afghan community - mental health profile
TRANSCRIPT
Page | 1 Transcultural Mental Health Centre 23 August 2021
Afghan Community - Mental Health Profile
Background Afghan community in Australia
• Demographics
• Culture
Mental health Multilingual resources Afghan Community Organisations Service Providers References Note on culture Note: This profile is current as of 24 August 2021. Please check our website for further updates.
Background
On 15 August 2021 heavily armed Taliban fighters took control of the Afghan capital Kabul effectively bringing down the government of President Ashraf Ghani. Afghanistan has a long history of political turmoil, particularly in the four decades since the Soviet invasion in 1979. The Taliban first took control of Afghanistan in 1996 following the withdrawal of Soviet troops imposing their strict interpretation of Islamic law. According to Human Rights Watch the Taliban regime was marked by “systematic violations against women and girls; cruel corporal punishments, including executions; and extreme suppression of freedom of religion, expression, and education.” (Human Rights Watch, 2020) The Taliban were removed from power in Afghanistan by the invasion of US forces in 2001 following the 9/11 terrorist attacks. As part of the US-led coalition, the Australian Army sent over 26,000 troops (Australian Army, 2021) in efforts to stabilise and democratise the country and in 2004 a new constitution was adopted and a general election was held. In the following decades the Taliban continued to fight for power and in recent years have regained influence across Afghanistan. The US signed a peace deal with the Taliban in February 2020 and in April 2021 the US President Joe Biden announced the withdrawal of all US troops from the country by September 11. Following this the Taliban seized vast swathes of Afghan territory with little resistance from Afghan government forces, culminating in the seizure of Kabul on 15 August. (BBC News, 2021) Despite Taliban leaders claiming that the organisation has changed there is now a legitimate fear that the Taliban will reimpose the harsh rule of the 1990s. These events are causing immense distress and anxiety for Afghan communities in Australia and throughout the world.
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Afghan community in Australia
There has been a long history of Afghan migration to Australia going back to the mid 19th Century when Afghan men migrated to Australia as cameleers. The second wave of Afghan migration to Australia occurred in the 1980s as a result of the soviet invasion and ongoing civil war in Afghanistan while the mid 1990s saw another wave of migration consisting of Afghans fleeing the Taliban regime (Multicultural NSW). Demographics
• In 2016 13,029 people living in NSW reported having been born in Afghanistan, while
15,586 people had Afghan ancestry.
• The top ancestries of people born in Afghanistan included: Afghan 70.8%, Hazara
17.1%, English 2.7%, Australian 2.5% and Iranian 1.2%.
• 95.3% of people born in Afghanistan speak a language other than English at home.
The main languages spoken include Dari 46.3%, Hazaragi 27.1%, Persian (excluding
Dari) 12.8%, Pashto 6.8% and Iranic not further defined 1.0%.
• For those born in Afghanistan, 65.4% speak English well or very well, while 29.2%
speak English not well or not at all.
• In 2016 the religion of 91% of people born in Afghanistan was Islam.
• In 2016 4.6% of people born in Afghanistan were aged 0-14 years, 20% 15 -24 years,
29.3% 25-34 years, 19.7% 35 – 44, 12.6% 45-54, 8.6% 55-64 and 5.2% were 65 years
or over. The median age for people born in Afghanistan was 34 years.
(Australian Bureau of Statistics, 2016) Recent arrivals
• Between January 2019 and June 2021, there were 1,059 entrants to NSW who were
born in Afghanistan, 21.7% were part of the humanitarian migration stream, 77.3%
part of the Family stream and 0.1% part of the skilled migrant stream (Australian
Government Department of Home Affairs, 2021).
Humanitarian entrants
• The Australian government has granted about 8,500 humanitarian visas to Afghans
since 2013, including 1,800 visas to Afghan nationals employed by the Australia
military or government in Afghanistan and their family members. More than 4,200
Afghan nationals are living in Australia on temporary visas (Hurst & Doherty, 2021).
