Abstract
Afghan refugees experienced a surge of crisis in August 2021 after the U.S. troops withdrew operations in Afghanistan, leaving them exposed to the harms of the Taliban regime. Sudden evacuation led to family separation and uncertainty. Furthermore, the trauma of leaving loved ones behind and resettling into a new country of which this group had limited familiarity could have challenges in terms of integration. Through our brief practice note, we discuss the challenges faced by Afghan refugees resettling in the United States during these difficult times, along with implications for practitioners and service providers. We highlight strategies to ensure culturally responsive service provision for these refugees.
Afghan refugees have been exposed to significant trauma as a result of a sudden crisis in August 2021 when U.S. troops withdrew from their country, leaving hundreds of thousands of Afghans at imminent risk of harm by the Taliban (The United Nations Senate Committee on foreign relations, 2022). Of the Afghans who fled and were evacuated, nearly 76,000 are being resettled as refugees in the United States (Ben Fox Associated Press, 2022). The evacuation from Afghanistan is said to be the largest after the Vietnam War (International Rescue Committee, 2022). During this process of leaving behind everything they know and most of what they own, families were forced apart as some members were not able to leave together. “Leaving behind your birthplace where you have spent 50 years of your life is difficult and heart-breaking,” as expressed by a father who had to leave his two sons in Afghanistan (International Rescue Committee, 4th paragraph). The trauma that Afghan refugees experienced in the abrupt change within their country, the urgent need to flee, the struggle of leaving some family members behind, and the necessity of resettling into a new and unknown country in the midst of navigating loss and suffering will be profound (Refugee Health Technical Assistance Center, 2022). Effects of this trauma may result in acute and long-term stress and harm to individual, family, and community functioning during resettlement (Lipson, 2009). Due in part to this heightened stress and reduced social functioning, individuals and families will likely be at risk of poor social integration.
Furthermore, the culture of the host country can also significantly contribute to refugees’ ability to socially integrate, which is acutely concerning since the increased Islamophobia over the past few years, socially and in political debates, has promoted hatred against Muslims (Alfonseca, 2021; Konig-Reis, 2017). Of note is that Islam is the official religion of Afghanistan, with about 99.7% of Afghanistan residents being Muslim (Cultural Atlas, 2019); and therefore, most of Afghan refugees being resettled into the United States are also Muslim. Therefore, this hatred and persistent Islamophobia which has been visible in social and political acts of exclusion, such as mosque attacks and exclusionary policies centered on majority-Muslim nations, furthered under the Trump Administration can potentially impede Afghan refugee integration (American Civil Liberties Union, 2022; Hamilton, 2022; Klaas, 2019; NAFSA, 2021). Exclusionary policies targeting majority-Muslim nations included Executive Order 13769, which restricted travel from seven nations, in addition to the ending of Temporary Protected Status (TPS) for Sudanese immigrants and limiting TPS for immigrants from Syria, Yemen, and Somalia (Exec. Order No. 13780; U.S. Citizenship and Immigration Services [USCIS], 2022).
The path to apply for permanent status is lengthy and time consuming (Visa Place, 2022). Individuals who are conferred a refugee status are eligible to apply for a green card in a year of their arrival to the United States, and citizenship within 4 years of securing a green card. However, the legal status of Afghan refugees remains indeterminate as they came into the United States as humanitarian parolees during this crisis (Gelatt & Meissner, 2022). Several thousand Afghan refugees did not enter the U.S. soil through the Refugee Admissions Program, which means that they do not receive the same benefits as that of refugees who may have entered under that program (Hackman, 2022). More specifically, of the 75,000 refugees resettled since August 2021, an estimated 36,000 lack a clear pathway to permanent status in the United States (Simon, 2022). Those who arrived before March 15, 2022 are eligible for Temporary Protected Status (TPS), which in this case grants 18 months of protection from deportation, as well as the ability to work in the United States. This large group with TPS, as well as those who arrived after March 15, 2022, can apply for asylum, which is not guaranteed, so they have liminal status and uncertain futures at this time (Gelatt & Meissner, 2022). Given their temporary legal status, Afghan refugees are at a higher risk of poor social and economic integration (Hackman, 2022; Stempel & Alemi, 2020).
The weight of supporting social integration during resettlement rests heavily on resettlement agencies (United Nations High Commission for Refugees, 2020) that may have had to move into “crisis management rather than resettlement” (personal communication, 2021). However, despite this urgent need, organizations who contracted with the U.S. State Department to resettle refugees in communities across the country lack sufficient capacity after having reduced their workforce by 66% under former President Trump’s resettlement order (Karas, 2019). This reduced workforce could have serious implications for quality of services and the unequivocal burden of service provision on the limited staff at these agencies. Therefore, it is imperative for resettlement agencies to be adequately equipped to support Afghan families. As we are still learning how to respond to the needs of Afghan refugees, limited research exists about best practices that can be utilized by providers. In the following section of our practice note, we hope to highlight some approaches that can be supportive as providers navigate service provision to this group.
