Nurs fpx 8024 Assessment 2 Global Issue Investigation

Global Issue Investigation

Student name

Capella University

NURS-FPX8024

Professor Name

Submission Date

Global Issue Investigation

The international health issues still remain a burning challenge in a world that is becoming more and more interdependent, with pandemics and health disparities cross-border and requiring some concerted effort. The problem of mental health among humanitarian groups is a topical issue in the modern world (Kemmak et al., 2021). The evaluation is based on the way the nongovernmental organizations (NGOs) react to the international health issues with particular attention to the mental health and trauma services of refugees and displaced communities. Through the analysis of the approaches of certain international NGOs, interventions and the broad social determinants of the issue, the review informs about strengths, weaknesses and opportunities of culturally responsible and sustainable approaches to the issue of refugee mental health.

Description of the Problem

The level of forced displacement has been high. In 2024, there were 123.2 million forcibly displaced people in the whole world, 42.7 million of which are refugees. By April 2025, the total displacement will be more than 122 million, and the global requirement of mental-health and psychosocial support (MHPSS) is evident (UNHCR, 2024). Depression, anxiety and post-traumatic stress levels (PTSD) among refugees are significantly higher than the host communities. A meta-analysis of 2024 estimated pooled prevalence of 36, 36, and 35 percent of anxiety, depression, and PTSD in refugees, respectively (Chatarajupalli and Lindert, 2024). Raised depression, anxiety, PTSD, and suicide risk are also characterized by the World Health Organization (WHO, 2025) in the refugee and migrant population. The increased rate of people with mental disorders requires actions to be taken in order to solve the problem.

The displacement cuts across the board. Hosting is also targeted: by the end-2024, Iran, Türkiye, Colombia, Germany, and Uganda were home to approximately 37 percent of the population of refugees and others who need protection all over the world. The wars in Sudan, Syria, Afghanistan, Myanmar, and Ukraine drive enormous migrations (UNHCR, 2024b). Refugees are resettled in upper-middle, lower-middle, and low-income nations, most of which have a deficit in resources and expert trauma services are uncommon; least-developed countries host nearly a quarter of all refugees (UNHCR, 2024c). The access is further reduced by structural barriers, language, legal status, stigmatization, cost, and the lack of culturally competent services, even in the high-income setting, as demonstrated by recent umbrella/scoping reviews (Dumke et al., 2024). The combination of all the factors results in negative consequences of refugees.

The scale was facilitated by the fact that in 2023, the United Nations High Commissioner for Refugees (UNHCR) and partners could deliver MHPSS to approximately 1.3 million people, but this number does not imply that all of them receive treatment as required. The continuity of coverage and care is threatened by the continued funding constraints (UNHCR, n.d.). Mental-health needs of refugees are widespread, severe, and inequitably served, as they are in countries with the lowest resources. The problem must be tackled through prolonged, culture-focused MHPSS introduced to primary healthcare, building up of host country systems, and cross-ministerial cooperation to dismantle access obstacles and fill the treatment gap.

Social Determinants that Impact the Problem

The worst affected groups during displacement are refugees, internally displaced persons (IDPs) and vulnerable members of host population. By 2024, more than 120 million people have been displaced globally, with many residing in the chronic crisis conditions or camps, where mental health interventions remain limited in quantity (UNHCR, n.d.-a). The burden of the categories is greatest in women, children, older adults, and people with long-term health conditions.

Some of the key factors that lead to poor mental health among the displaced are socioeconomic problems such as poverty, food insecurity, unemployment, disrupted education, and overcrowded living conditions. There is evidence supporting that both of the issues are strongly associated with much higher risks of depression, PTSD, and anxiety, and socioeconomic disadvantage at the time of resettlement predicts worse long-term outcomes (Kirkbride et al., 2024). Combination of cash transfer, livelihood, and exposure to education have been demonstrated to reduce the symptoms of mental illness in both field research and trials.

There are also cultural aspects that affect care access. Social stigma of mental illness, reliance on somatic expression of distress and distrust of official providers of care often hinder treatment. The review confirms that language discord, definitions of sickness, which are shared culturally, and lack of trust in services are important obstacles to evidence-based care (Kemmak et al., 2021). The geography and environment are some of the factors that enhance inequities. The highest rates of mental health disorders are registered in populations of conflict-affected regions, such as the Middle East, the Horn of Africa, and South Asia, but the service density is the lowest. The rural environment is also characterized by climate shocks, fragile infrastructure, and shortage of personnel, which contribute to the lack of needs (WHO, 2022). Finally, the political context is the most important. Countries that have poor governance, restrictive asylum policies or lack of access to humanitarian services, often fail to implement mental health action plans. Conversely, countries that encompass mental health and psychosocial assistance into the multisectoral humanitarian interventions achieve broader coverage and more successful results.

