Case Example

Haroon

The following case example is a fictional composite of a refugee adolescent presenting to our school-based mental health program. As a composite example, he represents many of the experiences that refugee youth encounter.

Haroon was born in Africa and then lived in a refugee camp in the Ivory Coast. When he was 10, he came to the U.S., first to Minnesota, then to Maine, finally settling in Massachusetts where he now resides with his sister and brother-in-law.

By the age of 5 years old, many of Haroon’s relatives had been killed. Haroon and his siblings went to a refugee camp in the Ivory Coast. Their father was murdered and they were separated from their mother. While in the refugee camp, Haroon was both abused physically and emotionally. His body is still covered in the scars from being beaten.

In America, Haroon was left to his own devices most of the day because his only sibling, with whom he was staying worked long hours. Haroon learned English very fast and starting hanging out with other kids in the neighborhoods. As he got older, Haroon began to get into fights with his sister and brother-in-law around issues about what is appropriate behavior for African children. He was accused of becoming too Americanized and losing his culture. His sister wanted him to go to religious school on Saturdays, to which Haroon refused. This further created a divide between them. These conflicts lead Haroon to stay away from the house more and more and seek out his friends. His friends introduced him to drugs and alcohol. The sister found herself helpless due to language barriers and lack of knowledge of the American system. She was unable to find help for him.

At home, Haroon often felt alone, isolated and without a family connection; his sister and brother-in-law worked long hours to support the family, leaving him alone. Haroon spent a lot of time alone in his room and he often felt like a visitor in his own home. In the community, Haroon also felt alone and isolated due to being perceived as a “bad kid” and felt ostracized from the community. Haroon’s sister also felt isolated because of community shame attached to having a child rebel against the culture and fail in school. She could not talk to anyone in the community about her worries and due to language barriers could not find someone outside the community to talk to.

Despite the fact that both Haroon’s sister and brother-in-law were working full time, the family faced financial hardship due to paying high cost rent in an expensive metropolitan city and most of their money was going to rent and bills. Furthermore, they were sending money to relatives who were still in Africa living in refugee camps. Haroon’s constant trouble at school and in the neighborhood caused additional hardship because either his sister or brother-in-law needed to miss work to attend appointments and follow up meetings. Not knowing if they would lose their jobs due to missing so much work also caused a lot of stress within the family.