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Every year, thousands of refugees and asylum seekers arrive in Australia. They are often fleeing war, persecution and torture. Making sure they can access healthcare, including mental health services, is an important part of their settlement. But the Australian healthcare system can bring new challenges for them.
Audrey Bourget/Ildiko Dauda

14 Jun 2017 - 6:26 PM  UPDATED 15 Jun 2017 - 2:18 PM

Providing early support for refugees and asylum seekers makes integration much smoother. Australia's Humanitarian Settlement Services program (HSS) provides practical support to humanitarian entrants for up to a year after they arrive. Service providers like Settlement Services International (SSI), in New South Wales, deliver the program on behalf of the Australian Government. Yamamah Agha is the HSS Service Delivery Manager at SSI. She says several health services are available to refugees.

"When they arrive, we refer them to the Refugee Health Services for a comprehensive health assessment. After the health assessment they are referred for pathology and they are linked to a general practitioner. And if they need, they are also linked to a torture and trauma services, to a children's clinic if they have children and also to the dental hospital for any dental issues. If they need to be referred to a specialist, they are also linked to a specialist."

When it comes to mental health, many asylum seekers are affected by the trauma they faced in their country.

But Samantha Ratnam, the client services manager at Footscray's Asylum Seeker Resource Center, says that what they have to deal with in Australia is also stressful.

"From my work, what we know is that there are experiences that our clients had before they arrived to Australia that can really impact their mental health and cause poor mental health. And we know that the experiences in a place like Australia, when they are seeking asylum and while they wait for the outcome of their refugee application to be processed, we know that this experience as well can have really negative consequences for their mental health. So we work in some ways with the cumulative impact of both the pre arrival experiences and the post arrival experiences."

Samantha Ratnam also insists that not all asylum seekers have access to mental health services and that even when they do, only a handful of people are qualified to help them.

"Even if you're able to access a mainstream service, the circumstances and experiences of our clients are quite unique and particular. And those services need to be equipped to work, for example, in a culturally sensitive way to understand the experiences of our clients. Otherwise our clients don't feel comfortable."

Language barrier adds another level of difficulty when seeking mental health help. Talking about sensitive health issues in a language that’s not your mother tongue is not ideal.

This is why there are interpreters available, but Yamamah Agha says it's not always easy to get them to specialist

"The issue we face is mainly with specialists, where specialists, they refuse to use interpreters - many of the specialists - they refuse to use interpreters. So it becomes a real challenge for refugees having to either take someone from their family, which they may not be able to understand full English, or they have to cancel their appointment because their specialists   simply don't book an interpreter."

Some medical professionals rely on the patient's family members to interpret - and that can be problematic. The translation might not be reliable and, sometimes, children are being exposed to heavy issues.

Olivia Nguy is the client service manager at the Liverpool Migrant Resource Centre in Sydney's Western suburbs. She says they noticed high levels of mental health concerns among their clients.

"We've noticed a lot of incontinence among children from Syrian families, and we think that might be linked in with the impact of trauma as well. And we think it's also maybe because it's a much more recent conflict and there is an adjustment process, having lived a fairly stable, calm, peaceful, normal life and then having to deal with very traumatic and high conflict situations and being exposed to that is having a major impact on mental health."

Despite mental health issues being common, Olivia Nguy says there's still a stigma around them.

"It can be viewed as someone being crazy and it can be a real barrier for people to seek support for mental health issues. A lot of people reported that they've been socially isolated or ostracised from the community because of poor mental health."

This is why organisations like the Liverpool Migrant Resource Centre run information sessions around the adjustment process and mental health in general. They try to demystify mental health concerns and reassure people that it's quite common.

Service providers believe mental health services need to go hand in hand with other types of support. Because as 'it's hard to think about your headspace if you're worried about your next meal'.

"If you think about what our clients are fighting for... Lots of our clients don't have access to income, to work rights. So they're fighting to keep a roof over their head and food on the table so if you've got mental health concerns and you think about your basic needs being uncertain. You know, sometimes you are so focused on the material needs, you don't have the space to work on the mental health side of things, but it's impacting you. It really accumulates. A lot of our clients face a really tough time because of that."

Something to think about as Refugee Week is held in Australia from 18 to 24 June. Australians are encouraged to celebrate the courage of refugees and acknowledge the skills and energy refugees bring to the country.

For more information visit Refugee Week.

Useful links:

For more information about mental health initiatives in your language visit: Mental Health in Multicultural Australia 

Refugee Week 18 - 24 June 

World Refugee Day 20 June 

Settlement Services International (NSW) 

Liverpool Migrant Resource Center

Asylum Seeker Resource Center 

Asylum Seeker Resource Center's Telethon for World Refugee Day 

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