Nongovernment Funding Organization Involvement

Heartland Alliance International (HAI)

The target population of HAI is that of refugees, torture victims, and displaced individuals in weak or war-torn settings, especially in parts of the Middle East, Sub-Saharan Africa, and Latin America. Heartland Alliance International approaches mental health in combination with psychosocial support as a part of health and human rights initiatives by creating trauma services based in communities, offering one-on-one and group therapy, and training local practitioners in trauma-informed care (Heartland Alliance International, 2025). Program reports and evaluations show that a reduction of the symptoms and service utilization by the survivors of violence and the displaced populations are observed, which is additional evidence that MHPSS integration into health and community systems increases accessibility in humanitarian settings. However, extreme psychiatric patients are also a burden on the program capacity due to the limited referral options and absence of professional care in chronic crises.

International Rescue Committee (IRC).

The IRC focuses on caregivers, women, and young children in displacement cases, stress on caregivers, disruption on parenting, and child developmental threat. The organization implements and expands community-based parenting and psychosocial programs such as reach up and learn (RUL), such as phone-based versions adapted to the COVID-19 pandemic. The interventions are parents skills, psychosocial support and stimulation activities, which are delivered by trained community workers or remotely. Cluster-randomized trials and implementation studies have high feasibility and acceptability, and caregiver mental health outcomes and benefits of early-childhood among refugee populations (Bowden et al., 2022). A preliminary finding in cost-effectiveness studies is scalability potential, although effectiveness is contingent on the amount of participant retention and fidelity of delivery.

International Medical Corps (IMC)

The organization targets adolescents and adults living in long-term conflict settings such as Afghanistan and the Horn of Africa who are depressed, anxious, and have psychosocial distress. This is a task sharing strategy, whereby non-specialist health workers are trained on provision of short evidence based interventions such as problem management plus (PM+) and common elements treatment approach (CETA) via primary care and outreach in communities. Recent articles (20202024) show that task-sharing interventions reduce the presence of common mental disorders and expand coverage of services with the help of supervision and referral systems (Woodward et al., 2023). There are still problems with workforce turnover, financial deficits, and the introduction of services into the national systems, but when tackled, the programs of IMC have a significant positive impact on access and clinical outcomes.

Culturally Sensitive Intervention

One of the trauma-sensitive interventions that has shown a high degree of promise in the treatment of trauma in displaced populations is narrative exposure therapy (NET). It is a short, sequential, systematic psychotherapy that is specially designed to survivors of various traumatic events such as refugees and internally displaced persons. The method causes the participants to create a narrative of life over a period, incorporating traumatic and non-traumatic experiences (Ellis and Jones, 2022). The contextualization of trauma in the context of the wider life story then allows individuals to integrate traumatic memories, reduce avoidance and reclaim a sense of identity and continuity.

Community mental health care or refugee camp communities can be used to facilitate application of NET in human rights crises. The principles can be taught to local paraprofessionals, teachers or community health workers under the supervision of mental health professionals allowing for scale-up in low-resource settings. The sessions may be held in the native language of the participants and adapted to the cultural traditions of narratives (Ellis and Jones, 2022). It is necessary to integrate into the community: in some of the settings, social support and resilience are improved by engaging family or community members in the narrative process.

The strategy is also culture-sensitive due to its establishment on narrative, preserving collective memory, and transmission of values. Rather than subjecting the target to Westernized forms of therapy, NET uses a cultural resource that is already available. The treatment will be less stigmatizing because the approach legitimizes the traditions, thus making them consistent with the local norms. Also, due to the application of drawings or a play-based intervention, NET could be used across age groups (children and adolescents) and be cross-cultural and developmentally applicable (Ellis and Jones, 2022). Generally, NET extends existing task-sharing and community-based interventions with a low-cost and scalable and culturally suitable model of trauma care that can help both the healing process of individuals and the healing process of communities.

Conclusion

Displaced populations receive insufficient funding but high-priority global health concerns on mental health and trauma treatment. The examples of organizations such as Heartland Alliance, IRC, and IMC demonstrate the ability of task sharing, integrative and community based models to make care gaps and build resilience. Although there are still difficulties of scaling, cultural considerations, and poor systems, new opportunities are offered by culturally adapted interventions like narrative exposure therapy. The strengthening of alliances, sustainable funding, and culturally based approaches will be essential in propelling equity and improved results to the most vulnerable populations in the world.