Refugees In Australia Research Articles

A qualitative study of negative sociocultural experiences of accessing primary health care services among Africans from refugee backgrounds in Australia: implications for organisational health literacy

BackgroundPrimary health care is the first point of contact for patients from refugee backgrounds in the Australian health system. Sociocultural factors, including beliefs and value systems, are salient determinants of health literacy and access to primary health care services. Although African refugees in Australia have diverse sociocultural backgrounds, little is known about the influence of sociocultural factors on their experiences of accessing primary health care services. Guided by the theoretical framework of access to health care, this study examined from the perspective of African refugees how culturally and religiously conditioned, constructed and bound health beliefs, knowledge and practices influence their experiences of access to, acceptance and use of primary health care services and information in Australia.MethodsThis exploratory, qualitative study involved 19 African refugees from nine countries living in New South Wales, Australia. Semi-structured interviews were conducted and recorded using Zoom software. The interviews were transcribed verbatim and analysed using a bottom-up thematic analytical approach for theme generation.ResultsFour main themes were identified. The themes included: participants' experiences of services as inaccessible and monocultural and providing information in a culturally unsafe and insensitive manner; the impact of the clinical care environment; meeting expectations and needs; and overcoming access challenges and reclaiming power and autonomy through familiar means. The findings generally support four dimensions in the access to health care framework, including approachability, acceptability, availability and accommodation and appropriateness.ConclusionAfrican refugees experience significant social and cultural challenges in accessing primary health care services. These challenges could be due to a lack of literacy on the part of health services and their providers in servicing the needs of African refugees. This is an important finding that needs to be addressed by the Australian health care system and services. Enhancing organisational health literacy through evidence-informed strategies in primary health systems and services can help reduce disparities in health access and outcomes that may be exacerbated by cultural, linguistic and religious differences.

Understanding key priority areas of mental health among queer asylum seekers and refugees in Australia through the lens of structural violence: A modified Delphi method study

Abstract Queer asylum seekers and refugees (QASaR) are more likely to have poor mental health compared to non-QASaR. This paper examines key priority areas for refugee services to improve mental health outcomes of QASaR in Australia. The key priority areas were identified through a modified Delphi method (DM), comprised of two stages: a scoping review of literature and three rounds of consensus building process. In the second stage, twenty-one participants were involved, including QASaR, health/social care professionals, and people in policy/funding-related roles. Drawing on Farmer’s understanding of structural violence, our consensus suggests QASaR’s poor mental health is primarily produced by the asylum system, further exacerbated by the lack of safe queer-inclusive refugee services, and can be improved by supporting QASaR-led organizations. Greater investments in QASaR-led organizations and initiatives are needed to improve cultural safety of refugee services and achieve systemic change.

(Re)countering multilingualism and refugee-background students in Australian compulsory education

Compared with nations around the world, Australia has one of the highest rates of refugee resettlement per capita. Approximately 40 per cent of newly arrived refugees in Australia in 2018–19 were under the age of 18 and close to 90 per cent spoke a language other than English. Given that education is compulsory until the age of 16 in most states and territories of Australia, young people labelled as refugee-background students (RBSs) are tasked with navigating the English-only education system, in which their multilingualism is often viewed as a barrier; however, there are increasing calls for research to focus on the positive, affirmative practices of RBSs through a strengths-based approach in education, to counter a ‘damage-centred’ and deficit discourse. Thus, this article presents a systematic literature review of studies conducted in Australia with RBSs between 2010 and 2022. Specifically, this review explores the strengths-based multilingual practices of RBSs in compulsory education in Australia. Inspired by RefugeeCrit theory, we seek to highlight strengths-based examples of RBSs multilingual practices as examples of counter-narratives to the prevailing deficit discourse, while remaining attentive to issues of trauma, agency and multilingualism.

Examining the clinical validity of the global psychotrauma screen in refugees.

