Experiences of mental health services: Reflections of young clients with refugee backgrounds

Experiences of mental health services: Reflections of young clients with refugee backgrounds

15 April 2015
Experiences of mental health services: Reflections of young clients with refugee backgrounds

Recent research undertaken by Foundation House asked young people from refugee backgrounds about their experiences of mental health services.

This article is part of a series of resources being released during our Focus on... Working with culturally and linguistically diverse (CALD) adolescents.

It can be challenging for anyone to attend a mental health service.

But for a young person who has fled a war-torn homeland, is currently learning the language, culture and systems of a very different country, and who is anxious about what their family and friends will think of him or her for attending a mental health service – it can be a very difficult experience indeed.

The stigma around mental health problems is often greater within refugee communities, with a common perception being that only those who are seriously disturbed or “crazy” use mental health services.

These are some of the barriers that young people from refugee backgrounds face in accessing and using mental health services. For the small number of this population who do access these services, no previous research has explored their experiences.

In order to address this need, we conducted in-depth interviews with 16 young people (aged 18-25) who were refugees. We asked them a range of questions about being clients of Australian mental health services.

The young people we interviewed were born in Iraq, Iran, Afghanistan, Sudan, Democratic Republic of Congo, Ethiopia, Tanzania, Côte d'Ivoire and Pakistan. They had lived in Australia for an average of 5.2 years, and had seen mental health professionals in a range of private, public, non-profit and education-based services.

The following themes were particularly important to the young people interviewed:

  • Sociocultural influences on service utilisation. The young people wanted practitioners to understand that they and their communities commonly hold negative preconceptions about mental health services, and the professionals and clients within these services. They wanted efforts to be made to raise awareness about mental health among young refugees.
  • Accessible and responsive services. The way that services were structured and resourced really mattered to the interviewees. They criticised waitlists, narrow eligibility criteria and continuity of care issues; they praised welcoming services that could provide a dedicated practitioner for the number of sessions needed, as well as outreach and skilled interpreters.
  • A nuanced approach to cultural sensitivity. The interviewees wanted professionals to practice cultural competence, and in such a way that avoids group-based generalisations and assumptions. They wanted to be seen as individuals who were changing over time, and who were affected by multiple, dynamic sociocultural influences.
  • Recognise the impact of psychosocial and trauma-related stressors. It was important for practitioners to be mindful of how the young person had been affected by their journey as a refugee, both prior to and after arrival in Australia. For some young people, it was therapeutic to talk through the details, while respecting their preferred pace of disclosure.
  • Appropriate treatment strategies. The interviewees wanted professionals to be flexible and aware that their standard approaches might need modifying, and to offer approaches that make sense in relation to the young person’s ideas about the sources of their distress. This could include professionals being open to hearing about and addressing practical problems, either directly or by referral.
  • An attuned therapeutic relationship. The young people valued caring connections characterised by warmth, trust, a sense of recognition and responsiveness. They spoke at length about how the quality of listening mattered to them.

The study implications for practitioners are outlined in a guide available on the Foundation House website.

This study was funded by the Sidney Myer Fund and the William Buckland Foundation

Further reading and resources

The feature image is by David Wise, CC BY-NC 2.0.

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Authors

Madeleine Valibhoy

Madeleine Valibhoy is a Clinical Psychologist and carried out Project TYRES as a Research Fellow at Foundation House (Victorian Foundation for Survivors of Torture).

Josef Szwarc

Josef Szwarc is Manager of the Research and Policy Program at Foundation House (Victorian Foundation for Survivors of Torture).

Ida Kaplan

Ida Kaplan, Clinical Psychologist, is Manager of Direct Services at Foundation House (Victorian Foundation for Survivors of Torture).

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