Individuals of refugee background resettled in regional and rural Australia: A systematic review of mental health research

Hawkes, Clare; Norris, Kimberley; Joyce, Janine; Paton, Douglas

doi:10.1111/ajr.12785

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…Although a small sample, GPs' views were congruent in reporting high mental illness prevalence among their CALD communities and consistent with existing evidence among refugees/asylum seekers (Hawkes et al, 2021;Khavarpour and Rissel, 1997;Shawyer et al, 2017aShawyer et al, , 2017b. Findings are also consistent with the expected impact of environmental changes (i.e.…”

Section: Discussionsupporting

confidence: 78%

A qualitative evaluation of the questionnaire about the process of recovery (QPR) in culturally and linguistically diverse (CALD) populations

Kakuma,

Cajethan,

Shawyer

et al. 2024

IJMHSC

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Purpose Mental health recovery across cultures lacks understanding and suitable measures. The Questionnaire about the Process of Recovery (QPR) is a self-report instrument measuring personal recovery outcomes for consumers of mental health services. However, the extent of its relevance among culturally and linguistically diverse (CALD) communities is unclear. This pilot study aimed to examine the relevance and utility of the QPR among CALD consumers of primary mental health services in Australia. Design/methodology/approach Eleven individual, semi-structured interviews were conducted with two general practitioners (GPs) and nine consumers from two clinics, at locations with high Iranian and Burmese refugee or asylum seeker populations. Interviews were transcribed and analysed using a thematic framework approach. Findings Although almost all consumers had little or no understanding of the concept of personal recovery, they found the QPR culturally acceptable and understandable. Using the QPR during mental health consultations can help with needs identification and goal setting. Challenges in using the QPR included completion time, cross-cultural differences in concepts and norms for some items, and need for careful translation. Consumers suggested additional items regarding family reputation, sexuality, and spirituality. Originality/value The QPR is potentially a valuable tool to support mental health consultations with CALD consumers, from the perspectives of both GPs and consumers.

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Section: Discussionsupporting

confidence: 78%

A qualitative evaluation of the questionnaire about the process of recovery (QPR) in culturally and linguistically diverse (CALD) populations

Kakuma,

Cajethan,

Shawyer

et al. 2024

IJMHSC

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“…The barriers to effective healthcare provision facing former refugees settling in Australia have been noted in urban contexts, where the healthcare and settlement systems require adjustment to effectively address the needs of resettling refugees [59]. The few studies of these experiences in rural areas highlight additional challenges [70,71], with resettling refugees' lack of understanding of often opaque Australian systems combining with a lack of appropriate cultural and linguistic support from healthcare services and practitioners [72]. Although some healthcare workers can develop culturally sensitive approaches to providing healthcare for these populations, it takes time to develop these skills and there can be a loss of these staff due to the general challenges and turnover in these often remote locations [73].…”

Section: Rural Health and Resettlementmentioning

confidence: 99%

Social Capital and Rural Health for Refugee Communities in Australia

Mwanri

Miller

Walsh

et al. 2023

IJERPH

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Refugee resettlement significantly contributes to Australia’s migration programs, with recent policy directives prioritising rural resettlement. As a result, the cultural diversity of populations of several Australian rural towns has substantially expanded. Newcomers may encounter challenges becoming part of closed social networks and accessing the resources they need for a healthy life in resettlement. However, there are also benefits that stem from positive integration for newcomers and for receiving populations. As part of a larger study, which aimed to explore facilitators and barriers to successful resettlement in a rural setting, the objective of this paper was to show how social ties were important for participants’ health, both facilitating access to resources, including health services, and connecting people to health-promoting living conditions. In-depth individual interviews with 44 participants from refugee communities originally from Africa and South-East Asia, settled in a rural South Australian town, were conducted. Participants were invited to the study through snowball sampling via known connections between the researchers and key people within the communities. Interview transcripts were analysed using framework thematic analysis. The findings demonstrate how participants drew on connections within their cultural communities, reflecting collectivist cultural values. These social ties were key to enabling access to resources for health. These included emotional resources, such as a sense of belonging, as well as physical and practical resources, including food, housing, and/or accessing services. Several participants were also working towards a career in the health industry. Populations from refugee communities in rural towns are growing, not only with the continuation of new arrivals to these towns, but also as the settled populations expand their families and communities. Effective health service provision in these locations needs to serve these growing communities, and there is scope for services to tap into community networks to assist with this.

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“…This scoping review highlighted the fact that healthcare barriers that impact the integration of refugees into rural or regional areas are multidimensional and subject to variations in locally-speci c processes. This scoping review identi ed communication as a prominent barrier for refugees to access healthcare [13,14,42,43]. As previously identi ed, this di culty arises from the fact that refugees may have minimal literacy in the settlement country's language and that there is a lack of appropriate interpreters and exible support to learn that language, which gender responsibilities further exacerbate.…”

Section: Discussionmentioning

confidence: 98%

A scoping review on the barriers to and facilitators of health services utilisation related to refugee settlement in regional or rural areas of the host country

Coumans,

Wark

2023

Preprint

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BACKGROUND Healthcare access and equity are human rights. Worldwide conflicts, violence, and persecution have increased the number of refugees and/or asylum seekers. Because urban areas are already densely populated, governments have aimed to increase refugee resettlement in rural and/or regional areas. Because of the complex healthcare needs of refugees, this creates challenges for healthcare service providers. Identifying barriers to accessing healthcare in rural areas is therefore important to better inform policy settings and programmes that will provide culturally appropriate patient-centred care to the refugee community. METHODS This review scoped 22 papers written in English between 2018 and July 2023 from five countries (Australia, New Zealand, Germany, Bangladesh, and Lebanon) in order to provide an overview of the barriers and possible solutions to facilitate refugees’ access to healthcare. RESULTS The reviewed literature summarised the perceptions of at least 3,561 different refugees and 259 rural health service providers and/or administrators and identified major challenges. These include communication (illiteracy in the resettlement country language and lack of a suitable interpreter), lack of cultural awareness of health services, discrimination, and access difficulties (transportation, availability of health specialist services, cost). As a consequence, it was identified that improving access to affordable housing, employment through credential recognition, competence-level education for children, facilitating language training, and adapting health information would increase resettlement and encourage access to healthcare. CONCLUSIONS Refugees face significant barriers to accessing and engaging with healthcare services. This impacts their integration into rural communities and increases the prevalence of psychosocial issues like feelings of loneliness, low self-esteem, a lack of autonomy, and a lack of empowerment over informed decision-making, especially for women, jobless men, and the elderly. These findings support the need for additional support for refugees and healthcare providers to improve language proficiency and cultural competency. Policymakers need to improve the availability and accessibility of employment, housing accessibility, and service mobility. Additionally, more research is needed to assess the efficacy of emerging innovative programmes that aim to close the gap by delivering culturally appropriate patient-centred care to refugee communities in rural areas.

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Individuals of refugee background resettled in regional and rural Australia: A systematic review of mental health research

Cited by 8 publications

References 23 publications

A qualitative evaluation of the questionnaire about the process of recovery (QPR) in culturally and linguistically diverse (CALD) populations

A qualitative evaluation of the questionnaire about the process of recovery (QPR) in culturally and linguistically diverse (CALD) populations

Social Capital and Rural Health for Refugee Communities in Australia

A scoping review on the barriers to and facilitators of health services utilisation related to refugee settlement in regional or rural areas of the host country

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