The Global Psychotrauma Screen (GPS) is a brief transdiagnostic screener that covers a broad range of trauma-related disorders as well as risk factors known to influence the course of symptoms. We analyzed data from African war refugees in Australia (n = 70), including the GPS, the Structured Clinical Interview for DSM-5 Disorders (SCID-5), the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and the Brief Resilience Scale (BRS). Using the Youden's J Index to examine the clinical validity of the GPS subscales measuring PTSD, dissociation, depression, and generalized anxiety disorder (GAD), we found that a PTSD subscale score of 3 or higher, and a depression and dissociation subscale score of 1 or higher, was optimally efficient for detecting a probable diagnosis (Youden's J = 0.76, J = 0.72, and J = 0.90, respectively) with high sensitivity and specificity. We were unable to test the GPS clinical validity for GAD due to the low GAD occurrence. The GPS resilience item was not related to the total score (r = 0.02), indicating low convergent validity for resilience. Risk factors, including current stressors and childhood trauma history, were related to more severe GPS symptom scores, while lack of resilience, social support, and history of mental illness were not. We conclude that the GPS may be a useful screening tool for PTSD, depression, and the dissociative subtype in refugees.

‘Life would have been harder, harder and more in chaos, if there wasn’t internet’: digital inclusion among newly arrived refugees in Australia during the COVID-19 pandemic

ABSTRACT Digital technologies are transforming almost every aspect of people’s lives, with COVID-19 accelerating this transition. For refugees, access and familiarity with these technologies is critical to wider aims of social integration. This article explores digital inclusion during the COVID-19 pandemic, using data from studies conducted in 2020 and 2021 with refugees recently resettled in Australia. Inclusion was mapped against three domains – access, affordability, and literacy – from the annual Australian Digital Inclusion Index. Our study found that many respondents reported comparatively high digital inclusion. However, certain characteristics, such as gender, age, presence of children and country of birth, correlated with lower levels of inclusion within some refugee sub-groups. Our research makes three contributions: it examines levels of digital inclusion among recently arrived refugees during COVID-19; it explores how these levels relate to social links and bonds; and it discusses sample differences according to gender, age, language group and type of digital inclusion.

Improving rates of immunisation in refugee populations in Australia.

Despite an established humanitarian program running for many years, the health needs of refugees resettled in Australia, particularly immunisation, have not been met adequately. Under-immunisation is one of the top health issues for this population. While there is no population-level immunisation coverage data, seroprevalence studies based on small cohorts of refugees show suboptimal immunity to various vaccine-preventable diseases and lower vaccine coverage for this group than the general population. This is compounded by gaps in immunisation policy and service delivery that further perpetuate access issues and may contribute to under-immunisation. This is particularly pertinent against the backdrop of the coronavirus disease 2019 (COVID-19) pandemic, where there have been significant disruptions in the delivery of routine and catch-up immunisations. This paper briefly analyses the status quo and draws on the key policy considerations for enhancing the equitable provision of immunisation for refugees as recommended by the 2019 World Health Organisation technical guidance report to provide a clear, overarching direction for empirical work on immunisation service delivery for refugees in Australia.

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Refugee livelihood perspectives: Post-traumatic growth in histories of Vietnamese, Bosnian, and Tamil Refugees in Australia

Abstract Refugee livelihood studies have mostly focused on policy and international aid programming and have yet to explore refugee people’s long-term development beyond the initial resettlement period. This article examines the experiences of Vietnamese, Bosnian, and Tamil refugees resettled in Australia during the height of the multicultural agenda in the 1980s and 1990s. Drawing on fifty oral histories, the article argues that refugees’ struggle and transformation of trauma in the past fuelled civic engagement in their new host communities. It explores the nexus of refugee lived experiences, livelihoods, and post-traumatic growth in the context of multicultural Australia to consider refugee livelihood as a long-term process. Crossing disciplinary boundaries of history and psychology, the article shows how some refugees re-interpret their trauma as motivation for positive change, a manifestation of post-traumatic growth, expressed as civic engagement, including becoming political actors in response to their histories of trauma, resistance, and growth beyond resettlement.

Views and experiences of young women from a migrant or refugee background regarding the contraceptive implant in Australia

Young people comprise a significant proportion of migrants and refugees in Australia. Many encounter challenges in accessing contraception information and services. This study explored the views and experiences of young women from migrant and/or refugee backgrounds regarding the contraceptive implant and related decision-making. Interviews were conducted with 33 women, aged 15–24, living in New South Wales, Australia, who spoke a language other than English and had some experience of the implant. Three themes were developed from the data as follows: ‘Finding your own path’: contraception decision-making (in which participants described sex and contraception as being taboo in their community, yet still made independent contraceptive choices); Accessing ‘trustworthy’ contraception information and navigating services (in which participants consulted online resources and social media for contraception information, and preferred discussions with healthcare providers from outside their community); and Views and experiences of the contraceptive implant (while the implant was described as a ‘Western’ method, most participants regarded it as an acceptable, convenient, cost-effective, and confidential means of contraception). Decision-making regarding the implant is influenced by many factors which must be considered in health promotion efforts and when providing clinical care. Consideration of more informative health promotion resources, peer education strategies, and healthcare provider training is warranted to support contraception decision-making and choice.

