Alcohol, Tobacco, Other Drug Concerns of Newly Arrived Women in Perth

Alcohol, Tobacco, Other Drug Concerns of Newly Arrived Women in Perth by Susan Lee Curtin University of Technology Womens Health Services

Thank you! Thank you to all the women who participated. Thank you to all the service providers who participated or referred women to participate! Thank you to the bilingual workers and interpreters for the invaluable work!

Thank you Thank you also to • Womens Health Services Staff • Curtin University of Technology • West Australian Network of Alcohol and Other Drug Agencies • Office of Multicultural Interests

Background • Womens Health Services (WHS) in Perth, Western Australia works with women from over sixty different nationalities, including many newly arrived migrants and refugees.

Backgrounds • Migrant and refugee women access many programs within WHS • However, there are very low numbers of women from ethnic backgrounds accessing the alcohol and other drug (AOD) services for women at WHS

Background • WHS staff felt these low numbers reflected service delivery not matching women’s needs rather than to lack of need. • Difficult to obtain funding for specific initiatives with ethnic women as had only anecdotal evidence

Approach to the Project • A community approach emphasizes alcohol and other drug concerns impact on the whole community not just the user • It is important for everyone in the community to be informed not just those who have a particular problem.

Approach to the Project • Suspected that there were common alcohol and other drug issues and common barriers to women accessing services • Rather than each ethnic group having specific issues and barriers.

Focus Groups and Interviews with Service Providers • Service providers all worked with new arrivals and were a mix of mental health professionals, health professionals, and social service professionals • 22 service providers working with migrant and humanitarian entrant women. There were 4 interviews and 5 focus groups.

Focus Groups and Interviews with Newly Arrived Women • All women participating in the project were 18 years of age or more, Australian citizens, permanent Australian residents or in the process of being granted permanent residency, and had been in Australia 5 years or less • There were 26 women participating in one of 6 Interviews or 5 Focus Groups.

Questionnaire • Further explore issues raised in the focus groups and interviews • Developed a questionnaire using both new questions and questions from existing surveys for comparison • National Drug Household Survey and the WA Health Survey

The Questionnaire • 268 women complete the questionnaire • The questionnaire took between 20 minutes to over one hour to complete depending on the education levels and English language ability of the woman.

Getting information to newly arrived women • Women were asked what was the best way to get information out to newly arrived women like themselves • Need a variety of methods to disseminate information and information about services • Many service providers using only one or two ways

“ It might be hard to get them there…. It might be difficult… but generally you get the message across… if you talk…” Nigerian woman

How women would like information • Information Sessions or talks Very useful 41% Useful 41.8% Best Times to Meet • Saturday mornings (39.9%) • Saturday afternoon (23.5%) • Sunday afternoons (20.5%) • Only 13.8% of women said weekday mornings were a good time for them to meet

Ways to get information to women

“… such information some times they can find but it’s in English and that is a major problem. Is it possible such information … important information to be translated into Arabic?” Iraqi woman through an interpreter

What information or activities are important? • 77% How to get work, qualifications leading to work • 73% Information on women’s health • 65% Exercise Classes for women • 59% Information on eating better on a budget • 52% Information on how to get a GP or talk to a GP

What information or activities are important? • 44% Information on depression • 35% Information on family violence • 26% Support for women with postnatal depression • 17% Information on illegal drugs • 13% Support for women whose husbands or children are drinking too much alcohol

Smoking • Most women surveyed did not smoke • 3.1% (n=8) smoked daily • 4.3% (n= 11) smoked occasionally

“…smoking leads to loose character.” Asian woman

“Sometimes when I’m stress and have too much problem I smoke outside. But after I think okay I stop. When I’m really under pressure then I start smoke because I don’t know what to do and nervous… but I know that it’s not good but stop. But sometimes the smoke makes me little bit better. Will lighten up thing again. But I’m not like, you know, a heavy smoker and I just need company when under pressure smoking…” Domestic Violence Survivor

