A need to acclimatize to linguistic, climatic, and cultural differences can be extremely intimidating. In response to such physical, psychological, and emotional turmoil, it is very normal for them to experience symptoms such as depression, post-traumatic stress disorder (PTSD), helplessness, fear, guilt, self-blame, grief, rage, and anxiety. Most refugees have escaped conditions of discrimination, domination and exploitation in their home countries, only to confront similar situations and experiences in their host country (Hart, 2009). Refugee families experience trauma due to the unstable environment in their home countries but there are also a myriad of events that happen even after they are displaced that could also be considered traumatic, and have an adverse effect on refuge individuals and families (Weine et al, 2004). There is a high prevalence of PTSD among refugees; numbers vary from 35-80%, although most mental health professionals and researchers believe the higher end of the spectrum to be more accurate, as many refugees do not seek out mental health services. (Montgomery, 2010). Mental health professionals working with refugees often identify problems in three basic areas- anxiety/depression, PTSD, and substance abuse (Rado, 1997). Excessive alcohol and substance use are linked to a wide range of causes, such as psychological trauma, limited capacity to cope with stressful events, insecure living situations, frustration, anger and fear concerning the future (Steel & Schilperoord, 2010). Mental health professionals need to address what treatment can begin in childhood and adolescence, to help reduce the risk of addiction later in life, and how best to reach out to the refugee population to educate them about what mental health services are available. The assessment of refugees' psychological distress is difficult. Most of the tools and measurements designed to measure trauma were not developed specifically for refugee populations, and the few that were made specifically for refugees are lacking descriptions of how they were developed, their reliability and their validity (Hussein & Bhushan, 2009).
