Soft tufts of brown hair peek from a sling draped across her chest; inside is a baby boy, perfect in every way except for his cheeks - red and chapped from a rash - and a cough that escapes his tiny lips.

Adib hasn't taken her 3-month-old to a doctor yet. Her son, in fact, hasn't had a proper checkup since birth.

"When he was born, I got a ride to the hospital," she said through an interpreter. "No ride since then."

Transportation is just one of many challenges Adib's family faces.

She and her husband can pay the rent, but sometimes food and diapers are scarce. Their Salt Lake City apartment is sparse, but Adib can only compare it with her last home - a disease-ridden refugee camp rife with violence and despair.

"America good," she said, thrusting a thumb in the air, proudly using some of the English she has learned in the past 2 1/2 years. "America good!"

For many refugees, coming to Utah is a chance to cheat death and build a better life, yet finding a safe new home hardly means their troubles have ended.

Each refugee copes in his or her own way, and their stories mostly have happy endings, with families slipping successfully into middle-class life. In rare cases, the ending is tragic, as Utahns learned last Monday when Bosnian refugee Sulejman Talovic methodically murdered five people he had never met, before police officers shot and killed him.

In using the case and others involving immigrants to plead for more services for refugees, the Utah Consortium of Minority Groups last week argued better mental health care and other services may have helped prevent the tragedy.

Alija Music, another Bosnian refugee, tends to agree.

The 36-year-old came to Salt Lake City nine years ago, the same year as Talovic's family, and found certain types of assistance readily available. Food stamps. Help finding an apartment. Household items and clothing.

Glaringly absent, though, was counseling "to ease the mark on our souls," he said.

Music said Talovic's problems must stem from his childhood experiences. Standing outside Al-Noor mosque in Salt Lake City on Friday, he said that this is what "we all believe."

The boy's quiet demeanor, his "being so much into himself" might have made matters worse, he said.

Arrival: The history of refugee resettlement in Utah reads like a shorthand account of modern global conflict. When upheaval overtook Southeast Asia in the 1970s and 1980s, Vietnamese, Cambodians and Laotians streamed into Utah. The Balkans erupted in the 1990s, and Kosovars, Serbs and Bosnians followed. Thousands of Sudanese and Somalis fled conflict in their homelands and hundreds landed here.

There are Russians, Cubans, Turks, Syrians and more. Next, more Iraqis and Iranians will come, said Patrick Poulin, director of the International Rescue Committee (IRC) office in Salt Lake City.

Today there are tens of thousands of refugees in Utah, with more than 9,500 arriving between 1995 and 2005. Bosnians made up the largest group in that period, with nearly 2,500 refugees, followed by about 1,000 each from the former Yugoslavia and Somalia.

Refugees seeking resettlement must first contact the United Nations, which works with several destination countries, including the U.S. Then, Homeland Security agents screen and interview potential U.S.-bound refugees, the State Department's Peter Eisenhauer said.

Once cleared, refugees' cases are handed to one of 10 organizations, including The U.S. Conference of Catholic Bishops and the IRC, which relocate refugees to Utah.

Of the thousands of refugees who come to the U.S. each year, several hundred find their way to Salt Lake City.

"The job market is healthy. Housing is generally affordable and available," said Christine Petrie, IRC national resettlement director. "There's a good sense of community." During the first six months here, the IRC or Catholic Community Services of Utah provide housing, job placement assistance and health screening. Medical expenses are paid by the federal government for the first eight months, and refugees have access to counseling through Valley Mental Health.

The agencies work quickly to brief refugees on everything from learning English to balancing a checkbook.

"Our mission is to teach the refugee how to be self-sufficient," said Aden Batar, a Somali refugee who is now an immigration attorney for CCS of Utah.

After six months, however, much of that assistance ends and refugees are referred to the Asian Association of Utah (AAU), which, despite its name, helps newcomers from all countries until they have been in the U.S. five years and are eligible to apply for citizenship.

Many new refugees remain overwhelmed. They need help paying bills, understanding how direct deposit banking works and building their language skills. "The majority depend on us a lot," said Jamaal Hamid, a Somali refugee who works for AAU. Beyond the basics, the organization also provides counseling for those who have been raped, tortured or seen loved ones killed, said Gabriela Cetrola, who runs the group's treatment program.

Depression is common, as is post-traumatic stress disorder (PTSD).

Valley Mental Health psychiatrist Katharina Trede said 80 percent of the 300 or so refugees she sees suffer from PTSD, a condition that leaves them in a state of hyper-vigilance. Loud sounds make them jumpy, they sleep poorly and have nightmares, she said.

"Your brain just won't stop being in this fearful state that it was in for so many years," said Trede, who leads her agency's cultural diversity team.

Nonetheless, Cetrola emphasizes that few refugees ever inflict violence on others because of their problems.

No counseling: Simply having such services available is not always enough, those who work with refugees say.

Trede said symptoms of PTSD can take years to surface because refugees are so busy learning how to cope in a new place that the brain is in survival mode and doesn't have time to let all these symptoms out.

The disorder may show up long after the five-year period during which most refugees are eligible for services.

At that point, those who seek counseling may lack health insurance to pay for it.

Many refugees lose federal health insurance coverage after eight months, and most don't find jobs that include benefits.

Cultural barriers among Bosnians and other groups also prevent some from seeking help.

"Therapy and counseling is seen as being for the crazy," Cetrola said.

This disconnect is among the problems the U.S. refugee support system faces, said Richard Mollica, of Harvard University's Program in Refugee Trauma.

Refugees known to be getting counseling can have trouble fitting in with their communities.

"Once you put the label that someone has a mental problem, it's really a big burden on them," he said.

Service providers need to find ways to reach out, especially to young men, who are among those refugees most at risk for developing mental health problems, he said.

Even before the Trolley Square shootings, refugee advocates were examining ways to improve Utah's support system.

A 2006 meeting of Utah refugee advocates noted that improved case management and better communication are needed among refugees, service providers and advocates.

Connections exist between service agencies, schools, the courts, law enforcement and other government agencies, but there may be a need to re-examine how these groups interact.

And there's no escaping the reality that while the needs are enormous, resources are limited, especially in the schools, which continue to offer services even after most other refugee assistance expires.

"I'm only one person working in schools ... there are not enough of us to go around," said Joyce Kelen, a Salt Lake City School District social worker and counselor. "There is a lot of trauma and students who are suffering but we don't have enough resources to help."

Kelen works in elementary schools, but said challenges only intensify when refugee children reach middle and high school. Students may have seven different teachers and it's more difficult for parents to connect with anyone.

Schools can refer students to programs such as CCS of Utah, "but they don't have enough help either," she said.

Improvement: Kelen and other refugee services providers work tirelessly every day to help those who have so many needs, and even critics acknowledge their ongoing efforts to improve the system.

Poulin, head of the IRC's local office, said all Utahns have a role to play.

"If we look at how we can make things better for everyone, well guess what, we make it better for refugees, too," he said. "Can we all just put out our hand and help each other?"

Services that support refugees may not be perfect, but many point out they have helped countless newcomers create comfortable lives for themselves.

Like Adib, the Somali mother, Bosnian refugee Maruf Arifovic is grateful for the help he's received.

"I don't see any problems for Bosnians here," said Arifovic, who came to Utah seven years ago with his wife and two daughters.

Today, he and his family are living the American dream. He owns his own home, one daughter has graduated from college and another will soon.

"There is support in schools and in the community," he said. "It depends what kind of values you have in your life."

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* JESSICA RAVITZ, ROXANA ORELLANA and PEGGY FLETCHER STACK contributed to this story.