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Foundation House An integrated model of refugee mental health care

Foundation House An integrated model of refugee mental health care. Jenny Adams. Foundation House. Refugee mental health organisation – survivors of torture and trauma 3 sites across Melbourne >130 staff Operating since 1988 Counsellors – social workers, psychologists

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Foundation House An integrated model of refugee mental health care

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  1. Foundation HouseAn integrated model of refugee mental health care Jenny Adams

  2. Foundation House • Refugee mental health organisation – survivors of torture and trauma • 3 sites across Melbourne >130 staff • Operating since 1988 • Counsellors – social workers, psychologists • Complementary therapies team - since1990 • Mental health clinic – psychiatrists and psychologists under Medicare • Schools team • Research and policy

  3. Client groups • Clients – refugees and asylum seekers from 30 different countries • Currently majority from Iran, Afghanistan, Iraq, Sri Lanka, Burma, Bhutan, African countries – Ethiopia, Congo, Sudan

  4. Complementary therapy modalities: • Herbal and nutritional medicines – fully funded dispensary

  5. Massage

  6. Yoga groups

  7. Structures that support collaboration • Group supervision and debriefing • Weekly team meetings • Regular professional development attended by all staff • In house training and induction for new staff

  8. Case study – “Tenzing” • Tibetan woman 48yo • Referred by counsellor • PH 6/12 imprisonment in Tibet for participating in demonstration. Endured beatings, solitary confinement & periods of starvation • PC “pains all over body”, headaches, insomnia and nightmares • Diagnosed PTSD with depression • Frequent crying • Constipation • Not receptive to counselling but grateful for advocacy • Devout Buddhist with strong faith in traditional Tibetan medicine

  9. Collaborative care • Regular discussion with counsellor – check that treatment goals consistent, compatible. Compare presentation. • Travel training by student on placement • Liaison with GP to exclude medical diagnoses and check prescribed meds • Referred to Tibetan Buddhist centre and arranged meeting with senior monk. Liaised with interpreter to assist her with transport

  10. Case study – CT treatment • Herbal medicine, dietary and lifestyle advice for sleep and depression (walk son to local park each day) • Dietary and lifestyle advice plus herbal medicine and fibre supplement for constipation • Massage to reduce anxiety and relieve pain. Massage oil to use at home prn.

  11. Case study • Regular appointments over 2 years – fortnightly to monthly to 2nd monthly • Sleep improved. Reduced hyperarousal • Pain decreased – more manageable but still dominant symptom • Fewer headaches (from 2/wk to 1-2/month) • Less depressive symptoms • Constipation chronic!

  12. Thankyou! • Client and interpreter • Colleagues at Foundation House • Judy Singer

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