Refugees and Risk of Mental Illness & Suicide Rates

Nature of the issue

There is need to address refugees in Australia. Mental illnesses encompass a range of mental health conditions. Some of the major mental health disorders which afflict refugees include dementia, mood disorders, anxiety disorders, eating disorders, and among other psychotic disorders. If these disorders are not checked, they may increase suicides rates among the population. According to the Australian Bureau of Statistics (ABS) (2011), an average of 2,000 Australians commits suicide every year. Among the high risks groups include those from culturally and linguistically diverse backgrounds. This means that based on the data collected over the past years, refugees are at a higher risk of committing suicide. Even though mental illness & suicide rates can affect the entire population, cultural influences have a perverse and profound impact on the outcomes of mental illnesses such as anxiety disorders and mood disorders. A significant number of refugees suffering from mental illness lack access to treatment or fail to seek treatment due to various reasons.

Outline the evidence base relating to this health indicator

Refugees from diverse backgrounds experience psychological distress due to various issues affecting them such as war, separation from family members and friends, physical change of place of residence and stress related to adapting to new cultures. Severe psychological distress affects their mental health which if not treated can lead to development of mental illnesses. According to Triggs (2013), closed detention leads to mental illnesses especially in children among immigrants and refugees in Australia. The research notes that there are increased cases of self-harm or suicide and mental illnesses among refugees held in detention centers. The research indicates that mental illnesses are the commonly reported ailments afflicting asylum seekers in Australia. The report also indicates that mental distress is positively correlated to refugees being held in concentration camps or detention centers. Mandatory detention for asylum seekers is seen as the major factor contributing to deterioration of their mental health.

Deans et al. (2013) conducted a detailed study into the forms of illnesses reported by refugees and immigrants in the Royal Darwin Hospital. The retrospective observational study was conducted over a one year period in 2011. According to the results, the emergency department wing of the hospital reported a total of 518 attendances by asylum seekers mainly from Afghanistan and Iran. A total of 187 refugees (24.3%) were diagnosed with mental health problems, 138 of them reporting incidences of self-harm. Mental health problems were recorded as the most prevalent among the refugees, with a diagnostic rate of 24.3% as earlier mentioned. Other studies also support the above results. Procter, Leo and Newman (2013) conducted a retrospective study into the causes of death among asylum seekers. The study found that suicide and self-harm were the major causes of death among asylum seekers.

Comparison between the chosen community and the general population

There is sufficient evidence indicating that refugees or asylum seekers are more likely to suffer from mental illness and attempt suicide compared to the general population. Refugees make up the vulnerable population in terms of mental health. Certain factors predispose them to mental illnesses and suicide. These factors include war, loss of loved ones, torture, changes in social-economic status, language barriers, and lack of employment and among other experiences which significantly contribute to development of mental health issues. On the other hand, the general population is not afflicted by such problems which translate to less mental health issues and cases of suicide. Refugees from conflict zones are often affected by posttraumatic stress disorder (PTSD) due to exposure to traumatic and life changing events. A meta-analysis conducted by Steel et al. (2009) indicated that about 40 percent of refugees from conflict zones experience PTSD symptoms.

Studies indicate that refugees are at a higher risk of suffering from mental health problems and end up in suicide compared to the general population. According to Steel (2009), studies involving refugees and the general population as the control group give substantial evidence on a higher prevalence of mental illnesses and cases of suicide among refugees. These trends were not only reported in Australia, but also across the entire world. The refugees are therefore vulnerable to mental illnesses due to their earlier encounters with traumatic events. The general population in Australia is less exposed to traumatic events and hence less mental health problems. In addition, it is comparatively difficult to address the health issues afflicting refugees compared to the general population. This is due to various challenges experienced in the process such as language barrier, discrimination and lack of adequate resources to seek help or specialized treatment.

