systems, and xenophobia, discrimination, or marginalization. All these factors can cause or exacerbate mental health difficulties among migrants and refugees.
Considering the complexity of responses to and potential outcomes of trauma, loss, acculturation challenges, and the multifaceted needs of migrants and refugees during resettlement in a host society, mental health professionals play a key role in providing competent, trauma-informed, and culturally responsive services to this population. However, the mental health professions’ traditional role and notion of value neutrality (the assumption that the act of counseling or psychotherapy operates in a vacuum that is free of sociopolitical considerations) neglect the societal inequities and environmental conditions that significantly predispose and affect the mental health of migrants and refugees. Consequently, prescribed interventions may ask migrant and refugee clients to adapt to unjust environments or inequitable social systems, leaving the root causes of psychological distress and larger societal issues unaddressed.
In moving outside the therapeutic office setting and beyond professional neutrality and the traditional therapeutic relationship, mental health professionals can begin to address all the contributing factors associated with migrants’ and refugees’ mental health issues by employing a human rights-based approach to advocacy and engaging in social action. Social action is based on the premise that environmental factors are key to determining behavior, and a human rights-based approach acknowledges the social, economic, and political forces that result in the mental health challenges experienced by migrants and refugees (Burns, 2009). For mental health professionals, this means that clinical expertise must be complemented by a commitment to social justice and action that challenges systemic inequalities, breaks down structural barriers, condemns inhumane practices, and protects migrants’ and refugees’ human rights.
Mental health professionals engaged in advancing social justice for migrants and refugees should be guided by four principles of social justice (Soken-Huberty, n.d.):
- Human Rights: Human rights are universal. They apply to everyone based on their inherent humanity. Human rights are internationally recognized and enshrined in laws and declarations, including the universal human rights of asylum, protection, and nonrefoulement.
- Participation: Social justice demands the participation of all, especially the participation and elevation of marginalized voices. Mental health professionals support migrant and refugee clients’ participation through a rights-based approach which promotes clients’ active and meaningful involvement in immigration cases, resettlement, and every aspect of their lives.
- Access: All people should have access to the resources, opportunities, and services they require to meet their basic needs and develop fully.
- Equity: While equality assumes a level playing field and aims to provide resources equally across communities and groups of people, equity assumes that systemic disparities exist and aims to provides communities and groups of people with what they need to succeed.
By applying the principles of human rights, participation, access, and equity, mental health professionals may advocate and engage in work that advances social justice for migrants and refugees. Here are some recommendations for mental health professionals:
- Gain knowledge and understanding of the issues facing migrant and refugee populations, as well as global drivers of forced migration.
- Elevate the voices of survivors by creating public forums for migrants and refugees to speak about injustices endured, where mental health and well-being is connected to the promotion of justice. Alternatively, elevate the positive stories and contributions of migrants and refugees to society.
- Use an ecological perspective and human rights-based approach when developing and providing services to migrants and refugees – taking into consideration all determinants of mental health, including social climate and the receiving community.
- Provide culturally responsive and linguistically appropriate services. Advocate within respective professions for the use of culturally responsive interventions and culturally sensitive assessment measures.
- Conduct participatory action research to understand, ensure, and maintain positive outcomes for migrants and refugees and the communities they live in. Conduct research that examines how local, state, and federal laws and policies contribute to poorer mental health outcomes or improve well-being.
- Expand and refine roles as mental health professionals to include consultant, advocate, change agent, expert witness, community-based provider, and ally.
- Partner and collaborate with community-based organizations to provide comprehensive services, including social, mental health, and legal services, which are in settings where migrants and refugees are likely to frequent. Evidence suggests that when these various services are provided together, there is an increase in the use of mental health services (APA, 2013).
- Partner with government organizations, nonprofits, resettlement agencies, and community organizers and activists on social justice change. These partnerships can lead to proposals on policy reforms that hinder equitable access to resources, opportunities, and services, as well as shape laws and policies that are more equitable towards migrants and refugees.
- Engage in social justice change using innovative tools (i.e., social media platforms, opinion editorials, etc.) that can shape important policy conversations, influence public attitudes, and advance a social justice agenda focused on the mental health of migrants and refugees.
As mental health professionals, we are in the unique position of having an ethical obligation not only to witness and reduce the suffering of our migrant and refugee clients, but also to fully embrace the work of social justice as fundamental to our common humanity.
