Keynote Presentations 2017

The conference featured nine keynote presentations from speakers recognised as experts in their fields from Lebanon, the United Kingdom, New Zealand and Australia.

PLENARY 1:

International, regional and national perspectives on refugee trauma recovery and resettlement

Director, Restart Center for Victims of Violence and Torture, Lebanon

International, regional and national perspectives on refugee trauma recovery and resettlement

Despite the country’s small size, Syrian refugees in Lebanon have already surpassed one million. Today, one in five people in Lebanon are Syrian refugees, hence rendering every resident’s daily struggle even more challenging. Unfortunately, Syrian refugees are living in unfavorable conditions, with limited access to basic needs, housing, education, security, health and mental health care. The most prevalent mental health problems observed among Syrian refugees include depression, anxiety-related disorders, post-traumatic stress disorder (PTSD), and psychosis. In 2016, 369 300 refugees were in need of resettlement from the Middle East and North Africa region (MENA). As this growing number exceeds present placement opportunities, finding solutions for the resettlement issue is more crucial than ever, not just for refugees, but also for survivors of violence, ill treatment and torture. One of Restart Center’s main purposes is to solidify the legal framework for the criminalization and abolition of torture both nationally and regionally. Approximately 600,000+ Syrian refugees in Lebanon have experienced or witnessed torture. Violence is what most of refugees have faced and endured especially before they have fled the war. Accordingly, multidisciplinary teams such as Restart’s are involved in providing a range of needed services like rehabilitation, medical services, psychological services, and even juridical services.

Recorded lecture published in the Psychevisual journal

Foundation University of New South Wales Professor of Psychiatry, Liverpool Hospital, NSW Australia

Refining an ecological model of refugee health

We confront a daunting set of challenges in responding to the needs for mental health and psychosocial services (MH&PSS) for refugees and other post-conflict populations worldwide.  At a global level, there is a huge discrepancy between the number of refugees (approximately 65 million), the prevalence of mental disorders and related distress reactions in these populations, and the availability of resources (human and material) to provide appropriate MH&PSS for all those in need.  It is vital therefore for actors in the field to achieve a high level of consensus regarding the models that should be adopted to guide policy, planning and implementation of the range of MH&PSS.  At present, there is a tendency for specialists to advocate for specific services or programs focusing on particular needs groups.  Each specialist program has its benefits and limitations.  Brief trauma-focused psychotherapy programs can be readily established and implemented by lay workers, but questions remain concerning their long-term outcomes and their limits, for example, in assisting a minority of survivors with the most disabling complex traumatic stress reactions.  Also, programs may be difficult to sustain unless they are properly funded and securely embedded within public health services where workers receive ongoing supervision.  Generic mental health services, are an essential component of interventions but the priority given to severe mental disorders usually means that those with trauma-related disorders do not receive adequate attention.  Broader psychosocial programs aimed at building resilience and restoring community cohesion may be of value for those with less severe forms of distress but stricter criteria need to be developed to determine selection for participation, given the large pool of potential participants.  In addition, greater attention needs to be given to methodologies for assessing outcomes.  At the society-wide level, emerging evidence indicates that participation in truth and reconciliation processes may produce inconsistent effects; on the one hand, these processes may help to re-build social capital and community connectedness; on the other, they may provoke or exacerbate trauma-related symptoms, for example, of PTSD.  All modalities of intervention require further evaluation and research to determine their place and priority in the comprehensive array of services offered refugees.  Research needs to focus not only on the benefits but limitations and potential adverse effects of contemporary interventions.  At the wider level, there is a pressing need to reach a consensus regarding an overarching ecological model for guiding policy and the design of comprehensive programs of intervention. Such a model will ensure recognition that no single approach or agency can meet all psychosocial and mental health needs. Clarity in the role and activities of each agency and close inter-agency coordination are vital to avoid duplication of efforts. Establishing a consensus concerning the foundations of a comprehensive model of response will go a long way to enhancing the effectiveness of advocacy in the MH&PSS field.