• Afghan people who came to Australia as refugees include: Hazara people fleeing
ethnic persecution; intellectuals, activists and journalists; those who assisted the
Australian mission in Afghanistan and ‘Women at Risk’ visa holders (SBS, 2021).
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Culture
Afghan people are known as Afghan rather than Afghani which refers to the currency of Afghanistan. Afghanistan is a multiethnic nation. The Pashtun are the largest and most politically dominant ethnic group, most of whom speak Pashto and are Sunni Muslims. Pashtuns often come from rural environments. The second largest group are the Persian speaking Tajiks, who are also Sunni Muslims and tend to be more urbanised and educated. The third largest group are the Hazaras. Hazaras are Shia Muslims and have experienced systematic persecution and marginalisation from the political process for centuries in Afghanistan. There are also small communities of faiths other than Islam in Afghanistan, including Christians, Sikhs, Hindus and Baha’i. Afghan culture is largely collectivist and patriarchal with strong respect for the family and elders. Households can be large and multigenerational. In some sections of society women may be confined to domestic roles and there may be a separation of genders outside of the family or close-knit community. Most Afghans are Muslim and faith in Islam is notable in many aspects of life, nevertheless many Afghans do not necessarily follow a conservative interpretation of Islam. References and Further reading
Special Broadcasting Service. SBS Cultural Atlas - Afghan Culture https://culturalatlas.sbs.com.au/afghan-culture/afghan-culture-afghans-in-australia State of Queensland (Metro South Health) 2016 Food and cultural practices of the Afghan community in Australia – a community resource https://metrosouth.health.qld.gov.au/sites/default/files/content/community-profile-afghan.pdf
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Mental Health
Many Afghan people living in Australia will have experienced significant trauma. Studies among Afghan refugees have shown a high incidence of depression (Rintoul 2010), Post-traumatic Stress Disorder and anxiety (Ahmad 2020, Hamrah 2020). The present situation in Afghanistan is likely to contribute to increased worry about family and loved ones still in Afghanistan and fear for the future of the country. For some their own traumatic experiences may be rekindled by seeing images of what is currently happening in Afghanistan. Some of the factors that may contribute to mental distress and discourage mental health help seeking for Afghan people living in Australia include:
• Having experience traumatic events, such as witnessing the death of a loved one
• Having experienced political or religious persecution
• Living though years of conflict and war
• Stressful escape and transit experiences
• Prolonged grief, loneliness and separation from family and loved ones
• Difficulty in adjusting to a new culture
• Changing gender roles and expectations
• Loss of social status in resettlement
• Intergenerational conflict
• Experience of family violence
• Somatization of psychological issues
• Settlement challenges such as lack of English language skills, unemployment,
difficulty in finding appropriate housing and lack of transport options
• Low levels of mental health literacy and lack of understanding of western models of
mental illness
• Different mode of delivering health care in Australia i.e., a community outreach
model in Afghanistan
• Cultural reluctance to discuss emotions, especially for men
• Lack of culturally appropriate treatments
Despite these challenges Afghan people are resilient. Strong community ties and close family relationships are known to moderate the impact of traumatic experiences. Many Afghans take solace and pride in the maintenance of Afghan culture and traditions and/or religious beliefs and participation in religious rituals. The ability to acculturate to the Australian way of life, especially for young people can contribute to wellbeing.