How the aspect of diversity is impacting on these identified differentials

Diversity has a significant impact on the outcomes of health illnesses and cases of suicide in Australia. Culture plays a crucial role in the mentioned differential. Racial discrimination is one of the aspects that have a significant impact on the mental health of refugees. Racial discrimination occurs when an individual is treated differently due to their ethnic origin, race, descent, colour, and sometimes immigration status among other factors. Some cultures may label people from a different cultural background as inferior or develop stereotypes towards them. This has a negative effect on the mental health of those who are negatively stereotyped. Studies indicate that individuals who experience racial discrimination are likely to develop mental health problems due to the stress associated with the experiences. According to Irving & Mosca (2010), there is a link between racial discrimination and psychological distress. Racial discrimination leads to psychological distress which ultimately leads to anxiety and depression.

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Other aspects of diversity such as language barriers also tremendously impact on the mental health of refugees. According to Steel et al. (2009), there are strong links between language barrier and the risks of experiencing stress and mental health problems. Adapting to new cultures can be a difficult experience to refugees. This is particularly so when there exist wide variations in the language, values, customs and cultural beliefs held by the two factions. Refugees who experience language barriers are likely to be socially isolated, which worsens their predicament. In addition, refugees with language challenges are less likely to seek help on their mental health problems. It is difficult for majority of refugees to adopt the culture of the general population. These factors increase the risk of suicide among the refugees. Refugees who receive community support are able to quickly integrate into the new culture due to the support they receive. Family cohesiveness is also important in reducing the risk of stress.

Different cultures respond to situations in various ways. Refugees suffering from mental illness are confronted by stigma which varies depending on the type of culture. Stigma is defined as disapproval or mark of shame attached upon some individuals in the community. Stigma has a significant impact on refugees suffering from mental health issues. Some cultures perceive mental health issues in a negative manner. Certain cultures associate mental health problems with witchcraft or curses. People suffering from mental health problems in such communities are afraid to come up in the open to receive treatment due to fear of being stigmatized. The different cultures affect the way refugees seek support services, and hence impact their health.

Potential causes of disparity between refugees and the general population

There are a number of reasons why there exists many disparities between refugees and the general population in Australia. Disparities existing between the two factions can be traced to the entire process of migration, personal factors and government policies relating to the well-being of refugees. These factors affect the health of the refugees as well as access to treatment facilities. Environmental determinants also potential causes of disparities between refugees and the general population. Language barriers area also potential causes of disparities. Refugees may at times find themselves in foreign countries where they do not understand the local dialect. This hinders their ability to obtain health services, engage in productive activities such as starting small businesses and hinders their ability to develop social relations with the local individuals. The different culture also causes disparities since refugees often experience culture shock. Refugees may take long to adapt to the local culture, hindering their ability to engage in meaningful tasks.

Refugees often live in marginal situations which significantly curtail their ability to gain financial independence. This means they are much vulnerable to unforeseen issues in the environment. Migrants lack the financial muscle required to start own businesses unlike the general population which have access to loans from banks and other financial institutions. It is difficult for refugees to acquire loans or funding for their businesses since they lack collateral for obtaining loans. This makes it difficult to start or expand businesses. According to Irving & Mosca (2010), refugees are discriminated against by the government during formulation of national policies. They are also disregarded in national exercises such as health data collection. This means that during the formulation of national health policies they are not taken into consideration. This contributes to disparities in the health of refugees and the general population. In addition, there is little research available on the health risks associated with refugees and in the challenges in general faced by refugee communities. Lack of relevant research hinders implementation of robust policies which can change the plight of refugees.

References

Australian Bureau of Statistics (2011). Causes of Death Australia, 2011. Retrieved from: http://www.abs.gov.au

Deans, A. K., et al. (2013). Use of Royal Darwin Hospital emergency department by immigration detainees in 2011. The Medical Journal of Australia, 199(11): 776 – 778.

Irving, G., & Mosca, D. (2010). Future Capacity Needs in Managing the Health Aspects of Migration. Background Paper for World Migration Report 2010, International Organization for Migration.

Procter, N. G., Leo, D. D., & Newman, L. (2013). Suicide and self-harm prevention for people in immigration detention. The Medical Journal of Australia, 199(11): 730 – 732.

Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among 49 populations exposed to mass conflict and displacement: A systematic review and meta-analysis. JAMA, 302, 537-549. doi: 10.1001/jama.2009.1132

Triggs, G. (2013). Mental health and immigration detention. The Medical Journal of Australia, 199(11): 721 – 723.