Search

COVID-19 brings increased risk to the mental health of asylum seekers and refugees in Australia on temporary visas. Rapid government changes due to the COVID-19 pandemic are resulting in significant and sustained hardship on this already vulnerable group. This discursive paper is both an explainer and a resource for mental health nurses and health professionals with scope of practice in primary care and emergency departments responding to this population. The aim of this paper is to alert clinicians to the drivers of mental and suicide related distress and to provide recommendations as to how to therapeutically engage and support this group. Drivers include complex intersections between legal uncertainty, economic, social and mental health stress as drivers of entrapment, acute mental distress and suicidal ideation. Information about the COVID-19 related factors as drivers contributing to worsening states of distress may help guide clinicians to consider protective factors designed to mitigate the onset or worsening of mental distress, plus aid in the development of health policy and service-delivery arrangements of support and therapeutic engagement.

This research explored participants’ experience and perceptions of a two-day suicide prevention education programme, and any impact that it has had on them and their work with refugees and asylum seekers since. At approximately six months post-training (May to September 2018), semi-structured telephone interviews were conducted with 15 participants. The interviews were audio-recorded, transcribed, and thematically analysed. Thematic analysis of the data identified two overarching themes and five subthemes. The two overarching themes were: (1) Changes to the individual and their practice; and (2) The culture and context of the work. Participants described a range of impacts that the training had on them and their workplace, in both personal and professional domains. The study findings suggest that equipping workers with skills and knowledge in culturally tailored and evidence-based suicide prevention can lead to an increased sense of hope, optimism, confidence, and agency and reportedly enabled workers to more readily intervene when presented with clients directly or indirectly communicating suicidal ideation. Findings support existing literature regarding gatekeeper training effectiveness. However, given the unique context of asylum seeker and refugee suicide, they also extend our understanding of the impact of bespoke or tailored approaches to gatekeeper training.

Background: There are concerning rates of suicidality among asylum seekers and refugees in Australia, and tailored suicide prevention initiatives are needed. Aims: We aimed to evaluate the impact of a tailored suicide prevention education program for people working with asylum seekers and refugees. Method: Attendees of the education program completed self-report questionnaires at pretraining, posttraining, and 4–6 months follow-up. Results: Over 400 workers, volunteers, and students across Australia took part in the education program. A series of linear mixed-effects models revealed significant improvements in outcome measures from pretraining (n = 247) to posttraining (n = 231). Improvements were maintained at follow-up (n = 75). Limitations: Limitations of this research were the lack of a control group and a low follow-up response rate. Conclusion: Findings suggest that a 2 days tailored suicide prevention education program contributes to significant improvements in workers’ attitudes toward suicide prevention, and their confidence and competence in assessing and responding to suicidal distress.

Background: Safety planning involves the co-development of a personalized list of coping strategies to prevent a suicide crisis. Aims: We explored the perspectives of workers regarding safety planning as a suicide prevention strategy for people of refugee background and those seeking asylum in Australia. Method: Participants attended suicide prevention training, specific to refugees and asylum seekers, at which safety planning was a key component. Semistructured, posttraining interviews (n = 12) were analyzed thematically. Results: Four key themes were identified: safety planning as a co-created, personalized activity for the client; therapeutic benefits of developing a safety plan; barriers to engaging in safety planning; strategies to enhance safety planning engagement. Limitations: First-hand refugee and asylum-seeker experiences were not included. Conclusion: As a relatively low-cost, flexible intervention, safety planning may be valuable and effective for these groups.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

© 2020 Informa UK Limited, trading as Taylor & Francis Group. Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Therapists and counsellors who provide trauma-focussed therapy and support to refugees and asylum seekers are often exposed to distressing and confronting stories of war, violence, torture, loss and grief, and other atrocities. In addition to this, working within an immigration and detention context has been reported to further contribute to experiences of burnout, vicarious trauma, and other adverse consequences of working with traumatised populations. There is a scarcity of research seeking to understand how therapists address these difficulties and maintain well-being to help them continue in this field of work. This mixed-methods research aimed to identify and explore factors associated with mental health and well-being among workers, with a particular focus on the role of clinical supervision. Participants were staff (n = 50) who identified as providing therapeutic support to refugees and asylum seekers either in Australia or in Australian-run detention facilities. Participants took part in an anonymous online survey which focussed on the psychological impact of their work, professional quality of life, and clinical supervision and incorporated free-text items. Thematic analysis of free-text data revealed four themes related to maintaining well-being at work including relationships and support seeking; physical and contemplative practices; professional growth; and balance and boundaries. Results from the quantitative analyses revealed several variables related to supervision that were important for well-being. In particular, the findings suggest that rapport and overall alliance with one's clinical supervisor are protective of secondary traumatic stress and depression, respectively. Important aspects of supervision were also explored in greater depth through qualitative and quantitative inquiry, increasing our understanding of the mechanisms underlying the relationship between clinical supervision and mental health and well-being for this group.