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When working with Afghan Australians research suggests that using community leaders and elders to act as mental health knowledge brokers and bicultural bridges between the community and health care services can be useful. Further reading
Afrouz, R. B.R. Taket, A. (2021) ‘Experiences of Domestic Violence among Newly Arrived Afghan Women in Australia, a Qualitative Study’ The British Journal of Social Work 51:2 , 445–464, https://doi.org/10.1093/bjsw/bcaa143 Ahmad F., Othman N,, & Lou W. (2020), ‘Posttraumatic stress disorder, social support and coping among Afghan refugees in Canada.’ Community mental health journal. 2020;56(4):597-605. https://link.springer.com/article/10.1007/s10597-019-00518-1 Alemi, Q. James, S., Cruz, R. et al. (2014) ‘Psychological distress in Afghan refugees: A mixed-method systematic review.’ Journal of immigrant and minority health. 2014;16(6):1247-61. www.ncbi.nlm.nih.gov/pmc/articles/PMC3912229 Cheng, I-H. Wahidi, S. Vasi, S. et al. (2015) ‘Importance of community engagement in primary health care: the case of Afghan refugees.’ Australian Journal of Primary Health. 21(3):262-7. https://pubmed.ncbi.nlm.nih.gov/25102862 Copolov, C., Knowles, A. Meyer, D. (2018), ‘Exploring the predictors and mediators of personal wellbeing for young Hazaras with refugee backgrounds in Australia.’ Aust J Psychol, 70: 122-130. https://www.tandfonline.com/doi/abs/10.1111/ajpy.12171 Hamrah, M.S. Hoang, H. Mond J. et al. (2020) ‘The prevalence and correlates of symptoms of post-traumatic stress disorder (PTSD) among resettled Afghan refugees in a regional area of Australia.’ Journal of Mental Health. 1-7. https://doi.org/10.1080/09638237.2020.1739247 Iqbal, N. Joyce, A. Russo, A. et al. (2012) ‘Resettlement experiences of Afghan Hazara female adolescents: a case study from Melbourne, Australia.’ International Journal of Population Research 1-9. https://downloads.hindawi.com/archive/2012/868230.pdf Jewkes, R. Corboz, J. Gibbs, A. (2018) ‘Trauma exposure and IPV experienced by Afghan women: analysis of the baseline of a randomised controlled trial.’ PLoS One. 13(10): e0201974 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201974 Kanji, Z. Cameron, B.L. (2010) ‘Exploring the experiences of resilience in Muslim Afghan refugee children.’ Journal of Muslim Mental Health. 5(1):22-40. https://core.ac.uk/download/pdf/47263383.pdf
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Knefel, M. Kantor, V. Nicholson, A.A. et al. (2020) ‘A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: a randomized controlled trial.’ Trials 21, 57 (2020). https://doi.org/10.1186/s13063-019-3839-9 Maroney P, Potter M, Thacore VR. (2014) Experiences in occupational therapy with Afghan clients in Australia. Aust Occup Ther J. 61(1):13-9 https://pubmed.ncbi.nlm.nih.gov/24397287 Mehraby, N. (2002). ‘Counselling Afghanistan torture and trauma survivors’ Psychotherapy in Australia 8(3). https://startts.org.au/media/Research-Doc-Counselling-Afghan-Survivors-of-TT.pdf Refugee Council of Australia. (2019) Humanitarian family reunion: Perspectives from the Hazara community www.refugeecouncil.org.au/humanitarian-family-reunion-perspectives-hazara-community <viewed 19 August 2021> Rintoul A. (2010) Understanding the mental health and wellbeing of Afghan women in South East Melbourne. Foundation House, Brunswick, Victoria. https://refugeehealthnetwork.org.au/wp-content/uploads/Afghan+MH+report+final+2.pdf Sharifian, F. Sadeghpour, M. Barton, S. M (2021). ‘English language learning barriers of Afghan refugee women in Australia.’ International Journal of Applied Linguistics, 31(1), 65-78. https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijal.12320 Slewa-Younan, S. Yaser, A. Guajardo, M.G.U. et al. (2017) ‘The mental health and help-seeking behaviour of resettled Afghan refugees in Australia’. Int J Ment Health Syst 11, 49 https://doi.org/10.1186/s13033-017-0157-z Slewa-Younan, S., Guajardo, M.G.U., Yaser, A. et al. (2017) ‘Causes of and risk factors for posttraumatic stress disorder: the beliefs of Iraqi and Afghan refugees resettled in Australia. Int J Ment Health Syst 11:4 https://doi.org/10.1186/s13033-016-0109-z
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Multilingual Resources
Transcultural Mental Health Centre
Dari
• Consumer Medication Brochures: Antipsychotic medications, Benzodiazepines,
Bipolar disorders how medicines can help, Clozapine and Depression how medicines
can help.
