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1 – 10 of over 2000Gabriella Karakas and Daniel R. du Plooy
Despite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental…
Abstract
Purpose
Despite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental health services, there is a lack of in-depth studies specifically focusing on Bosnian refugees in Australia – one of the largest ethnic groups of displaced peoples. This qualitative investigation seeks to convey the experiences of mental health services by five Bosnian refugees in Melbourne, highlighting perceived pathways and barriers to service utilisation. This study aims to address two primary research questions: firstly, what characterises the experiences of Bosnian refugees in Australia when accessing mental health services? Secondly, what are the main barriers encountered by this population when seeking mental health services?
Design/methodology/approach
This study used qualitative inquiry and in-depth interviews to investigate the experiences of Bosnian refugees with mental health services in Australia. Data was collected through face-to-face interviews with five Melbourne-based Bosnian refugees who had previously accessed mental health services. Participants were recruited from community groups or associations using purposive sampling. Thematic analysis was used.
Findings
Key themes were revealed, such as the crucial role of social and community services, preferences for individual vs group therapy, potential re-traumatisation from therapeutic engagement, distrust of government-run mental health services and concerns regarding psychopharmaceutical prescription practices. Addressing barriers to mental health service access necessitates a multifaceted approach, including flexible social and community service support, an increased number of co-ethnic professionals and a recognition of cultural variations for effective service provision. Implementing these strategies can enhance help-seeking behaviours, provide culturally appropriate mental health services and improve the experiences of Bosnian refugees in Australia.
Originality/value
To the best of the authors’ knowledge, this study is the first to qualitatively explore how Bosnian refugees in Melbourne perceived the adequacy and availability of mental health services upon arrival to Australia. They are a large and potentially vulnerable community, due to experiences of war trauma and dislocation from country of origin. A lack of understanding regarding how this cohort engage with mental health services can lead to persistent inequities and ineffective service provision. This study identifies unique experiences and perspectives of Bosnian refugee participants, including distrust of government-run mental health services, and concerns regarding psychopharmaceutical prescription practices. This research is expected to contribute positively to the discourse on mental health service provision for Bosnian refugees and wider refugee communities in Australia.
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Madeleine Claire Valibhoy, Josef Szwarc and Ida Kaplan
The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and…
Abstract
Purpose
The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services.
Design/methodology/approach
A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services.
Findings
Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services.
Practical implications
Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services.
Originality/value
This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.
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David Palmer, Ermias Alemu and Julian Hopwood
This research project explored how refugee community organisations (RCOs) could become more involved in the government's health agenda to improve the level of consultation and…
Abstract
This research project explored how refugee community organisations (RCOs) could become more involved in the government's health agenda to improve the level of consultation and responsiveness in the design and provision of mental health services for ethnic minorities. The method involved a review of relevant literature, interviews with refugee community organisation leaders and community workers, and a survey of refugee service users' involvement with RCOs. The research found that the causes and effects of mental ill health in refugees as understood by interviewees were consistent with much of the literature in this area. The mental health needs of refugees are very similar across nationalities and ethnicities, and distinct from those of the general population and of other migrant groups. Appropriate responses, as understood by community leaders and professional community workers, are currently only partly and insufficiently provided by statutory health services, and there is extensive unmet need.
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Olga Acosta Price, B. Heidi Ellis, Pia V. Escudero, Kristen Huffman-Gottschling, Mark A. Sander and Dina Birman
Purpose – This chapter discusses the promise of and challenges to providing effective and culturally responsive trauma-focused mental health services to immigrant and refugee…
Abstract
Purpose – This chapter discusses the promise of and challenges to providing effective and culturally responsive trauma-focused mental health services to immigrant and refugee youth and their families within school settings.
Design/methodology/approach – This chapter utilizes “practice-based evidence” to outline successes and address the barriers associated with the implementation of school-based, trauma-focused, evidence-based interventions in four immigrant or refugee-dense cities: Los Angeles, Chicago, Minneapolis, and Boston.
Findings – Making cultural adaptations to identified trauma interventions that were consistent with community priorities, cultural norms, and values resulted in more accessible programs and greater engagement in treatment services.
Practical implications – The strategies tested in these real-world settings contribute to the development of culturally competent trauma-informed services for immigrant and refugee youth and their families. Mental health providers and program developers will better understand the need for multilevel engagement strategies and for culturally driven modifications when employing evidence-based programs with immigrant and refugee youth.
Originality/value – This chapter adds to the scarce evidence about useful methods to engage immigrant and refugee youth and families in treatment and to increase the likelihood of positive outcomes.
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Brandon A. Knettel, Anna Oliver-Steinberg, M.J. Lee, Hillary Rubesin, Naomi N. Duke, Emily Esmaili and Eve Puffer
The refugee journey is fraught with challenges before, during and after resettlement. There is a critical need for mental health support upon arrival, and refugees face language…
Abstract
Purpose
The refugee journey is fraught with challenges before, during and after resettlement. There is a critical need for mental health support upon arrival, and refugees face language, cultural and logistical barriers. Arts-based therapies are a promising approach to mitigating such barriers. The purpose of this study was to elicit professional stakeholder perspectives on mental health challenges among refugees, the value of arts-based programs and future directions.
Design/methodology/approach
The authors conducted three 90-min focus groups with 19 professional stakeholders in North Carolina, USA. This included mental health professionals, professors and community services/resettlement workers. Participants were identified from professional networks and snowball sampling. Each group was held by videoconference, audio recorded and transcribed. Data were analyzed through a team-based approach using applied thematic qualitative analysis.