This article examines the legal challenges asylum seekers arriving by boat to Australia experience when seeking assistance with their claims and its impact on their mental health. The authors outline the experiences of asylum seekers in the “legacy caseload” group who have been waiting up to four years to have their protection claims assessed. The complex interplay between legal assistance to support refugee claims and the way those making claims inevitably struggle to understand, engage and participate in the process is analysed. It is argued that provision of legal assistance for this group will be essential to ensuring that the refugee status determination process is fair and allows asylum seekers to understand and participate more fully in the process. Recent changes to the assessment of claims combined with a reduction in funding for legal assistance create significant hurdles and combine to compound existing stress and emotional trauma leading to detrimental outcomes on the mental health of asylum seekers.

On 5 December 2014, the Australian Senate passed the Maritime Powers Legislation Amendment (Resolving the Asylum Legacy Caseload) Bill 2014 (Cth). This article discusses the intersections between an aspect of the new law – the ‘fast track assessment’ Refugee Status Determination (RSD) procedure, mental ill health and vulnerability of asylum seekers. Insecure visa status, post-arrival stressors and living in constant uncertainty and fear of rejection and repatriation are known to compound existing pre-migration trauma for asylum seekers. The ‘fast track assessment’ procedure, in which a large number of asylum seekers' claims for protection will be processed under the new law, suggests a likely worsening of mental distress, despair and deterioration. The combined nature of mental health and legal support are an increasing feature of a co-ordinated and much needed integrated response to assist vulnerable asylum seekers living in the community. It is suggested that asylum seekers with an existing mental health condition who receive negative outcomes during the RSD process are particularly vulnerable. All asylum seekers should have mental health support made available to them when visa decisions are handed down or shortly afterwards.

BACKGROUND: Mental illness is prevalent across the globe and affects multiple aspects of life. Despite advances in treatment, there is little evidence that prevalence rates of mental illness are falling. While the prevention of cardiovascular disease and cancers are common in the policy dialogue and in service delivery, the prevention of mental illness remains a neglected area. There is accumulating evidence that mental illness is at least partially preventable, with increasing recognition that its antecedents are often found in infancy, childhood, adolescence and youth, creating multiple opportunities into young adulthood for prevention. Developing valid and reproducible methods for translating the evidence base in mental illness prevention into actionable policy recommendations is a crucial step in taking the prevention agenda forward. METHOD: Building on an aetiological model of adult mental illness that emphasizes the importance of intervening during infancy, childhood, adolescence and youth, we adapted a workforce and service planning framework, originally applied to diabetes care, to the analysis of the workforce and service structures required for best-practice prevention of mental illness. RESULTS: The resulting framework consists of 6 steps that include identifying priority risk factors, profiling the population in terms of these risk factors to identify at-risk groups, matching these at-risk groups to best-practice interventions, translation of these interventions to competencies, translation of competencies to workforce and service estimates, and finally, exploring the policy implications of these workforce and services estimates. The framework outlines the specific tasks involved in translating the evidence-base in prevention, to clearly actionable workforce, service delivery and funding recommendations. CONCLUSIONS: The framework describes the means to deliver mental illness prevention that the literature indicates is achievable, and is the basis of an

INTRODUCTION: Cultural and linguistic diversity is a core feature of the Australian population and a valued element of national identity. The proportion of the population that will be overseas-born is projected to be 32% by 2050. While a very active process of mental health system reform has been occurring for more than two decades - at national and state and territory levels - the challenges presented by cultural and linguistic diversity have not been effectively met. A key area in which this is particularly an issue is in the collection, analysis and reporting of mental health data that reflect the reality of population diversity. The purpose of this study was to examine: what is known about the mental health of immigrant and refugee communities in Australia; whether Australian mental health research pays adequate attention to the fact of cultural and linguistic diversity in the Australian population; and whether national mental health data collections support evidence-informed mental health policy and practice and mental health reform in multicultural Australia. METHODS: The study consisted of three components - a brief review of what is known about mental health in, and mental health service use by, immigrant and refugee communities; an examination of national data collections to determine the extent to which relevant cultural variables are included in the collections; and an examination of Australian research to determine the extent to which immigrant and refugee communities are included as participants in such research. RESULTS: The review of Australian research on mental health of immigrant and refugee communities and their patterns of mental health service use generated findings that are highly variable. The work is fragmented and usually small-scale. There are multiple studies of some immigrant and refugee communities and there are no studies of others. Although there is a broadly consistent pattern of lower rates of utilisation of specialist public mental

Geia, L., Baird, K., Bail, K., Barclay, L., Bennett, J., Best, O., ... Wynne, R. (2020). A unified call to action from Australian nursing and midwifery leaders: Ensuring that Black lives matter. Contemporary Nurse, 56(4), 297-308. https://doi.org/10.1080/10376178.2020.1809107