“I didn’t want to leave my country” – mental health services as experienced by Bosnian refugees in Australia

PurposeDespite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental health services, there is a lack of in-depth studies specifically focusing on Bosnian refugees in Australia – one of the largest ethnic groups of displaced peoples. This qualitative investigation seeks to convey the experiences of mental health services by five Bosnian refugees in Melbourne, highlighting perceived pathways and barriers to service utilisation. This study aims to address two primary research questions: firstly, what characterises the experiences of Bosnian refugees in Australia when accessing mental health services? Secondly, what are the main barriers encountered by this population when seeking mental health services?Design/methodology/approachThis study used qualitative inquiry and in-depth interviews to investigate the experiences of Bosnian refugees with mental health services in Australia. Data was collected through face-to-face interviews with five Melbourne-based Bosnian refugees who had previously accessed mental health services. Participants were recruited from community groups or associations using purposive sampling. Thematic analysis was used.FindingsKey themes were revealed, such as the crucial role of social and community services, preferences for individual vs group therapy, potential re-traumatisation from therapeutic engagement, distrust of government-run mental health services and concerns regarding psychopharmaceutical prescription practices. Addressing barriers to mental health service access necessitates a multifaceted approach, including flexible social and community service support, an increased number of co-ethnic professionals and a recognition of cultural variations for effective service provision. Implementing these strategies can enhance help-seeking behaviours, provide culturally appropriate mental health services and improve the experiences of Bosnian refugees in Australia.Originality/valueTo the best of the authors’ knowledge, this study is the first to qualitatively explore how Bosnian refugees in Melbourne perceived the adequacy and availability of mental health services upon arrival to Australia. They are a large and potentially vulnerable community, due to experiences of war trauma and dislocation from country of origin. A lack of understanding regarding how this cohort engage with mental health services can lead to persistent inequities and ineffective service provision. This study identifies unique experiences and perspectives of Bosnian refugee participants, including distrust of government-run mental health services, and concerns regarding psychopharmaceutical prescription practices. This research is expected to contribute positively to the discourse on mental health service provision for Bosnian refugees and wider refugee communities in Australia.

Denial from the other side: Experiences of racism as narrated by South Sudanese refugees in Australia

This paper discusses experiences of everyday racism as narrated by South Sudanese refugee-background informants living in Australia. The paper draws on accounts of verbal and physical attacks reported during a sociolinguistic interview about the refugee experience and adaptation to the Australian lifestyle. The study contributes to the exploration of features of refugee narratives, using the socio-interactional approach to narrative analysis. Selected stories about racism are explored using positioning theory, paying attention to the discursive strategies narrators use to position themselves in the interactional world of the interview setting as well as the story-world. Their narratives demonstrate that despite the harsh experiences of everyday racism, they position themselves as resilient and strong individuals. They do this by drawing on their refugee history and making references to harder times. However, the stories also reveal their mitigation strategies to soften the accounts and either downplay or deny racism. However, by sharing their stories and making explicit evaluative statements about social injustice, they mobilise their agency to make their story heard.

Self-compassion and self-coldness and their relationship with psychological distress and subjective well-being among community-based Hazaras in Australia.

