Primary care institutions, including clinics, schools, and community organizations, because of their closeness to the family living environment, are often in a privileged position to detect problems in traumatized refugee children and adolescents and to provide help (Rousseau et al, 2012). .
Substance Abuse.
As previously stated, mental health professionals report that substance abuse is one of the main problems presenting in the refugee population. The presence of a mental illness can pose a risk for problematic drug use. The combination of deprivation, stress and limited access to health care means that refugees and asylum seekers have special mental health needs, which leaves young people and children particularly at risk (Mills, 2012). There are a variety of risk factors that lead to substance abuse, even without the presence of depression or PTSD. Some of these include unemployment, education, family trauma, social isolation, homelessness, poor attachment to parents, poor communication within the family, early parental death, and an unawareness of the consequences of substance abuse (Streel & Schilperoord, 2010). Within this web of interrelated factors, alcohol and other substances can be both an additional stressor and a consequence of stressors. Research is limited on the alcohol consumption patterns of refugee groups in the United States (Mills, 2012). In a study of 120 Cambodian refugee women, alcohol was reported to be used to cope with nervousness, stress, insomnia or pain (emotional and physical). They also cite that they use alcohol to forget their pasts, to escape from negative and traumatic memories (Mills, 2012).
Barriers to Treatment.
The stigma surrounding the use of drugs within many refugee communities deters members of those communities from accessing drug services and mental health treatment. Problematic drug users in refugee communities may wish to remain concealed.
