by Professor Suresh Sundram, Director of Research, Cabrini Asylum Seeker and Refugee Health Program
Why we exist
The Cabrini Asylum Seeker and Refugee Health Hub in Melbourne, Australia was established in 2016 to serve asylum seekers and new refugees in Melbourne and regional Victoria.
Although there are important paid roles within the Hub, it is reliant on the pro bono contributions of numerous health workers. The Hub is essential because the people that it serves are primarily people who are not provided access to the Federally funded healthcare system. Many of these asylum seekers are also not permitted to work and are therefore reliant on charity. It then becomes a forced financial choice for what is prioritised where food and shelter often override health needs. Moreover, the lack of work – intensified by the Covid 19 economic slowdown – exacerbates housing insecurity leaving many asylum seekers in transient accommodation complicating the provision of longitudinal care.
The Essentiality of Mental Health Services Especially During This Time of a Pandemic
The public health measures imposed because of the pandemic have caused many of us much strain and difficulty. The marginalisation of asylum seekers within the community through their enforced disconnection from mainstream modes such as employment, housing and welfare support has caused even greater hardship for this group. The isolation and loneliness from their alienation compounded by enforced lockdowns has further corroded their resilience exacerbating distress and mental illness.
The Hub has worked tirelessly to provide treatment, care and support for the physical and mental health care needs of those most adversely affected. In parallel we have been trying to understand how these new social factors interact with the lived experience of trauma that most asylum seekers and refugees bring with them from their home countries and migration journeys. Many fail to recognise or try to ignore the impacts of these stressors on their health and functioning and it is all too easy for workers to miss subtle signs of distress or mental illness.
The Future of Our Work
We developed a simple tool, the STAR-MH, for all workers regardless of training to complete with their adult asylum seeker or refugee client that will indicate the likelihood of a serious mental health issue that requires further clinical evaluation. It has been very positively received globally and we are now trying to secure funding to complete adolescent and child versions of the tool.
In understanding the complexity and nuance of how past and current experiences weave to create resilience and vulnerability to mental health and illness we hope to be able to characterise specific windows where targeting interventions will be most effective. By moving beyond generic and unsophisticated conceptions of how trauma and social factors impact on mental health to more nuanced and subtle understandings, we can develop and customise treatments for asylum seekers and refugees to improve mental health. Most importantly it will allow us to identify at-risk children and adolescents before they become unwell and ultimately prevent illness.
Called to be Human and Humanising, Bearing Witness Brings Healing
In treating and trying to understand asylum seekers and refugees, one of our most critical roles is to bear witness to their experiences, past and current. This validation, at the core of all healing, is maybe most apposite in the context of what many asylum seekers and refugees are experiencing in host societies where they are ostracised, excluded and rejected. We hope to provide an alternate experience through our work. A contemporary expression of our Cabrinian heritage.
Originally published on Cabrini World: https://www.cabriniworld.org/cabrini-asylum-seeker-and-refugee-health-program/