Refugee children and teens are an especially vulnerable population. Many of them experience trauma, either in war-torn home countries or during flight. And when they arrive in the U.S., refugee families continue to face stressors that make healthy adjustment difficult, including poverty and discrimination. These and other stressors can contribute to mental health issues, and cultural barriers, stigma and a lack of knowledge about mental health services make these issues harder to treat.
In partnership with refugee communities and agencies, Boston Children’s Refugee Trauma and Resilience Center (RTRC), under the guidance of Director, B. Heidi Ellis, PhD, develops prevention and intervention programs, conducts research, and develops resources to assist refugee families and providers serving refugee populations. RTRC staff regularly provide training and consultation on refugee youth mental health across the country, reaching more than 850 providers in the past six months.
In recognition of her pioneering work with refugee children and teens, Ellis was awarded Boston Children’s 2017 David S. Weiner Award for Leadership and Innovation in Child Health — an award honoring the exceptional work of an employee, health care provider or faculty.
“The Boston Children’s community is a global one, deeply committed to a mission of improving health for all children, from all backgrounds,” says Boston Children’s President and CEO Sandra L. Fenwick. “Now, more than ever, Heidi’s work — and the work of the RTRC — is so important to making Boston Children’s, our community, and our city, a welcoming environment for all families.”
The Boston Children’s Board of Trustees established the annual David S. Weiner Award in 1997 to acknowledge former President and CEO David S. Weiner’s 30 years of service to Boston Children’s Hospital. Employees, staff, providers or faculty from Boston Children’s can apply for this $30,000 award to support the recipient’s program or research initiative at Boston Children’s. The program or research initiative selected must improve the health and well-being of children through advocacy, community, or child health interventions or health services research.
Ellis and the RTRC embody Weiner’s mission by responding to the needs, and contributing to the improved health and well-being of refugee children and their families.
“This award is a clear indication of how Boston Children’s stands in support of vulnerable populations, and is an acknowledgement that the day-to-day work we do has real impact on the lives of children and families,” says Ellis. “At a moment in time when messages of acceptance and inclusivity are more important than ever, I am deeply grateful to work for an institution like Boston Children’s that recognizes this.”
Creating an innovative treatment model for refugee children
Ellis co-developed the Trauma Systems Therapy treatment model and then adapted it for refugee patients. The adaptation, Trauma Systems Therapy for Refugees (TST-R), was first implemented at Boston Public Schools, where it successfully engaged refugee youth in mental health treatment and reduced both post-traumatic stress disorder (PTSD) and depression. Today, TST-R is recognized as one of the only empirically-supported mental health treatments for refugee youth and has been disseminated across the country and abroad.
Watch the video and learn more about TST-R in the Boston Public Schools.
Ellis also leads the largest longitudinal study of refugee youth in existence, following 465 Somali adolescents and young adults in the U.S. and Canada. The ongoing study examines a range of adjustment outcomes — delinquency, gang involvement and civil engagement openness to violent extremism, to name a few — in order to provide critically needed empirical information on resettlement factors that promote or hinder the wellbeing of refugee youth.
This innovative, empirical and high-impact work in a novel field with a difficult-to-engage population has fundamentally shaped policy discussions around how to respond to the problem of youth radicalizing to violence.”
That research project is partly inspired by a 2008 incident in which a group of Somali youth became involved with the violent extremist group Al-Shabab. The widely reported incident brought increased scrutiny to Somali communities around the country, including many Ellis regularly worked with in the Boston area. The incident inspired Ellis to explore the risk or protective factors that contributed to radicalization. When federal and state agencies began to identify and arrest youth they believed to be in danger of radicalizing, it was Ellis’ research that showed their approach risked stigmatizing communities and criminalizing youth — and that mental health services had the potential to reduce vulnerability to radicalization.
“This innovative, empirical and high-impact work in a novel field with a difficult-to-engage population — has fundamentally shaped policy discussions around how to respond to the problem of youth radicalizing to violence,” says Boston Children’s psychiatrist-in-chief and Ellis’ longtime colleague, David DeMaso, MD. “Ellis has demonstrated a remarkable trajectory, building an innovative and highly successful program of research, services and training to support the health and well-being of refugee children and their families.”
DeMaso is far from alone in his thinking. Ellis is regularly invited to present her research findings to policymakers, including the Senior Counterterrorism Advisor to former President Obama and the Under Secretary of Civilian Security, Democracy and Human Rights at the State Department.
“I can say with confidence that the work of the RTRC has made substantial and important contributions to the health and well-being of refugee children in Massachusetts and throughout the United States,” says Jennifer Cochran, MPH, who directs the Division of Global Populations and Infectious Disease Prevention within the Massachusetts Department of Public Health.
Ellis says RTRC staff understand the developmental trajectories of immigrant and refugee youth in a way that takes into account the complexity of the real world. The next step, she explains, is to translate the research findings about diverse, and sometimes overlapping, developmental pathways into meaningful action.
“We must take on the challenge of identifying the most powerful levers for promoting the greatest resilience, and consider how to translate not only the findings of our research, but also the lessons we have learned about the process of our research into meaningful change.”
Learn more about Boston Children’s Refugee Trauma and Resilience Center.