U.S COMMITTEE FOR REFUGEES AND IMMIGRANTS
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World Mental Heath Day: Spotlight on Occupational Therapy Services at USCRI Cleveland

October 29, 2024

By: Rosalind Ghafar Rogers, PhD, LMHC,

Clinical Behavioral Health Subject Matter Expert with USCRI’s Refugee Health Services in Arlington, VA

In recognition of World Mental Health Day and the importance of prioritizing work to promote better mental health for refugees and other forcibly displaced populations, I would like to highlight the important work being done by occupational therapy service providers at USCRI-Cleveland.

So, what is occupational therapy and what role does it play in refugee resettlement and mental health? Individuals are inherently occupational, meaning that engagement in day-to-day, meaningful activities is necessary for identity development, increased self-esteem, a sense of belonging and competence, social inclusion, and well-being. Therefore, the inability to participate in meaningful occupations can have serious effects on the emotional, psychosocial, and physical well-being of people. For refugees and other forcibly displaced populations, participating in meaningful and purposeful occupations in a host country can help them develop their potential, overcome trauma, and enhance the necessary life skills to adapt to the host community and achieve social and cultural integration. However, many refugees and other forcibly displaced populations face occupational deprivation as a result of displacement, meaning that they are unable to participate in meaningful occupations and roles in a host country due to a variety of barriers that are out of their control, including limited language proficiency, unfamiliarity with host country norms, lack of familiarity with workplace practices and norms, and social isolation (Erickson & Kjergaard, 2017). Moreover, it is important to understand that participation in occupations is not a privilege, but a right (Suleman & Whiteford, 2013).

 

Occupational therapy (OT) is a client-centered healthcare profession that involves the use of assessment, intervention, consultation, and coaching to promote health, well-being, and participation in meaningful life activities or occupations (AOTA, n.d.). OT service providers are “prioritizing mental health in the workplace by providing one-on-one and group services to improve [refugee] clients’ self-esteem and confidence in their work role, promote positive mental health, and facilitate a sense of belonging,” according to Rachel Rogers, MOT, OTR/L, an Occupational Therapist with USCRI’s Cleveland office. Occupational therapists are well suited to work with refugees because many of the issues they are facing are occupation-based. Refugees and other forcibly displaced populations have a significant need to re-engage in meaningful occupations, establish healthy and familiar routines, make social connections, and enhance the necessary life and job skills for self-sufficiency and successful integration into the host community.

 

USCRI’s Cleveland OT and employment teams initially built rapport with and conducted a thorough needs assessment of refugee clients and the employer to develop goals, and a plan based on their occupational needs, beliefs, values, health status, performance skills, environmental contexts, resettlement experiences, and contextual barriers. Based on the information gleaned from the needs assessment, the Cleveland OT team developed and implemented weekly, themed OT group sessions over the course of 15 weeks, with modifications to meet the needs of four linguistic groups – Swahili-speakers, Kinyarwanda-speakers, Spanish-speakers, and Masalit/Sudanese Arabic speakers. The following themes were addressed weekly with refugee clients at their place of employment:

  • Workplace hygiene, including being provided with male or female hygiene kits that could be stored in refugee clients’ work lockers, the proper use of hygiene items, and the sequencing of self-care tasks in the workplace.
  • Combination lock use in order to learn and practice skills needed for operating combination locks, using graded options and peer-to-peer approaches.
  • Digital literacy, including learning to efficiently use their work tablets to prioritize and manage work-related tasks; learning to effectively use a mobile app to manage their work schedule, request time off, among other things; and a translated copy of their employer’s attendance policy and a “call off card.”
  • Enhancing independence with personal time management and promoting confidentiality, autonomy, and well-being by using earned time-off.
  • Cultural celebration, group closure, and certificate of appreciation ceremony for refugee clients, fostering positive mental health, a sense of achievement and belonging, and work team comradery.

 

At the completion of the 15-week OT group sessions, the employer expressed appreciation for employee performance improvements, reported a significant reduction (101%) in the turnover rate by hiring USCRI refugee clients, and a reduction in scheduling concerns. Refugee clients reported increased independence and relief in accessing their work schedules virtually and requesting time off, and at least two refugee clients were promoted to leadership positions since completion of the 15-week OT group session.

USCRI-Cleveland has also provided group-based OT services to refugee clients who were recently laid off from their employment. The OT group sessions that took place in a nearby recreation center provided a safe space for refugee clients to share their feelings and experiences related to the employment process. Refugee clients also received employment readiness skills with activities to promote positive mental health embedded in the program. “These activities aimed to increase self-confidence, positive self-talk and reflection, and create a sense of community centered on resilience,” according to Cassandra Mattix, MOT, OTR/L, an Occupational Therapist with USCRI’s Cleveland office.

In addition to providing occupationally therapeutic services to refugee clients, the Cleveland-based OT team also provided training for Matching Grant, Refugee Support Service, and Employment Engagement Programs’ team supervisors and staff that focused on increasing confidence and cultural awareness, as well as providing a training manual with a group plan template with space and activity considerations, translated visuals in six languages, and male and female personal hygiene kits for refugee clients. In addition, the OT team works with the Fun and Stuff Committee to provide seasonal activities, a monthly newsletter, and monthly off-site networking events to promote positive employee mental health through team building activities and health and wellness strategies. Highlighting the importance of workplace mental health, Cassandra Mattix stated, “These activities work to promote improved staff confidence, a sense of belonging, retention, and enjoyment in one’s work.”

 

To see an ABC News 5 Cleveland video featuring USCRI-Cleveland’s partnership with Hilton Hotel to provide employment assistance and OT services to refugee clients, click HERE.

To learn more about OT, the OT service learning program at USCRI, and one refugee client’s experience with these services, please watch this VIDEO.

 

For more information about the important OT work being done with refugees at USCRI-Cleveland, please visit https://refugees.org/uscri-cleveland/ or email Rachel Rogers, MOT, OTR/L at [email protected] or Cassandra Mattix, MOT, OTR/L at [email protected].

 

 

References

American Occupational Therapy Association [AOTA]. (n.d.). What is occupational therapy? Retrieved from

https://www.aota.org/about/what-is-ot

Erickson, K. & Kjergaard, K. (2017). A home away from home: An occupational manual for working with refugee populations

(Scholarly Project Paper, University of North Dakota). Occupational Therapy Capstones, 349, UND Scholarly Commons. https://commons.und.edu/ot-grad/349

Suleman, A., & Whiteford, G. E. (2013). Understanding Occupational Transitions in Forced Migration: The Importance of Life Skills

in Early Refugee Resettlement. Journal of Occupational Science, 20(2), 201–210. https://doi.org/10.1080/14427591.2012.755908


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