Eighteen years ago, when Anya Stepanova immigrated to Tennessee from the small town of Dimitrovgrad, Russia, she participated in adjustment support groups aimed at people resettling after leaving Eastern Europe.“Coming here and participating in the adjustment groups was a great help because that just gave me that sense of community right from the very beginning,” she said.The groups helped her make connections with people. Although it was difficult adjusting to a new culture, she knew she was not alone.Stepanova now provides one-on-one mental health counseling at Lutheran Community Services Northwest in Vancouver, which looks to start its own adjustment support groups for the Russian-speaking community this spring. Its existing services include immigrant counseling and advocacy and refugee resettlement.The SeaTac-headquartered nonprofit developed the refugee health screener, called the RHS-15, a tool that detects possible mental health issues among new refugees. Those who test positively are referred to mental health services. Overall, between 2015 and 2017, about one in five refugees from former Soviet Union countries tested positive for emotional distress and could benefit from mental health services, according to the Washington State Department of Health. The rates are higher among female and elderly refugees.Refugees from countries such as Syria and Iraq indicate higher rates of emotional distress. However, they are more likely to accept referrals to mental health services than those from the former Soviet Union. In 73 percent of cases, people primarily from Ukraine, Russia and Moldova declined services, according to the state Department of Health.