1. Australian Refugee Association Tuesday the 30 th of June Health Awareness Session Jan Williams

2. Introduction – session aims About SARHN Understanding the normal stages of resettlement for newly arrived families and individuals Knowing what to expect in terms of feelings states and health priorities Knowing how to offer support Knowing where to get help

3. The Stages Stage One: The period leading up to migration. Stage Two: Migration Stage Three: Settling in to a new environment Stage Four: ‘After the honey moon’ Stage Five: The final stage of resettlement During each stage Common Feelings experienced Health Priorities and support needs

4. Stage One: The period leading up to migration. The logistics of departure. Maybe a time of hardship and turmoil Many refugees will be in refugee camps A time of focussing on survival with little time to think about what to expect Unlike migrants refugees often have very little time to be well prepared

5. Feelings experienced in the pre migration period: Excitement Anxiety Hope Grief and loss Relief Fear

6. Health Priorities and Issues Pre departure screening Basic immunisation Worm and malaria medications Fitness to fly

7. Stage Two: Migration Process of migration varies enormously Pre migration information often conflicting and inaccurate The support and welcome individuals receive is crucial The trauma of arriving alone and without support ‘Culture shock’.

8. Feelings often experienced by newly arrived refugees: HopeInformation overload Excitement Disorientation ReliefApprehension AcceptanceConfusion Happiness Guilt

9. Health Priorities and Support Needs The role of Settlement Services Immediate health status Medicare and CentreLink Health undertakings Access to Screening and Immunization Basic info about the health system What to do in an emergency Assistance with transport Medications

10. Stage Three: Settling in to a new environment Experiences depend on the quality of resettlement services Individual coping skills vary At risk groups Poor health will impact on the settlement phase. Frequent pre occupation with ‘organising life’ Individuals often start to think about what they have left behind

11. Feelings experienced during the settling in stage: ExcitementSurvivor guilt OptimismDisorientation Hope for the future Frustration A Preoccupation withExhaustion planning for the future

12. Health Priorities and Support Needs The need for reassurance Understanding health information Connecting with local health services Appropriate support in attending appointments Culture and health hygiene Where to get help Health rights and responsibilities

13. Stage Four: ‘After the honey moon’ Dealing with concrete realities and challenges Responses depend on individual coping mechanisms, personal resilience, available supports. A potential for unhealthy coping mechanisms The enormity of the challenges ahead Survivor guilt Grief and loss issues

14. Feelings associated with trauma and loss: SadnessInsomnia DisbeliefChronic pain ConfusionRestlessness AngerDepression Survivor guiltAnxiety LonelinessAgitation HelplessnessNightmares

15. Health Priorities and Support Needs Often considerable support required. Physical health symptoms may manifest Chronic health conditions Post Traumatic Stress Disorder Encourage individuals to seek help Early intervention, support, education and assessment are vital Appropriate health responses crucial Reassurance that negative feelings are normal.

16. The final stage of resettlement: A positive and supportive resettlement experience will lead to long term physical and emotional health benefits The impact of cultural expectations clashing Conflict between the old and new culture, family pressures and relationship struggles

17. Positive feelings for the future: Safety A sense of achievement and success Connection and belonging Confidence in self and hope for the future Feeling comfortable with a bi cultural identity

18. Negative feelings for the future: Cultural dislocation Sadness and loss Frustration Family/ relationship problems Disappointment

19. Health Priorities and Support Needs Remaining connected to appropriate health care provider Preventative health programs Groups which promote connection, self care and belonging Family/ individual counselling DV services Meaningful existence Realistic expectations

20. Thank you!