Recorded lecture published in the Psychevisual journal

CEO, Victorian Foundation for Survivors of Torture (VFST), VIC Australia

The human displacement challenge – Understanding and framing our response to refugees and asylum seekers

Protecting people fleeing war, conflict and persecution is both a moral and legal obligation for a country like ours. At the end of 2015, 65.3 million people were either an asylum seeker, internally displaced or a refugee. Of the 65.3 million displaced people, 21.3 million are designated refugees with over half of them under the age of 18, an increase of 41% for that age group since 2014. Every person should know that they have a right to protection under the refugee convention – every refugee should be confident that as a part of that they will be properly cared for and every persecutor should fear that they will be brought to justice. Refugee resettlement is about protection, it is about sanctuary from persecution, it is about nation building and it is about justice. In the context of Australia’s contribution to this critical international issue, there is one inescapable starting point for the impact of policy on the protection, settlement and care of refugees. In this presentation Paris Aristotle will explore on how current policy creates two major classes of people recognised as refugees in Australia, and the different ways in which they are treated have major implications for their wellbeing and settlement. Australia is one of the top three countries in the world for accepting refugees referred by the UNHCR for resettlement, which is one of the best resettlement programs in the world, providing a diverse range of assistance and care to humanitarian program arrivals each year that we can be very proud of.  However, the same cannot be said about our historical and current approach to managing asylum seekers. This presentation will further elaborate on the current global refugee and humanitarian crises with more of a focus on Australia’s policy of treating asylum seekers. Finally, the presentation concludes with some recommendations for changing these policies.

Recorded lecture published in the Psychevisual journal

CEO, NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), NSW Australia

The role of torture and trauma recovery services in mental health and resettlement

Experiences in the 1980s demonstrated that mainstreaming refugee trauma treatment into regular mental health services didn’t adequately address the complex needs of people from refugee backgrounds resettling in Australia. This led to the establishment of specialist torture and refugee trauma services around Australia that integrate clinical and community development approaches with interventions to foster a positive recovery environment. The Australian specialist torture and refugee trauma services are founded on four pillars:

  1. Understanding of the refugee experience and the geopolitical context in which the trauma took place from a human rights solidarity perspective
  2. Understanding of the nature of torture and refugee trauma, and the interventions that can help achieve results with traumatised clients
  3. Cross cultural competence in adapting and utilising evidence based and traditional treatment approaches
  4. Learning how to support staff working with horrific stories on an almost daily basis so they can remain effective and healthy

This keynote presentation will explore the complex challenges faced by people from refugee backgrounds resettling in a high income Western country, including the main presenting psychological symptoms, the implications for resettlement and integrating into a new society, and mental health. The presentation will outline how specialist torture and refugee trauma services work clinically with clients, and how these are complemented by community and systemic approaches. The positive results achieved through these specialised interventions will be presented using evidence from neuroscience assessment tools.

Recorded lecture published in the Psychevisual journal

Dr Angela Nickerson

Senior Lecturer and Director of Masters of Psychology (Clinical) Program, University of NSW, Australia

New directions in refugee mental health research: Informing interventions

While rates of psychological disorders are elevated amongst refugees and asylum seekers, many individuals adapt well following persecution and displacement. Little is known, however, about the pathways to psychological distress and resilience amongst refugees. In recent years, there has been increasing research investigating processes underlying psychological outcomes in individuals from refugee backgrounds. This presentation will outline some of the recent advances in research examining cognitive, memory and emotion processes amongst refugees.  In particular, recent studies demonstrating the impact of emotion regulation on refugee mental health will be presented. The importance of understanding these processes for the development of effective interventions to treat psychological disorders in refugees will be discussed, and future research directions will be outlined.

