Ask the Expert:
Managing Psychiatric Medications in a Newly Arrived Patient
Some challenges arise when caring for newly arrived patients: reconciling medications prescribed in another health system, determining whether medications and doses are appropriate in the U.S., and addressing medications that may carry significant risks. In addition, for more complex patients or those on controlled medications, access to psychiatry care in your health system may be difficult or delayed.
Primary care providers (PCPs) should feel empowered to manage their patient’s mental health, especially if the patient plans to continue care at their office. If clinicians practice in an area where access to outpatient psychiatric care is challenging, seeking informal partnerships with your area psychiatric colleagues can help with guidance on medication regimens.
During a patient's first visit for a Domestic Medical Exam, focus on confirming all current medications, addressing any unsafe medications, and using shared decision making to establish follow-up for a long-term treatment plan, as opposed to changing the established treatment regimen.
Jessica Deffler, MD, provides insight into this emerging health topic through a newcomer scenario below. Dr. Deffler is an assistant professor in the Department of Family and Community Medicine at Thomas Jefferson University Hospital in Philadelphia, PA. She practices full spectrum primary care at the Hansjorg Wyss Wellness Center, a primary care office specializing in newcomer health.
CASE PRESENTATION
A 36-year-old man from South Africa presents to primary care for his Domestic Medical Exam. The clinician does not receive records of an Overseas Medical Exam, but the patient brings a medication list with him. He reports that his primary care provider in South Africa prescribed alprazolam 0.5 mg daily for anxiety and insomnia, duloxetine 120 mg daily for depression, and trazodone 50 mg daily for sleep. He has been taking these medications consistently for several years. He has approximately four weeks of medication remaining and requests refills so that he does not run out while establishing care in the United States.
Read Managing Psychiatric Medications in a Newly Arrived Patient (PDF) to learn what Dr. Deffler recommends in this scenario, including considerations for psychiatric regimen management, prescribing differences in other countries, and more.
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Communication Engagement Training: Interpreting and Communicating for Difficult Health-related Conversations
Friday, Sept. 18, 2026
1 – 3 p.m. ET | noon – 2 p.m. CT | 11 a.m. – 1 p.m. MT | 10 a.m. – noon PT
We are very happy to see that spots for this workshop filled up so quickly! For anyone who registers and is unable to get off of the waitlist, we will send you Dr. Ortiz’s 30-minute lecture as well as a resource guide for best practices when working with interpreters and navigating difficult conversation.
JOIN THE WAITLIST
Communication Engagement Training: Interpreting and Communicating for Difficult Health-related Conversations
LEARNING OBJECTIVES
- Identify best practices for person-centered communication during difficult health-related conversations.
- Recognize the complementary roles of the interpreter and clinician/resettlement staff member.
- Discuss advanced skills for building rapport, communicating clearly, handling tension, and demonstrating empathy when working across languages and cultures.
PRESENTER
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Priscilla Ortiz, PhD, CMI-Spanish
Language Services Program Manager
Children’s Hospital of Philadelphia
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MODERATOR
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Kate Yun, MD, MHS
Attending Physician
Children’s Hospital of Philadelphia
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Missed a webinar? Don’t sweat it!
The following recording has recently been approved for accessibility and is posted on our website:
Stay up to date on the latest publications
Take a moment and review some recent publications on newcomer health:
- Abutu PO, Shade MY, Barnason S, Abresch C, Fadul N, Idoate R, King KM. HIV-Tuberculosis Co-Infection Among Immigrants and Refugees in the United States: An Integrative Review. Int J Environ Res Public Health. 2026 Jul 29;23(8):987. doi: 10.3390/ijerph23080987. PMID: 42652303; PMCID: PMC13513483.
- Deluca G, Lin T, Baird J, Lewis C, Martin K, Jlilati S, Hamidzada S, Negash S, Shamshad A, Amanullah S. Evaluation of Emergency Department Visits by Refugee Children in Rhode Island. R I Med J (2013). 2026 Aug 1;109(8):38-42. PMID: 42520233.
- Marikh M, Alkhabbaz O, Sadaf S, Qaddura Z, Siddiqi B, Hafeez R. Experiential Learning in Refugee Health: A Convergent Parallel Mixed-Methods Study of Medical Student Challenges and Educational Needs in a Student-Run Clinic. Cureus. 2026 Jul 22;18(7):e113166. doi: 10.7759/cureus.113166. PMID: 42631001; PMCID: PMC13496514.
- Kandahari N, Kayhani NN, Moulana Zada F, Kayhani Z, Noor Z, Nelson N, Ivey SL. Health and Health Care Access Among Afghan Refugee Women in the United States. JAMA Netw Open. 2026 Aug 3;9(8):e2627727. doi: 10.1001/jamanetworkopen.2026.27727. PMID: 42566213; PMCID: PMC13451972.
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