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Greg

Greg Turner

Year of Award: 2017 Award State: Queensland Health And Medicine > Mental Health
Social Welfare > Immigrants And Refugees
To gain knowledge to further support the mental health of refugees settling in Australia - USA, Canada, Sweden, Germany, Denmark, UK
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This six-week Churchill Fellowship study explored ways to assist the mental health and wellbeing of refugees in resettlement. Countries and cities chosen were those that were well known for having high rates of refugee intakes and were in some ways similar to Australia so that learnings could be generalised to Australia. Grass-root and frontline refugee services and programs were initially targeted as they have the most contact and most developed relationships with refugees in resettlement. Researchers, clinicians and government agencies were also targeted. Mental health and wellbeing was considered in a broad context in alignment with the WHO definition whereby “every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. In total 36 individuals from 25 agencies were interviewed in a discussion format utilising a pre-established set of questions.

Overwhelmingly the study participants agreed there is a need for a focus on post-migration refugee resettlement mental health and wellbeing support and that the policies and practices of integration are inextricably linked to mental health and wellbeing. Promoting and preserving the mental health and wellbeing or refugees in resettlement is not the preserve of mental health professionals or services, but requires a whole-of-community response. Some countries visited had decentralised settlement services utilising place-based initiatives through a myriad of community associations and social networks with Sweden and the UK providing excellent examples. These frontline services, including people from refugee backgrounds, generally have intimate understanding of the resettlement and integration challenges and potential solutions. The national governments of most countries I visited have devolved resettlement funding and responsibilities to states (provinces or counties) and local councils (municipalities). Such devolution promotes community participation, and citizen action that doesn’t rely on government funding was a strong feature in the UK where I visited a number of successful refugee support programs. Government at all levels do have a major role to play however in enabling entrepreneurship by simplifying laws and reducing red tape to make it easier for refugees from CALD backgrounds to navigate the pathways into business and jobs.

Refugee sponsorship programs (organisational, community or private) are operating very successfully in the countries visited. Canada in particular has been operating Private Sponsorship of Refugees (PSR) programs for offshore refugees for many years and while successful there are learnings from these programs most notably in regard to the selection, education and preparation provided to sponsors, ongoing regular support, and consistency of practice across sponsors. Refugee participants I spoke with cautioned that while well intentioned sponsors can have paternalistic attitudes or perpetuate ‘the poor refugee’ label which doesn’t assist with the development of agency. Appropriate selection and training that ensures uniformity and consistency of practice can alleviate this along with support from specialists in refugee resettlement mental health.

The strongest theme emerging from stimulating conversations with clinicians with extensive experience in refugee mental health was that the clinical task was to support cognitive processes and promote the development of a sense of agency. Refugee participants agreed that cognitive difficulties and memory impairment were their most pressing issues with some saying this was the cause of their mental health issues and all identified with the idiom of distress “my brain is busy”. Those working directly with refugees also agreed that this was the biggest issue that they noticed with their clients. From discussions with a range of clinicians, support workers and refugees a working hypothesis for a cause for these cognitive issues is that the brain is overloaded with new learnings to the point that there is no time for neuronal consolidation and so the brain struggles to continue processing from short term memory into long term memory. A solution to this is to utilise a staged approach to new learning, avoid replication and provide practical information in easy to understand formats. Language service providers need to be aware of these cognitive difficulties and seek guidance from refugee resettlement mental health specialists. Further research is required to identify culturally appropriate interventions that assist with improving cognition and memory in the refugee resettlement context.


Key words: Refugee Resettlement, Refugee Mental Health, Refugee Wellbeing, Acculturative Stress, Settlement Stress, Sense of Agency, Migration, Integration, Acculturation, Community Participation 

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