Implications for Service Providers
Despite the pressures that resettlement agencies face with managing the Afghan refugee resettlement crisis, the role that these agencies can play is crucial. First, providers must remain aware of the stress and anxiety experienced by Afghan refugees during resettlement and remain patient and empathetic with them during intake procedures. Second, providers must understand the diverse and likely shifting needs of this community, employing culturally responsive assessment approaches. Utilizing instruments such as the Refugee Health screener (Hollifield et al., 2013), along with others that can capture the mental health needs, experiences of domestic violence, and/or family conflict may be helpful as providers unpack the immediate needs of this group. Third, providers can supplement the information that they collect through these measures with open-ended questions during intake which can be a source of additional information. Fourth, in tandem with conducting regular assessments to measure mental health and well-being, providers might consider family- and group-based services to enhance community-level support and connections, as many Afghan communities are rooted in strong family- and community-based structures (Cultural Atlas, 2019). Providers can work with local representatives and/or community leaders to determine the nature of the groups, such as appropriate norms based on gender, age, and language. These strategies may facilitate stronger rapport with providers who demonstrate an understanding of cultural norms through multiple forms of culturally appropriate services and may facilitate open conversations about acute and long-term needs. As needs are identified during resettlement, it is critical for resettlement agencies to provide a range of holistic services toward successful integration and promotion of emotional well-being, which could also be in the form of learning groups as some providers have shared with us (personal communication with service providers, 2021). Culturally responsive service provision can be a key strategy to ensuring a smooth resettlement process for Afghan refugees (Huslage et al., 2021).
Per conversations with providers serving this cohort of Afghan refugees, the unprecedented circumstances that prompted their migration has led to needs that are distinct from prior refugee groups (personal communication with service providers, 2021). In response, providers must consider that previously used interventions may not be effective for recently arrived Afghans. Evaluation of client outcomes and the effectiveness of interventions is essential to ensuring adequate support toward the goals of social and economic integration.
In addition to these direct practice strategies, providers are well positioned to engage in macro-level approaches to advocate for Afghan refugees. For example, providers can support Afghan refugees by lobbying for their rights through solutions such as the Afghan Adjustment Act (Gelatt & Meissner, 2022). This Act urges Congress to provide a legal pathway for Afghan evacuees being resettled; this is critical as humanitarian parolee status granted to Afghan refugees has a limited validity of only up to 2 years (International Rescue Committee, 2022). Despite the fact that humanitarian parolees, which is the status with which most Afghans entered the United States, are allowed access to services such as Medicaid, food assistance, and placement support, their access to these benefits is only through March 31, 2023 or the term of their parole status (Center for Medicare & Medicaid Services [CMS], 2021). Conversely, refugees typically remain eligible for such benefits for a 7-year period (Medicaid and CHIP Payment and Access Commission [MACPAC], 2022). Furthermore, ensuring that parolees are made aware of these provisions is essential (Butler & Sheriff, 2021).
The discrimination and high rate of hate crimes due to the increasing Islamophobia across the United States can be detrimental to the successful integration of Afghan refugees. Therefore, initiating awareness and informational workshops for the general public can be helpful in ensuring a welcoming and safe environment for Afghan refugees. Having interactive sessions where Afghan refugees are paired with a sponsoring family to provide opportunities for integration is another important way of supporting integration and ensuring Afghan refugee families feel welcomed. Any programs that are developed for Afghan families must be developed by engaging and eliciting the feedback of community members utilizing community-based participatory approaches (Agha & Rai, 2020). To facilitate this process, researchers are encouraged to partner with practitioners to develop culturally sensitive data collection strategies and interventions.
Ultimately, it is imperative that the capacity of resettlement agencies be increased through federal and state funding. Enhanced capacity that enables sufficient staffing and resources can aid in supporting Afghan families through resettlement and integration to promote improved overall well-being. Providing support to refugees escaping crisis can be stressful for providers, which increases risk of burnout and compassion fatigue (Akinsulure-Smith et al., 2018; Lusk & Terrazas, 2021). Along with supporting Afghan refugees, ongoing self-care and mutual support among resettlement providers are essential. Our society continues to navigate humanitarian crises. To adequately respond to these catastrophic events the United States, as a leading nation of the world, carries an urgent responsibility to enhance capacity and strengthen service provision.
Footnotes
Disposition editor: Sondra J Fogel
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
