Refugee, immigrant, and migrant (RIM) populations face a higher burden of psychological distress related to pre-migration trauma and post-migration stressors, yet there is limited evidence on the real-world effectiveness of community-based counseling. This retrospective, observational study used de-identified program data from 20 adult RIM clients that received counseling through the Georgia Mental Health Alliance (MHA) to evaluate changes in mental health outcomes and factors associated with treatment response. Primary outcomes were PSYCHLOPS scores. HSCL-25, RHS-15, trauma exposure, PMLDC, SIQ, WHO-5, and EQ-5D-3L were secondary outcomes and provided context. Linear mixed-effects models were used to assess overall change and subgroup differences. Participants entered care with high levels of distress but showed statistically significant and clinically meaningful reductions in PSYCHLOPS scores over time, while HSCL-25 showed a nonsignificant downward trend. Gender and selected sociodemographic factors were associated with baseline distress and exploratory differences in trajectories.