Hazaras are a newly emerging community in Australia and limited research has explored their mental health. The first aim of this study was to explore levels of psychological distress and subjective well-being reported by Hazaras in Australia, and whether scores on psychosocial variables (self-compassion, self-coldness, acculturation, resilience, spirituality), psychological distress and domains of subjective well-being differed by sociodemographic groups. The second aim had two parts: (a) to examine bivariate relationships between the psychosocial variables, psychological distress and subjective well-being; and (b) to examine whether the psychosocial predictor variables independently contributed to subjective well-being and psychological distress when controlling for sociodemographic characteristics. Seventy-two Hazaras (58 men and 14 women), with a mean age of 28.82 years (SD = 8.84) and average length of time residing in Australia of 10.17 years (SD = 4.11), completed an online survey. There were sociodemographic differences in relation to key variables of interest; for example, participants who did not have family members in Australia reported lower levels of global life satisfaction. Moderate negative relationships were found between self-compassion and psychological distress and between self-coldness and subjective well-being. Self-coldness, self-compassion, resilience and acculturation contributed uniquely to psychological distress and subjective well-being when controlling for sociodemographic variables. Although migration programmes that provide permanent residency and allow family members to join refugees in Australia are limited, they appear important. Many of the difficulties facing Hazaras are ongoing, external and beyond their control (e.g. visa status); however, there is a possibility that self-compassion can play a role as a protective factor.

Living at the Fence – Navigating Complexities While Settling in New Country: Lived Experiences of South Sudanese Refugees in Australia

ABSTRACT Australia welcomes significant numbers of humanitarian arrivals every year. Over 24,000 South Sudanese have come to Australia in the last two decades, and most faced difficulties during the settlement process. The aim of this study was to understand the barriers and challenges that have impacts on settlement and integration experiences among South Sudanese refugees in Australia. Further, this explored the factors influencing the social and cultural integration of South Sudanese refugees living in Australia for more than five years. This study used a phenomenological approach with purposive and snowball sampling to recruit 26 participants who self-identified as South Sudanese refugees. Participants were recruited via community networks and were invited to participate in a semi-structured interview. The interviews were conducted by a bilingual interviewer and were analysed thematically. Participants’ experiences portrayed the complexities of integrating into a new society and experienced multiple challenges and barriers. Despite this identity dilemma, they showed a consensus about the experiences of coming to and living in Australia with close association with a group identity. While there are positive elements of the integration experience, inter-generational conflicts require further investigation. Government and settlement organisations need to make an effort to understand the context while developing appropriate processes.

Age at arrival and integration outcomes of refugee youth and emerging adults: a longitudinal study.

Age at arrival is one factor that could influence the integration of humanitarian migrants, especially for children and teenagers. Previous research has focused on the influence of the age at arrival on education, employment, social and language learning outcomes, but there is limited research, especially for longitudinal study, on other important measures of integration. Moreover, young adult and adolescent refugees, and the relationship between age and integration outcomes are under-studied. To address these gaps, this study examined the relationships between age at arrival and different dimensions of integration of young refugees in Australia, using five years' panel data from the Building a New Life in Australia (BNLA) longitudinal study from 2013 to 2018 (282 individuals). Our findings indicate that age at arrival is significantly correlated with multiple integration outcomes. Old entrants tend to have a higher probability of having a paid job but have poorer mental health and English proficiency. On the other hand, older entrants were more likely to know their rights well compared to younger entrants at arrival. However, younger entrants' knowledge of their rights overtook older entrants four to five years after their arrival. These findings suggest that a shorter assessment process and enabling earlier entry especially among refugee youth and young adults could effectively improve their future settlement outcomes under the current humanitarian policies and system.

Providing permanent protection to refugees in Australia: Real change or window dressing?

This article argues that the recent changes to Australia’s rolling temporary protection regime do not mark a shift away from Australia’s flawed and unjust asylum system for two key reasons. First, the government did not repeal the temporary protection regime nor the fast track process. Secondly, the changes mobilise and perpetuate the inherent hostility of Australia’s asylum seeker policies targeting ‘irregular arrivals’. This article offers a critical analysis of the design and operation of Australia’s asylum system, as well as an examination of the 2023 changes and the political and journalistic discourse surrounding their announcement.

