B7. Service Delivery – Oral Paper Session

Friday, 31 March 2017

From little things big things grow: Towards a framework for sector reform to support people from refugee backgrounds in their recovery

Service sectors such as health, education, employment and community services play a crucial role in supporting recovery of individuals, families and communities from refugee backgrounds. The Victorian Foundation for Survivors of Torture has a unique integrated trauma recovery model that includes improving the capacity of services systems and client communities to promote the wellbeing of survivors.
This paper will focus on successful approaches to long term sector reform based on the work of the Victorian Foundation for Survivors of Torture in the areas of education, health, employment and community services using policy and practice examples.

The interventions to support sector development include: establishing dialogue between refugee-background communities and service providers; active partnerships between specialised and mainstream services, policy advisors and researchers to support service-level and broader sector development using principles of co-design; supported by professional and organisational development and resource development. A key part of the success is early strategic investment to develop and trial models of program delivery that can then be scaled up. Research partnerships play a crucial role in building the necessary evidence regarding effectiveness of particular approaches.

Sue Casey (Victorian Foundation for Survivors of Torture)

Presentation currently unavailable

“Damaged” & “Difficult”: Deconstructing the Disempowering Discourses that Dominate Refugee Resettlement

Trauma and the risks of trauma work tend to dominate discussions of refugee resettlement, effectively pathologizing refugees, in addition to those who work with them. This preoccupation with trauma does not allow for alternative discourses of resilience and ignores the detrimental effects of negative resettlement experiences such as prejudice and poor access to support and services. It also disregards the opportunities for personal and professional growth documented in studies exploring the experiences of professionals working in resettlement.

This critical discourse analysis, informed by post-structuralism and post-colonialism, explores the extent to which a cross section of professionals (psychiatrists, psychologists, counsellors, social workers, cross cultural workers, and interpreters) engaged in refugee resettlement in New Zealand, reproduce and/or resist these disempowering discourses. The importance of reflecting on the representation of resettling refugees will be reiterated and implications for successful resettlement identified.

Marieke Jasperse (University of Otago, Wellington)

Talking about health and experiences of using health services with people from refugee backgrounds

Health care can of itself make a significant contribution to the psychological recovery and positive resettlement of people from refugee backgrounds (Foundation House 2012), however many face barriers to accessing health services in Australia. There is increasing recognition that consumers should be meaningfully involved in health policy, planning and service delivery, and evidence that consumer involvement leads to improvements in quality, safety and patient experience of healthcare services. People from refugee backgrounds are underrepresented in processes designed to inform healthcare service planning and delivery, such as surveys, consultations, advisory committees and complaints mechanisms. This project aimed to consult with people from refugee backgrounds and people seeking asylum in Victoria about their health and experiences of using healthcare services. We engaged with bicultural workers employed in health, community, and settlement services to advise us about the consultation strategy and to conduct consultations with refugee background communities they work with. This approach was effective at reaching under-represented groups, such as people who are newly arrived, people seeking asylum, and women. Consultations were conducted with 115 people and groups from refugee backgrounds across Victoria. Thematic analysis of the consultation responses identified eight key themes impacting on the health, wellbeing and healthcare service access of people in this cohort: healthy eating and food security; social connectedness; physical exercise and sport; health information and knowledge about health service systems; communication with health providers; accessibility and appropriateness of services; mental health; and income and employment. The project has informed a range of recommendations for healthcare services and various levels of government on how to provide more accessible and appropriate healthcare services for people from refugee backgrounds.

Lauren Tyrrell (Victorian Refugee Health Network, Foundation House)

Engaging and supporting general practice in refugee health

People from refugee backgrounds, including people seeking asylum, can experience complex physical and mental health conditions as a result of human rights violations, torture and trauma, disruption of basic services, poverty and hardship, and prolonged periods of uncertainty (ASID/RHeaNA 2016). Timely access to health care is crucial for optimising health outcomes and addressing health inequities. General practice is a major provider of health care in Australia to people from refugee backgrounds. More general practices are needed who are willing, able and confident to deliver health care to people from refugee backgrounds. This project developed and trialled an approach to engaging and collaborating with private general practices to deliver accessible and appropriate health care to people from refugee backgrounds. The project was approved by an institutional ethics committee. Interviews, discussion groups and surveys were conducted with refugee health professionals, general practice staff, and community liaison workers. A multi-sectoral project advisory group informed the design. The Victorian Refugee Health Network partnered with two community health services and worked with refugee health nurses to co-create and trial tools and resources to support general practice in refugee health. The tools support conversations with practice staff about their motivations, values and challenges when working with people from refugee backgrounds, which informed the development of practice-led action plans that were trialled with six general practices. The project found that utilising co-creation principles promotes a strengths-based approach to working with general practices; values-based interviews can assist in the development of ongoing relationships with the practice; and that general practice engagement requires time, flexibility and skills. The tools are available to be used by others who wish to engage general practice in refugee health.

Samantha Furneaux (Victorian Refugee Health Network, Victorian Foundation for Survivors of Torture (Foundation House)), Philippa Duell-Piening (Victorian Refugee Health Network, Victorian Foundation for Survivors of Torture (Foundation House)), Sarah Christensen (IPC Health), Sue Jaraba (IPC Health), Maria Loupetis (EACH Social and Community Health), Ruth Varenica (IPC Health)