Young refugees living in South Australia: an exploratory study of help-seeeking for psychosocial problems
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Date
2010
Authors
de Anstiss, Helena
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Abstract
Australia has welcomed in excess of 700,000 refugees and people in refugee-like circumstances since the end of the Second World War. Provisions are in place for 13,500 more to be added to this number each year. Children and adolescents have accounted for approximately 40.0% of Australia's humanitarian intake at any given point in time but in recent years this figure has climbed to 58.0%. Current knowledge suggests that a significant minority of these young arrivals may be at increased risk of a range of social, behavioural, and mental health problems resulting from multiple stressful experiences before, during, and after migration. A seeming consensus has emerged in Australia and other Western resettlement countries that most refugee children and adolescents with mental health problems are not accessing mental health care, although there is very little empirical research to document it. The large and diverse bodies of literature on refugee child and adolescent mental health have not been matched by a commensurate interest in help-seeking and service utilisation. Most service utilisation research has centred on Western, and to a lesser extent, ethnic minority adult populations, neglecting both children and adolescents. Moreover, most studies focus on specialist mental health services and neglect the full range of service sectors and settings where mental health care is provided. In the absence of data for all sectors, it is not possible to accurately determine service utilisation estimates and patterns, particularly for children who are known to access mental health care across a range of sectors. An emerging child and adolescent help-seeking literature consistently reports widespread underutilisation of mental health services by children in the general population. A smaller literature suggests a similar trend for ethnic minority children and adolescents. While these findings may be applicable to refugees, it cannot be assumed. The unique characteristics of
the population group require targeted research. The present study investigated the nature and scope of help-seeking and service utilisation among refugee children and adolescents from the former Republics of Yugoslavia, the Middle East, South Asia, and Northern and Western Africa. The study was an exploratory and descriptive (without a priori hypotheses) mixed methods investigation. A cross-sectional questionnaire was used to assess help-seeking and service utilisation estimates and patterns, and focus groups were used to provide context-rich data on a range of issues relevant to help-seeking and service utilisation. In total, 447 parents of children aged 4-17 years and 152 adolescents aged 13-17 years completed the questionnaire. A further 85 adolescents aged 13-17 years participated in one of 12 focus group discussions. Of the 7.3% of children and adolescents found to have a mental health care need, 75.9% did not access any services, whether in the specialist mental health care sector or in any other sector where mental health care is provided. Moreover, 74.2% did not access any informal help either. The service utilisation findings were both supported and explained by the focus group participants. The adolescents across and within ethnic and gender groups consistently reported that they did not, and would not, venture beyond their close friendship networks for professional help with their problems even if the problem was very troubling or distressing. Reasons include low priority placed on psychological issues; poor mental health and service knowledge; general distrust of helping professionals and agencies; individual and network induced stigma associated with mental health problems and help-seeking; various social and cultural factors affecting how problems are understood, whether help is sought, and from where; and for males, conformity to masculine behavioural norms that discourage the expression of emotional and personal problems. Refugee child and
adolescent access to mental health care can be improved if the mental health care system is willing to make the necessary changes and adjustments to accommodate the needs of refugee families. Strategies are required at both the policy and service delivery levels. At the policy level, there needs to be refugee-specific mental health policy and planning; more integrated, multi-sectoral, multi-agency mental health promotion, early intervention, and prevention programs; a modification of ethnic-specific services to take in the special needs of children and adolescents; and a greater commitment to improving system, organisational, and worker cultural competence and capacity. At the service delivery level, there needs to be improved service promotion; planned regular community outreach; targeted education campaigns to raise community awareness of mental health issues and the services available; a greater commitment to including refugees in service planning and development; school and community-based programs
School/Discipline
University of South Australia School of Health Sciences
School of Health Sciences
School of Health Sciences
Dissertation Note
Thesis (PhD)--University of South Australia, 2010
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Copyright 2009 Helena de Anstiss
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EN-AUS
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