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Refugees are known to experience high rates of mental illness whilst in detention and after settlement
The emergence of 9.9 million refugees that has been accumulated from all over the world as recorded for the year 2006 was an eye opener towards the presence of social crisis of the present day society. The United Nations 1951 Convention has developed an official definition of the term refugee that explain a refuges as “a person who is outside his/her country of nationality or habitual residence; has a well founded fear of persecution because of his/her race, religion, nationality, membership in a particular social group or political opinion; and is unable or unwilling to avail himself/herself of the protection of that country, or to return there, for fear of persecution.” Considering the Australian scenario with respect to refugee settlements it was observed that on humanitarian ground Australia sheltered more than 750,000 immigrants from all over the country since 1947. Victoria has been the home for thousands of refugees and asylum seekers in the previous thirty years of the history of Australian community. In consideration with the Humanitarian Program Victoria was been the shelter provider from 44,880 refugees who have arrived to the city for last one decade. The Family Migration Program and Skilled Migration Stream can be cited as initiatives that are in alignment with the Humanitarian Program. Hence although the country has welcomed a huge population of refugees from all over the world but a number of social and cultural aspects are found to exert an adverse affect on the overall mental health of the refugees and the asylum seekers (Kirmayer et al., 2010). The subsequent segments of this essay shall focus to understand the underlying socio-cultural factor that has been reflected in the mental health status of the refugees.
Key challenges with respect to refugee settlements
Although providing shelter to the refugees can be considered to be an ethically justified act but a number of challenges are found to surface in parallel with this issue. It is can established fact that people who has to leave the native country and had to seek for resettlement in foreign nation are exposed to a high degree of trauma and directly and adversely influence the mental health of such group of individuals. Traumatic effects including post traumatic effects of war, separation from family members, the existence of human rights abuse, journey related trauma and trauma from physical and psychological torture can be highlighted as the major challenges in this respect. Apart from this the aspects like prolonged deprivation faced by the refugees in the refugee camps with minimal access to a healthy living, presence of safe shelter, adequate drinking water, food supply and provisions for primary health care are also considered to contribute in the gradual deterioration of the mental health of the refugees. Lack of employment facilities and inadequacy with respect education of the refuges children can also be included as the major challenges with respect to the topic of discussion (Lai, 2010).
Psychological experiences of the refugees
An insight into the psychological experience that has been prominent within the refugees it has been segmented into three main types of experiences: the preflight experience, the flight experience and the resettlement experience. The presence of physical and psychological disturbances or trauma with being witnessed of criminal activities like murder and other social abuse can be included within the preflight experience of the refugees. On the contrary the flight experience and the experience of resettlement can be considered as the experience obtained from the extensive and stressful travels, undesirable event in the refugee camps. Also separation of the children from their parents, loss of culture and adaptation to a completely new environment are also included under the resettlement experience of refugees. The presence of language barrier can also be cited as one of the major resettlement experience of the refugees (Laugharne, 2012).
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The socio-cultural factors responsible for mental health deterioration of the refugees:
The clear indication of the incidents of social isolation based on racism and discrimination has been one of the major reasons behind the degrading mental health of the refugees. It is also observed that the presence of prolonged anxiety, uncertainty, safety issues and absence of family support has also exerted a gradual yet deep impact on the mental framework of the refugee population. Another aspect that should be highlighted in context of the discussion is the presence of huge cultural diversity has also influenced the mental health such group of population. As people from different countries are found to migrate to a country as accumulate as refugees huge cultural variation is observed within the refugee population. This cultural diversity has been considered to be a major setback with respect to the adjustments issues of the refugees and also directly influence their mental health. Hence cultural dislocation and lack of financial support has contributed towards the mental trauma that has subsequently affected the mental status of the refugees (Newman, 2011). Exploring the psychological impacts of the refugees clear indication of trauma related syndromes inclusive of distress, avoidance, persistent feeling of sadness, loneliness, emotional numbing, hyper arousal, presence of intrusive thoughts are clearly evident.
Studies have also supported the presence of a connection between pre migration trauma and mental health in resettlement with respect to the mental setup of the refugees. Often the incidents of forced migration are also considered as a causal factor that affected the mental health of the refugees and asylum seekers. The prevalence of Posttraumatic Stress Disorder or PTSD along with feeling of depression, guilt and anger are also observed among the mentally unbalanced refugee population. About 10-40% of the refugees are found to reflect the symptoms of PTSD while 50-90% of the children and adolescent population are found to become susceptible towards this particular mental syndrome. The post displacement factors particularly social isolation, identity crisis due to absence of employment and financial support, presence of inadequate justice towards the refugees can be enlisted as the other social factors contributing to the deteriorated mental health situation of the refugees. However the issue of interaction with the near environment and adjustments to a new geographical location along with cultural relocation has also been pivotal socio-cultural factors in this respect. The presence of ethnic minority groups within the refugee population can also be highlighted with respect to the topic of discussion. Hence with reference to the social model of ‘Acculturation’ the ethnic minority groups are considered as an isolated group from the larger community (Straiton, Reneflot and Diaz, 2014).
Apart from the above mentioned factors that are considered as the prime causal factors in degrading the mental health of the refugees it is also important to mention the contribution of Posttraumatic Stress Disorder towards the improper cognitive functioning of the refugees. Additionally the present of physical injuries like brain injury, malnutrition, psychological distress particularly depression has resulted in the occurrence of neuropsychological abnormalities adversely affecting the mental status of the refugees.
Mental health programs for the refugees
Exploring the present scenario of Australia with respect to the mental health improvements of the refuges the care services are delivered under the initiative of the governing body of Australia whereby such services are provided by the Adult Multicultural Education Services or AMES, the Red Cross and Life without Barriers and the AMES Humanitarian Settlement Services Consortium. Hence in order to improve the overall mental health of the refugees the Governing body of Victoria has emphasized on implementation of specialist clinical mental health services with a community based support service. The facilities for counseling the survivors of trauma under the administration of the Victorian Foundation for Survivors of Torture can be cited in this regard (Rees et al., 2013). This particular organization also known as the Foundation House has provided specialized counseling services to the refugees who have become the victims of trauma and torture. The state governing body of Victoria, the Commonwealth Government and the philanthropic trust organizations are the main funding source supporting the mental healthcare services that are provided by the various organizations. Apart from this the initiatives undertaken by the Refugee Health Program, Refugee Health Fellow Program and the Victorian Refuge Health Network can be put forwarded that has considerable emphasize on improving the mental health of the refugees and asylum seekers of Australia. The installation of the interpreting service in order to remove the constraints faced due to language barrier has contributed to better accessibility of the refugees. The example of ‘Health Translation website’ can be cited in this respect (Newman, 2011).
Therefore with reference to the above cited examples it is justified to mention that the Australian government has given considerable importance regarding the mental health issues of the refugees and asylum seekers whereby an initiative to deliver the optimal healthcare services to the refugees has proven to produce positive results.
To conclude it is justified to mention that the mental health of the refugees are observed to be negatively affected by a number of social and cultural factors wherein the psychological assessment of the refugees is not yet properly developed. Therefore understanding the present scenario with respect to the mental health situation of the refugees it is important to emphasis on the proper psychological; assessment. The practice of disability evaluation along with medical evaluation of the mental health status of the refugees is important to improve the overall mental health of such population. Finally it can be inferred that in order to improve the mental health situation of the refugees it is important to completely eliminate the practice of social discrimination, racism and the practice of isolation based on cultural diversity. However emphasis is required to restore the balance between the mental and physical health issues of the refugees and this can be addressed with focus on reducing the occurrence of disease along with emphasis on the health promotional activities.
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