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 well known for having high rates of refugee intake and were in some ways similar to Australia.
Grass-roots 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 that the policies and practices of integration are inextricably linked to mental health and wellbeing, which requires a whole-of-community response and is not the sole preserve of mental health professionals or services.
Sweden and the UK provided excellent examples with frontline services, including people from refugee backgrounds, generally having 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). This promotes community participation and citizen action that doesn’t rely on government funding.
However, government at all levels does have a major role 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.
Canada’s Private Sponsorship of Refugees (PSR) programs for offshore refugees is successful yet offers various learnings – 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 ensures uniformity and consistency of practice, along with support from specialists in refugee resettlement mental health.
The strongest theme emerging from clinicians with experience in refugee mental health was of the need 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. Those working directly with refugees also agreed that this was the biggest issue that they noticed with their clients.
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 it 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 providing 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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