Common Bond Institute

Social Health Care For Newcomers

Bridging the Treatment Gap through Telehealth

Tax Deductible Donations to our humanitarian programs can be made through our US Federal 501(c)3 Nonprofit partner organization: International Humanistic Psychology Association


The Need:

The US and Canada are experiencing a steady flow of refugees being resettled across both countries from regions of conflict and turmoil around the world. Many arrive suffering from severe mental health symptoms, including psycho-emotional trauma, due to experiencing profound violence and loss, with little or no ability to communicate in English, and come from cultures where mental health treatment is uncommon and heavily stigmatized.


At the same time, particularly for those coming from nonwestern cultures and speaking nonWestern languages who are resettled in medium or small size host cities and towns:


    • Service providers in most of these communities – including mental health service providers – do not speak the native language of these newcomers, or have a cultural understanding of the societies they come from. Added to this complication are the scarcity of therapists in the US  experienced in working with war trauma for this population, and the current shortage of mental health providers available in general to the wider US public.

    • Translators with the required languages skills are also scarce or nonexistent in these same communities. Those that do exist very often do not have the training and orientation to adequately perform as mental health translators in a therapy session, particularly in the areas of strict confidentiality, unbiased translation, and self care to avoid burnout

The wide-ranging life changes a newcomer faces permeate every aspect of daily life and experience. The emotional and psychological challenges of these changes, occurring at multiple levels and all at once, effecting all aspects of normalcy, places substantial strains on the energy and resilience required of a person to adequately adjust to them. For those also impacted by trauma this challenge is particularly overwhelming, and often insurmountable, if the trauma is not healed.


Humanitarian assistance to refugees typically tends to focus primarily on the most concrete and visible needs, such as medical, food, shelter, clothing,  and other socio-economic needs. Although medical and socio-economic needs can be significant contributing stressors to a newcomers capacity to successfully resettle and productively move forward with their lives, limiting the support focus exclusively or primarily to these categories of needs more often leads to the neglect of less immediately visible and more long term debilitating psycho-emotional wounds.


Over time these wounds can become embedded in a person’s consciousness, body, self-identity, and world view, and increasingly emerge as major blocks to daily functioning that seriously undermines progress in all other areas of adjustment, support, and overall quality of life. There is also the risk of the unresolved trauma experiences of family members having long term negative effects on the health and well-being of other family members and close relationships, and in the case where there is a large number of newcomers suffering from unresolved traumas, negative effects on the newcomer community broadly. In some cases profound unresolved trauma can negatively impact future generations as transgenerational trauma.


Organizations and community representatives in host communities assisting the resettlement of refugees consistently point to major and often debilitating mental health symptoms, including psycho-emotional trauma, as the main obstacle to an individual successfully making the transition from being uprooted out of their previous lives and sense of place, to adapting, integrating, and moving forward to a new life in an often very different society, culture, language, and geography.


The continuing lack of treatment for refugees struggling with trauma that is needed to achieve this level of healing, recovery, and stability is primarily due to language and cultural gaps that preclude accessing English-language-only-based mental health services.
Contributing  factors are lack of familiarity with mental health services, and heavy stigma regarding acknowledging and seeking help for mental health needs.


While there exists some local in-person and virtual efforts in some communities in the country to address this need to varying degrees, these are more limited in languages and cultures offered, types of services provided, access, and numbers served; and most often located in larger urban areas where there are more skill resources available than in small to medium sized cities. The largest, most critical, and growing gap in service to this population occurs in small to medium host communities.


No multi-lingual, culturally sensitive service delivery system for this at-risk population currently exists nation-wide to address this growing need for newcomer mental health services in most host communities, and particularly in medium to small cities and towns spread across the country.

The result is that severe mental health needs go unattended and are allowed to become chronically dysfunctional in a person’s life, to the detriment of both the individual and the community they are becoming part of.

The Service:

Social Health Care For Newcomers

Bridging the Treatment Gap

A service provided from any location to any location in the US and Canada

This initiative addresses the need for critical mental health services to non-English-speaking newcomers through a teletherapy service delivery system tailored to bridge language and cultural gaps, and reach recipients anywhere in the US or Canada.


Three categories of resources are identified to establish and successfully operate this service:

    • tele-health technology,
    • human resources for service delivery and coordination,
    • and funding resources.