• Coping personally with war
• Kessler 10 and accompanying brochure Whose recovery and outcomes are they
anyway?
All TMHC resources in Dari TMHC resources in Farsi English versions of TMHC resources
Embrace Multicultural Mental Health
Dari
• What is series: What is anxiety disorder, What is bipolar mood disorder, Challenging
behaviours, What is depressive disorder, What is an eating disorder, What is mental
illness, What is a personality disorder, What is schizophrenia
• Supporting parents and families: the mental health and wellbeing of children and
young people
• Glossary of terms – Accessing mental health services
• Mental health and wellbeing
• Getting Professional Mental Health Help - What are the steps?
• Mental Health Awareness (Audio file)
• Trauma
Hazaragi
• What is series: What is a bipolar mood disorder, What is a depressive disorder, What
is an eating disorder, What is a personality disorder, What is schizophrenia
• Getting Professional Mental Health Help – What are the steps?
• Trauma
Embrace resources in Farsi English versions of Embrace resources
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Multilingual Resources
STARTTS
Progressive muscle relaxation and visualisation audio recordings available in Dari and Farsi
at www.startts.org.au/resources/resources-for-sale/relaxation-cd
NSW Health
• Edinburgh Postnatal Depression Scale in Dari
• Edinburgh Postnatal Depression Scale in Farsi
Multicultural Centre for Women’s Health Victoria
• Be kind to your mind (Dari) fact sheet.pdf
• Be kind to your mind (Farsi) fact sheet.pdf
• Be kind to your mind (English) fact sheet.pdf
Queensland Transcultural Mental Health Centre
• Supporting someone in your community who is suicidal - Hazaragi
• Supporting someone in your community who is suicidal - Farsi
• Supporting someone in your community who is suicidal - English
South Eastern Melbourne Medical Local
• When you are feeling sad or worried - Afghan community video - Dari
• When you are feeling sad or worried - Afghan community video - Hazaragi
• When you are feeling sad or worried - Afghan community video - Pashtu
• When you are feeling sad or worried - Afghan community video - English
Victorian Department of Health
• Trauma reaction and recovery Dari
• Trauma reaction and recovery Farsi
• Trauma reaction and recovery Hazaragi
Australian Government
• Coronavirus and mental health resources in Dari
• Coronavirus and mental health resources in Hazaragi
• Coronavirus and mental health resources in Pashto
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Afghan Community Organisations
Afghan Australian Noor Association 37 Cowper Street, Granville NSW 2142 Email: [email protected] Phone: (02) 8677 9609 Website: www.aanoor.org.au Afghan Community Support Association of NSW 5 Fourth Avenue, Blacktown NSW 2148 Phone: (02) 9831 2436 Facebook: www.facebook.com/ACSANSW Afghan Fajar Association Incorporated (AFAIC) Level 3, Suite 2, 171-179 Queen Street, Campbelltown NSW 2560 Phone: (02) 4627 1188 Fax: (02) 4628 6068 Mobile: 0421 199 581 Website: afaic.org.au Afghan Women on the Move Email: [email protected] Website: www.awotm.com Australian Afghan Hassanian Youth Association (AAHYA)
1 Bellona Avenue, Regents Park NSW 2143
Phone: (02) 9738 7460 or +61 466 630 314
Website: aahyas.org.au
Hazara Women of Australia Inc. Najeeba Wazefadost President Hazara Women of Australia Facebook: www.facebook.com/HazaraWomenofAustralia Kateb Hazara Association Inc. Sydney 38 Adderley St East, Lidcombe NSW 2141 Phone: 0425 350 144 Facebook: www.facebook.com/Kateb-Hazara-Association-Inc-Sydney-1445162455769258 Support Association for the Women of Afghanistan (SAWA) Australia NSW Inc. Email: [email protected] Website: https://sawa-australia.org
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Service Providers
Transcultural Mental Health Centre (TMHC)
