Refugees experience psychological stressors in the migration process. Stressors occur while fleeing their country of origin, in the refugee camps, in flight, during initial resettlement, and the post resettlement period. Over time, they may develop symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) as well as other self-harm behaviors (suicide attempts, substance abuse, excessive gambling, etc.). PTSD is a Mental Health conditions that is triggered by a terrifying event—either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, and severe anxiety, and uncontrolled thoughts about the event.
Lack of awareness about mental health problems and resources can negatively impact refugees’ transition and integration into their new community. Mental Health First Aid (MHFA) and Question, Persuade and Refer (QPR) have been used to train refugees in the United States. The training is aimed to promote mental health awareness and provide participants the skills to help those in distress.
Photo: BNS
Mental Health First Aid
The Mental Health First Aid (MHFA) training provides the knowledge needed to prepare community members to recognize and assist individuals who are in crisis. MHFA is an 8-hour long training course performed in one full day, delivered by certified MHFA instructors. It introduces participants to risk factors and warning signs around depression, anxiety, trauma, psychosis, eating disorders, substance use disorders, and self-injury and suicidal behaviors. By the end of the training, participants learn action plans to help people who may be struggling.
Question, Persuade, and Refer
QPR stands for Question, Persuade, and Refer, which is an emergency mental health training intervention that teaches anyone to help save a life from suicide. People trained in QPR use a “chain of survival” approach (like CPR) in which they learn to recognize early suicide warning signs, question their meaning to determine suicide intent or desire, persuade the suicidal person to accept or seek help, and refer the suicidal person to appropriate resources. QPR offers hope through positive action. QPR is a 2-4 hours long training course delivered by certified instructors.
Bhutanese community leaders across the U.S. are certified MHFA and QPR trainers. A list of trainers and their locations appears below. If members of your community would benefit from knowing more about mental health and having the skills to help those in need, reach out to a trainer in your area to host a course!
Table: List of Trainers
| Trainers | Address | Expertise | |
| 1 | Mr. Ashok Gurung | Pittsburgh, PA | Adult Mental Health First Aid (Adult-MHFA) |
| 2 | Mr. Yadhu Dhital | Pittsburgh, PA | Adult Mental Health First Aid (Adult-MHFA) |
| 3 | Ms. Sona Shilpakar | Pittsburgh, PA | Adult Mental Health First Aid (Adult-MHFA) |
| 4 | Mr. Laxman Chamlagai | Richmond, VA | Youth Mental Health First Aid (Youth-MHFA) |
| 5 | Mr. Chandra Chhetri | Richmond, VA | Youth Mental Health First Aid (Youth-MHFA) |
| 6 | Ms. Uma Devi Mishra | Chicago, IL | Question, Persuade & Refer (QPR) |
| 7 | Mr. Mani Biswa | Lynn, MA | Question, Persuade & Refer (QPR) |
| 8 | Mr. Mitra Dhital | Seattle, WA | Question, Persuade & Refer (QPR) |
| 9 | Mr. Keshab Sharma | Akron, OH | Question, Persuade & Refer (QPR) |
| 10 | Mr. Dharani Adhikari | Salt Lake City, UT | Question, Persuade & Refer (QPR) |
| 11 | Mr. Birendra Dhakal | Clarkston, GA | Question, Persuade & Refer (QPR) |
| 12 | Mr. Yam Kharel | Nashville, TN | Question, Persuade & Refer (QPR) |
| 13 | Ms. Sarita Rasaily | Lynn, MA | Question, Persuade & Refer (QPR) |
| 14 | Mr. Karan Thapa | Rochester, NY | Question, Persuade & Refer (QPR) |
If you know anyone in the Bhutanese community who are certified trainers and interested in helping others, please send their information to [email protected] to update this list.
For the contact information of the trainers: Please send e-mail to Mr. Ashok Gurung, based in Pittsburgh, PA (email: [email protected]), one of the trainers in the list.
Note: For some reasons, some of the trained individuals may have their credential expired. Even in that case, they still can share the knowledge they have learnt, which might be very helpful.