“Many of them do (smoke) but it’s not brought up as an issue. And I don’t know if we’re so much bringing it up as a question.” Service provider working with Humanitarian Entrants

Alcohol • Most women surveyed did not drink alcohol • 23.5% had a standard drink in the last 12 months with most of these women only drinking occasionally

“I don’t know about others but myself I just wanted to try new things because in my own country we don’t and I didn’t drink wine and I found over here, oh wine’s good.” Thai woman

Problems Associated with alcohol • In focus groups with community women and service providers people reported very infrequent problems with women drinking themselves. • The problems that were reported by both service providers and community women were often to do with others people drinking and their behaviour as a result.

Other problems Assoc with Alcohol • …because one time on the bus I sat by one man who smoked and drink and he was very drunk and sat by me and just talking to me.. talking to me and I was…when I get out of the bus I was miserable… • African woman

Has some one who has been drinking alcohol or taken drugs verbally abused you? • 16.9% said yes • 22.5% in National Drug Household Survey

Has some one who has been drinking alcohol or taken drugs physically abused you? • 4.3% said yes • 3.5% in National Drug Household Survey

Has some one who has been drinking alcohol or taken drugs put you in fear? • 21.3% said yes • 15.3% in National Drug Household Survey

Illicit Drugs • Most service providers working with newly arrived women do not ask their clients about their alcohol or drug use

“… or they filled in the little thing in the (health questionnaire) have you used any recreational drugs. People frequently put down or I used marijuana last week or ecstasy a month ago as though, you know, like well did I have a cup of tea, …” Doctor working at a woman’s health service

Illicit Drugs • Of the 268 newly arrived women who completed the questionnaire five women reported using cannabis since coming to Australia. • One respondent reported using other drugs but refused to specify which drugs or usage.

Illicit Drug Use Anecdotal evidence suggests that • there is higher rate amongst young men • and in people who have been here longer than 5 years.

Since coming to Australia have you been worried about or had any arguments with family or friends about their use of alcohol marijuana, khat or other drugs?

Concerned about Others AOD Use • 8.8% (n = 23) of women said yes • Who is using? • Husbands, sons, daughters, and friends • What are they using: alcohol, marijuana, heroin, ice and mixture of these

Are you confident enough to talk about illegal drugs to your children? • 41% Said No • 17% of the women interviewed said information on illegal drugs was among the top 5 of information topics and activities they wanted

Using AOD services • Just over 71% of women said they would use such a service, if they needed one • The majority of women would be very comfortable or ok in using an interpreter to discuss such issues

Suggestions from service providers and women • Have AOD information available in multicultural settings • Incorporate AOD information into other types of health and social service information e.g. parenting, driving, employment

Areas for Further Research and Exploration • Overseas Students: • Women’s health information including alcohol and other drug information • Information on women’s safety

Areas for Further Research and Exploration: • There seems to be poor understanding by older women of the health risks of heavy drinking • Current information and prevention activities are geared towards young people with little appropriate information for older women

Take Home Messages • Alcohol and other drug use by newly arrived women is low compared to other community groups. • However, some women are using and newly arrived women are impacted by other people’s AOD use. • Service Providers need to ask women about their use and the impact of others use on them

Take Home Messages • There are common alcohol and other drug issues and common barriers to women accessing services • Poor understanding by women involved with the project of what AOD agencies do and that you can seek support as a significant other.

Take Home Messages • Women had concerns about the cost, confidentiality and the police becoming involved • Service Providers need to change how they deliver services (especially around prevention) in order to be more accessible to women from ethnic communities

Take Home Messages • It’s easy to focus on newly arrived humanitarian entrants and forget the majority of people do not arrive in this category. • Newly arrived women (0 to 5 years) are only a small portion of all overseas born people in WA.

Thank you for listening! My contact details are: Susan Lee Womens Health Services suelee@whs.org.au or 9227-9032

Alcohol, Tobacco, Other Drug Concerns of Newly Arrived Women in Perth