Findings
Interviewees described a need for targeted, culturally compatible mental health services for refugee families, including trauma-informed, family-focused services with language interpretation. Arts-based therapies were viewed as highly acceptable and culturally responsive approaches for understanding distress and building resilience and less stigmatizing than traditional mental health services. Services in schools and community settings would further reduce stigma and minimize logistical barriers. Participants identified needing strong, culturally sensitive assessment tools to measure treatment progress as a key future direction.
Originality/value
The study offers novel insights into the value of arts-based approaches and considerations for program development. The next phase of the project will obtain the perspectives of refugee parents and children to understand client preferences for arts-based therapies.
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Matthew Fish and Olivia Fakoussa
Pre- and post-immigration trauma and stress make refugees a particularly vulnerable group in terms of mental health and well-being. The purpose of this paper is to describe a…
Abstract
Purpose
Pre- and post-immigration trauma and stress make refugees a particularly vulnerable group in terms of mental health and well-being. The purpose of this paper is to describe a listening project undertaken in Plymouth, UK, which sought the views of 17 service users (n=12) and staff (n=5) from four local support organisations, for people with refugee and asylum seeker status and those with diverse cultural backgrounds. Aims of the project were to expand Western-centric understandings regarding beneficial support and the promotion of good mental health and well-being in this population.
Design/methodology/approach
Responses were subjected to thematic analysis, co-conducted with a service user. Participants were asked about their personal understandings of mental health and well-being and what supports or hinders well-being.
Findings
The findings enabled the development of a model incorporating 10 threads which support and 9 holes that can hinder well-being.
Research limitations/implications
The relatively small numbers of participants compared with the numbers of asylum seekers and refugees in Plymouth may not be fully representative of the general population in Plymouth and the UK.
Originality/value
Despite increasing cultural diversity within the UK population, available mental health services exist mainly as developed from a Western psychological model of mental distress and treatment. This research provides services with a more informed understanding of mental health for asylum seekers and refugees. As such it is of value towards future service design in Plymouth and the UK. Findings also contributed to a successful funding bid to set up a peer-led support project in the city.
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This article is concerned with strategies for combating health inequalities for refugees. It explores a service provider's (St Pancras Refugee Centre) response to the mental health…
Abstract
This article is concerned with strategies for combating health inequalities for refugees. It explores a service provider's (St Pancras Refugee Centre) response to the mental health and social care needs of refugees in the London Borough of Camden. Drawing on primary and secondary research, the article presents relevant findings and theoretical discourse in this area. It also draws on my own experience of working with refugees, providing a holistic approach to their social care requirements. The main focus is an examination of how social care and mental health needs are addressed. The article argues that providers need to develop services which engage with users on a mutually beneficial level in order to combat health inequalities and provide adequate health and social care provision.
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Refugees are among the most socially excluded and marginalised groups in the UK. This paper examines ways in which the refugee service user's voice can be heard and the power…
Abstract
Refugees are among the most socially excluded and marginalised groups in the UK. This paper examines ways in which the refugee service user's voice can be heard and the power imbalance between service provider and service user addressed. Lessons learned from addressing the needs of refugees can be extrapolated for other disadvantaged groups.
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This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing…
Abstract
Purpose
This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing on the Canadian context.
Design/methodology/approach
A narrative literature review has been applied to this manuscript. This approach allows the integration of a wide scope of literature and perspectives, from academic literature to grey literature (e.g. governmental reports and dissertations). Nevertheless, the limitations of this type of review were also discussed.
Findings
In spite of the gaining popularity of the resilience lens, which emphasizes an individual’s ability to overcome adversities and stressful events, more work is required for its effective integration into health practice, programs and policies, particularly as it relates to refugees’ and asylum seekers’ mental health care.
Originality/value
Careful consideration of refugees’ and asylum seekers’ mental health needs and Canadian mental health service delivery and policies is a critical first step in reaching such a goal.
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Dora Bernardes, John Wright, Celia Edwards, Helen Tomkins, Darias Dlfoz and Andrew Livingstone
The literature tends to use ‘asylum seeker’ and ‘refugee’ interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique…
Abstract
The literature tends to use ‘asylum seeker’ and ‘refugee’ interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique position in British society which differentiates them from people with refugee status and which may have implications for their mental health. For example, ‘asylum seekers’ are supported and accommodated in dispersal areas under the National Asylum Support Service and they are not entitled to work. This mixed‐methods study investigated asylum seekers' symptoms of psychological distress, using mental health screening questionnaires (N = 29) and asylum seekers' subjective experiences of the asylum process, its potential impacts on their mental health, and participants' suggestions for tackling mental health needs, using in‐depth interviews (N = 8). Asylum seekers, refugees and practitioners working with asylum seekers were consulted from the outset regarding the cultural sensitivity of the measures used. Given the potential limitations of using ‘idioms of distress’ across cultures, interview data provided rich descriptive accounts which helped locate the mental health needs that the asylum seekers experienced in the specificities of each participant's social context. Asylum seekers originated from 13 countries. The results revealed that psychological distress is common among asylum seekers (for example anxiety and post‐traumatic stress), but so are post‐migratory living difficulties (for example accommodation, discrimination, worry about family back home, not being allowed to work). They also report mixed experiences of health and social care services. These results suggest that asylum seekers' unique social position may affect their mental health. Implications for practice are presented and potential limitations highlighted.
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