1) Technology:


Tele-Health Technology is an already well established resource, with the prevalent availability and use of services like Zoom and tele-health platforms that can be secured as a technical vehicle for hosting this service delivery system. Using such an existing platform can better allow for the Social Health Care For Newcomers program to more quickly operate confidential service delivery, interpreter and psychosocial aid orientation and training, service provider support, communication with host community representatives, service agencies, and newcomer communities, and coordination of the overall service delivery system.

Necessary elements include:

    • An integrated virtual tele-health platform that meets the technical needs and required legal and professional standards to host the on-line service.
    • Client access to virtual technology equipment and the internet, and guidance on how to use the technology.

2) Human Resources for Service Delivery and Coordination:

A. Direct Service Providers:

A national registry of therapists, coping skills trainers, trained mental health translators, and trained paraprofessional social health aids offering:


    • Trauma informed Individual, couples, family, and group therapy, offering an eclectic list of therapy models and methods tailored to the needs of this population,
    • Self-help coping and resilience building skills training to instill effective self-care abilities in individuals and families to further support treatment and re-empowerment, as well as equip them with the ability to potentially offer emotional support to other family members and community members,
    • Case management for a coordinated, whole-person/holistic approach to providing services,
    • Psycho-social and emotional support and advocacy,
    • Psycho-education targeted to newcomer communities to increase awareness and understanding of mental health symptoms, counter stigma, and promote normalization of mental health needs and services,
    • Confidential, unbiased translation.

Although in many cases there will be therapists and skills trainers available within the network who have the necessary language and cultural skills to enable communicating directly with clients in virtual sessions, mental health professionals who do not have these requisite skills utilize a resource of prepared translators to allow them to provide treatment through 3-way tele-therapy sessions.


To build local capacity and as an adjunct to professional mental health services selected members of a newcomer community will be offered paraprofessional skills training and support in taking on psychosocial support and advocacy roles for their community as Social Health Aids, under the guidance and supervision of professional mental health service providers. Members of the newcomer communities are also seen as a natural resource for providing translators.


The visible presence of members of the newcomer community itself involved in providing support services for it’s members helps to promote a sense of individual and communal re-empowerment, and strengthen individual and communal resilience, confidence, esteem, and dignity.

B. Coordinating Body:


A central coordinating task group made up of mental health and social service professionals for management of the service delivery system and support of parties involved in providing services.


Functions include:

    • Ongoing coordination, guidance, monitoring, evaluation, and further development and extension of the service delivery system,
    • Support of service providers,
    • Providing certified orientation and training to translators and paraprofessional psycho-social aids. Formal certification ensures consistency in quality of translation services and mental health aid services, and supports seeking funding for their reimbursement.
    • Ongoing liaison with resettlement support organizations in host communities, mental health service agencies assisting newcomers, and newcomer communities.
    • Coordination and evaluation to meet requirements of potential funding sources.

Those with experience in training mental health translators and para-professional psycho-social aids conduct orientation and training sessions, and offer on-going support focused on:


    • Understanding and commitment to confidentiality and ethical standards.
    • For translators:  their role as unbiased, objective translators.
    • For psycho-social aids: promoting progressively advancing their skill set and numbers.
    • Emotional support and self care skills to manage and debrief from the expected stress and emotional impact of regular exposure to traumatic content.

C. Host Community Representatives/Partners:

Local stakeholders representing community organizations in host communities involved with resettlement support, service agencies, and social health aids who are available to:


    • Identify and refer individuals for treatment,
    • Support and assist clients in accessing and consistently participating in virtual service sessions arranged for them.
    • Ensure they have the needed equipment, internet access, and understanding for using the virtual platform

An Advisory Network of representatives of mental health service agencies, resettlement organizations from host communities, and newcomer communities will provide insights and feedback to the coordinating group on the overall effectiveness of the service and possible improvements.

3) Funding Support for Sustainability:

A. Insurance and Health Care Reimbursement to Direct Service Providers:

    • Payment to professional mental health therapists and skills trainers:
      Available sources: Medicaid, Refugee Medical Assistance (RMA), the Children’s Health Insurance Program (CHIP), or the Health Insurance Marketplace.
    • Payment to translators and paraprofessional aids:
      Research and advocacy for possible payment for essential health care related translation and mental health aid services through one or more of these health care insurance programs, and/or from other funding sources.

B. Grants:

Government, foundation, and corporate grants, as well as funding resources within host communities, to support overall operations.

Scaling Up the Service Delivery System Geographically

The Teletherapy For Newcomers model is designed to be scalable, replicable, and sustainable. Potential for implementation of the the service to meet the widespread need nationally are:

    • An initial pilot project conducted within a limited region.
    • Progressively extending access to the service system regionally and nationally.