Recorded lecture published in the Psychevisual journal

Psychiatrist, Trauma Clinic London, United Kingdom

A clinician’s perspective on refugee trauma recovery and resettlement

Clinical practice occurs in a context.  In this presentation, Stuart Turner will present his experience of some of the key international policy failures (chiefly from a European perspective) as they affect the resettlement and recovery of refugees.  These include, for example, the current death rates from crossing the Mediterranean (more in each of 2015 and 2016 than were killed in many recent European and N American disasters – including the attack on the World Trade Center).  Examples of the difficulties involved in determining status using the Refugee Convention will be illustrated.  This will lead on to a consideration of the general issues involved in providing treatment.  Being a refugee is not a diagnosis and so all treatments have to be based on a prior assessment/formulation.  He finishes with a challenge for services in developed countries – to help develop strategies for the large refugee populations elsewhere.

Recorded lecture published in the Psychevisual journal

PLENARY 3:

Community development perspectives on refugee trauma recovery and resettlement

CEO, Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT), QLD Australia

Abstract currently not available

Recorded lecture published in the Psychevisual journal

Founder of RASNZ, the Auckland Refugee Council (ASST) and the Auckland Refuge Family Trust

Yes we can; but together: Social capital and refugee integration: A practitioner’s view

This keynote address will discuss how the concept of social capital appears to be embedded in the goals of the New Zealand Refugee Resettlement Strategy, especially in the goal of participation. It will explain how the New Zealand sector has evolved from a grassroots charity approach to a situation where people from refugee backgrounds are integral to policy and service development. The concept of social capital refers to the relationships between people and their social networks which is based on reciprocity, trust, shared norms and social agency. This leads to cooperation, openness and compromise. It has been likened to the glue that holds society together. Refugee experiences can greatly disrupt a person’s sense of control and connections with others. Susan will explain the different types of social capital: bonding, bridging and linking, and how they are crucial for successful integration into a new society following persecution and forced displacement. Networks of social relationships ensure people from refugee backgrounds can live meaningful lives. Relationships cement concepts of citizenship and refugee rights – social, cultural and economic (eg. employment, housing, education and health), and civil and political rights (eg. language, security or residency/ citizenship). She will provide an example of a project called ‘WISE’ implemented in Auckland to strengthen and build social capital in refugee resettlement. She will also speak about the fostering of bridging social connections between the Maori and refugee communities. The presentation concludes by discussing the potential of social capital to add to our understanding of achieving refugee integration through fostering community connections and provides a critique of community approaches versus individualised approaches to trauma which can inhibit people from a refugee background achieving their full potential and realising their human rights.

Recorded lecture published in the Psychevisual journal

Research Fellow and Psychologist, Queen Margaret University, Edinburgh, Scotland, United Kingdom

Exploring integration pathways

This keynote presentation will outline the ‘Indicators of Integration’ framework, developed by Dr Strang and colleagues through UK Home Office funded research exploring a wide range of theoretical, practice and grassroots perspectives. The indicators of integration identified include: markers and means (employment, housing, education, health); social connections (social bridges, social bonds, social links); facilitators (language and cultural knowledge, and safety and stability); and foundation (rights and citizenship). This framework is now being used to support policy development in a number of different countries. Alison will explore some of the strategies employed in Scotland to assist people from refugee backgrounds integrate into Scottish society during the asylum seeking process and upon being granted protection. She will report on the Holistic Integration Service a partnership of organisations supporting new refugees led by the Scottish Refugee Council. Using data from the service she will share insights into the impact of access to rights such as welfare benefits and housing on refugees’ integration experiences, and examine the centrality of the personal connections made between people. Finally Alison will explain the development of the ‘New Scots: Integrating Refugees in Scotland’s Communities’ strategy for refugee integration in Scotland which she has chaired since its inception in 2012. The strategy, structured according to the indicators of integration framework, is led by a core group steered by Scottish Government, local government and Scottish Refugee Council, comprising representatives from refugee community groups and key stakeholders from each sector. The partnership is built on the understanding that integration is “… a two-way process that involves positive change in both the individuals and the host communities and which leads to cohesive, multi-cultural communities” and benefits from a close interdependent relationship between policy, practice and research.

Recorded lecture published in the Psychevisual journal