The terms ‘migrant’ and’ refugee’ are sometimes used interchangeably, but they have very different meanings. Migrants are people who have chosen to pursue life in another country. Refugees have left their country to escape war, persecution, or a natural disaster. Recognise the unique journey of each family to allow you to understand what support they need.
Read further about cultural diversity in Australia at the Australian Human Rights Commission page - Face the facts: Cultural diversity.
Also, refer to Practice Guide Working with people from Culturally and Linguistically Diverse backgrounds.
Mental health issues in migrant and refugee families
It can be difficult for migrant and refugee families to settle into life in Australia. It is important to consider some of the challenges the family may be facing, and how this may be contributing to the mental health issues present.
Research indicates there are several factors associated with increased risk of mental health disorders for migrant families include:
- limited English proficiency
- separated cultural identity
- loss of close family ties
- lack of opportunity to make use of occupational skills/educational attainment
- pre-migration trauma exposure
- stress associated with migration and adjustment to a new country
- experiences of racism.
Additional factors contributing to increased risk of mental health disorders for refugee families include:
- long-term detention
- temporary protection
- restriction of access to services
- human rights violations
- fear of family remaining in country of origin.
Protective factors for migrant families include:
- religious beliefs and observance
- better English proficiency
- younger age at migration
- a higher sense of personal control
- stronger social support
- higher self-efficacy.
Additional protective factors for refugee families include:
- a sense of belonging to family and community
- perceived social support.
(Minas, et al., 2013.)
The experience of refugee children and families prior to settlement in Australia
Refugee children and families have fled their home and country often when violence or a war has broken out. Some experiences prior to leaving their country include:
- violence to themselves and others around them
- witnessing killing, rapes and other assaults on family and others around them
- living in constant fear
- separations from family members.
After leaving their country, families often then spend time in temporary accommodation, such as refugee camps for lengthy periods of time, sometimes years. Some experiences in camps include:
- inadequate accommodation
- food shortages
- rape and physical violence
- parents struggling to parent their children
- separations from family members
- ongoing uncertainty.
(The Trauma and Grief Network, n.d.Tip Sheet: Refugees and asylum seekers: Supporting recovery from trauma).
More than one-third of the world's 19.9 million refugees live in refugee camps, often without adequate food or services. The conditions vary from camp to camp, as do the chances of families returning to their homes or being resettled in countries like Australia. From the world's largest refugee camp in Kenya to Za'atari in Jordan, which struggles to house tens of thousands of refugees fleeing Syria, life inside the camps is something alien to most Australians.
Trauma in refugee families
The experiences of refugee children and their families can have deep and long-term impacts. Refugees are at higher risk of mental health issues and psychological distress as a direct result of the adversity they have experienced.
Be aware though that what one person may experience as traumatic, another may not. Avoid making assumptions that a child or adult has 'trauma' or label them as 'traumatised' based on their exposure to horrific events. Each person will have a unique response based on the type and severity of the experience, age, gender, resilience, mental health, and support. Talk to each child and adult to understand how their responses.
Signs someone is impacted by trauma include:
- injuries, illnesses, chronic pain
- anxiety, sadness, fear, anger, irritability, guilt, shame
- intrusive thoughts, flashbacks, nightmares, trouble sleeping, memory and concentration problems
- changed sense of self, beliefs, loss of trust, disempowerment, loss of self-esteem
- difficulties with personal relationships, social withdrawal.
Read the Working with Refugees Social Worker Guide for more information on working with people who are refugees.
Trauma responses in refugee children and young people
As outlined in this tip sheet from the Trauma and Grief Network, ‘Refugees and asylum seekers: Supporting recovery from trauma’, these difficulties may present in young children:
- separation anxiety — wanting to be close to family members all the time
- not being able to sleep alone
- crying, tantrums and demanding behaviour
- difficulty in forming friendships and social relationships with others
- developmental difficulties — the child may have not been able to receive the developmental opportunities needed for normal development.
Some responses from older children and adolescents include:
- feelings of responsibility in caring for or looking after other people in the family
- difficulties in making and maintaining friendships
- academic difficulties due to little schooling and also due to the impact of prolonged exposure to trauma and adversity
- missing school due to wanting to stay close to family, not feeling safe in their new environment
- isolation from peers
- acting out behaviours resulting from stress, feelings of powerlessness and overwhelming memories and emotions
- family conflict due to the pressure to adapt to the new culture and its conflict with the culture of the family
- depression and anxiety
- self-harm or suicidal behaviours — young people in refugee communities are at higher risk than their peers from non-refugee backgrounds.
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