“We Were Already in Lockdown”: Exploring the Impact of the COVID-19 Pandemic on Asylum Seekers and Refugees in Australia—Mental Health, Social Isolation, Abandonment, and Financial Precarity

“We Were Already in Lockdown”: Exploring the Impact of the COVID-19 Pandemic on Asylum Seekers and Refugees in Australia—Mental Health, Social Isolation, Abandonment, and Financial Precarity

Designing an online educational program to improve immunisation service delivery for migrants and refugees in Australia and New Zealand

Migrants and refugees are likely to be under-immunised according to the host country's national immunisation schedule and may remain under-immunised post-resettlement for various reasons. In Australia and Aotearoa New Zealand, primary health care professionals including general practitioners and nurses provide the majority of routine and catch-up immunisations for migrants and refugees. However, immunisation service delivery for migrants and refugees is complex, with evidence that unmet training needs for immunisation providers, particularly in the development of catch-up plans, is a significant barrier to immunisation service delivery for this group. Targeted professional development opportunities for immunisation providers are essential to improve their awareness, confidence, and capability to improve immunisation service delivery for migrants and refugees. We developed an educational program to support learning for immunisation providers and equip them with the requisite knowledge and confidence to improve immunisation service delivery for refugees and migrants. The development of the multi-module online educational program drew on evidence-based web design principles, adult learning theories, and its content aimed to complement general immunisation training and align with the continuing professional development standards of Australian and New Zealand general practice and nursing colleges. Input from experts and feedback from a few selected providers in Australia and New Zealand added to the robustness of the program. This program has the potential to improve the understanding and capacity of immunisation providers, to improve vaccination experiences and increase overall vaccine uptake among migrants and refugees.

Understandings and applications of self-compassion and self-coldness among Hazaras in Australia: a qualitative study

ABSTRACT Objective Emerging research suggests that self-compassion and self-coldness are involved in the treatment of psychological difficulties among refugees and asylum seekers. Self-compassion involves treating oneself with warmth and care and self-coldness involves treating oneself with harsh judgement. We aimed to explore the unique understandings and applications of self-compassion and self-coldness among Hazara asylum seekers and refugees in Australia. Method Eleven Hazaras (ninemen and two women) who were seeking asylum or had a refugee background were interviewed about their understandings and applications of self-compassion and self-coldness. Transcripts of interview recordings were analysed using reflexive thematic analysis. Results Participants reported wide variation in their understandings and applications of self-compassion and self-coldness. Participants broadly reported difficulties turning inwards with self-compassion. Participants also tended to place the needs of others before their own because of their histories and community/cultural ideas about self-compassion, such as self-compassion being selfish or justified only if in service of others. Experiencing significant external stressors, such as long standing family separation and visa insecurity, were also barriers to contacting private experiences. Conclusions The current study identified several important barriers among the Hazara community in applying self-compassion. Descriptive terms for self-compassion and self-coldness are also provided by the community and might inform clinical approaches.

In from the Periphery: Becoming (G)locally Cosmopolitan in Springvale

How might notions of what is cosmopolitan be geographically reinterpreted through the diverse settlement of recent migrants and refugees in Australia? This article brings this question to bear on Springvale, a suburb in the Australian city of Melbourne, discussing the area’s geographical circulation of people, businesses and products as a means of understanding the interstices between marginalised cultures or traditions and the role of architecture and the built environment in this context. Discussion of these questions involves the description of the physical and spatial environment of Springvale, concentrating on its commercial and industrial centres. In part, this illustrates the marginalisation of certain buildings and uses, but also how the process of establishing new kinds of activity and identity alters the nature of environments. The result is that these perceptually and geographically peripheral zones are paradoxically becoming centres in a diversifying metropolis, affording new nodes of usage and inhabitation that are arguably becoming sites of “local cosmopolitanism.”

Understanding the effects of being separated from family on refugees in Australia: a qualitative study

ObjectiveTo understand the impact of family separation on refugees living in Australia. MethodThirteen participants with a refugee background and experiencing separation from family participated in a semi‐structured qualitative interview. Interviews were coded and a thematic analysis was conducted using NVivo software. ResultsIdentified themes were organised under four domains. Domain 1 focused on the personal impact of family separation. Themes were the effects on mental health and functioning, driven by incessant worrying about the safety of family and the absence of key attachment figures, the specific effects of having missing family, alterations to self‐identity and family dynamics. Domain 2 focused on themes relating to actions taken to find missing family, connect or reunite with separated family. Domain 3 highlighted the coping strategies, support mechanisms and protective factors used by participants. Domain 4 identified core beliefs about the importance of family unity, focusing on security, settlement and a happy future. ConclusionsFamily separation has an enduring effect on the wellbeing of refugees, with key pathways being ongoing fear and insecurity, disrupted social attachments and identity shifts in relation to the future self. Implications for public healthRefugees separated from or missing family struggle with ongoing stress and adjustment issues.