TMHC Clinical Consultation and Assessment Service TMHC’s clinical services provide information and consultation about mental health and cultural issues; information about government and non-government health and welfare services and clinical intervention using bilingual clinicians for individuals and families who are connected with a NSW Health mental health service. Contact Phone: (02) 9912 3851 or Toll free 1800 648 911, Monday – Friday, 8:30 am and 5:00 pm. Email: [email protected] Website: www.dhi.health.nsw.gov.au/tmhc TMHC Community Capacity Building in Strengthening the Mental Health of New and Emerging Refugee Populations TMHC’s community capacity building program for refugees provides mental health and wellbeing information sessions for community groups and service providers who work closely with communities and distribution of mental health and wellbeing resources, including language-specific resources. We also work with community and service providers to develop initiatives tailored to specific needs Contact Samantha Eid, Mental Health Consultant - Prevention and Community Engagement Phone: 0448 861 115 Email: [email protected] NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors
(STARTTS)
STARTTS provides culturally relevant psychological treatment and support, and community interventions, to help people and communities heal the scars of torture and refugee trauma. STARTTS provides training to services, advocacy and policy work. STARTTS Brochure in Dari STARTTS Brochure in Farsi STARTTS Brochure in English
Contact Phone: (02) 9646 6700 Email: [email protected] Website: www.startts.org.au
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Mental Health Community Living Supports for Refugees
Community Living Supports (CLS) is a NSW state-wide program which supports people with
a severe mental illness to live and participate in the community in the way they want to.
Mental Health Community Living Supports for Refugees (MH-CLSR) is a community-based
program located in seven Local Health Districts (LHDs) that provides support for refugees
and asylum seekers with mental health issues to live and participate in the community in
the way that they want to.
Local MH-CLSR service providers in NSW are: South Western Sydney Local Health District Call New Horizons: 1300 726 372 Or STARTTS: 02 9646 6666 (ask for CLS-R) Email: [email protected] Sydney Local Health District Call New Horizons: 1300 726 372 Or STARTTS: 02 9646 6666 (ask for CLS-R) Email: [email protected] Mid North Coast Local Health District Call New Horizons: 1300 726 372 Or STARTTS: 02 9646 6666 (ask for CLS-R) Email: [email protected]
Hunter New England Local Health District Call STARTTS: 02 9646 6666 (ask for CLS-R) Email: [email protected] Murrumbidgee Local Health District Call Australian Red Cross: 0478252652 (state language if interpreter needed) Email: [email protected] Illawarra Shoalhaven Local Health District Call Grand Pacific Health: (02) 42869200 Website: Community Living Supports for Refugees Western Sydney Local Health District Call Anglicare Sydney: 1300 111 278 Email: [email protected]
Jesuit Refugee Services
Jesuit Refugee Services Australia runs a specialist casework service for people seeking asylum, refugees, and migrants in vulnerable situations. Contact Phone: (02) 9098 9336 Email: [email protected] Website: https://aus.jrs.net/en/jesuit-refugee-service
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NSW Mental Health Line - Call 1800 011 511 The Mental Health Line offers professional help and advice and referrals to local mental health services. If English is not your first language you can use the telephone Translating and Interpreting Service (TIS) to speak to a mental health professional at the Mental Health Line. Call TIS on 131 450 and ask them to ring the Mental Health line on 1800 011 511. NSW Refugee Health Service
The NSW Refugee Health Service aims to protect and promote the health of refugees and people of refugee-like backgrounds living in NSW, including early health assessment and educates health service providers on refugee health and related issues and acts as a link between agencies working with refugees and health services. Contact Phone: (02) 9794 0770 Email: [email protected] Website: www.swslhd.health.nsw.gov.au/refugee Settlement Services International (SSI)
SSI is a community organisation and social business that supports newcomers and other Australians to achieve their full potential. SSI works with all people who have experienced vulnerability, including refugees, people seeking asylum and culturally and linguistically diverse (CALD) communities, to build capacity and enable them to overcome inequality. Contact Phone: 02 8799 6700 Email: [email protected] Website: www.ssi.org.au The Refugee Council of Australia maintains a database of additional refugee and asylum seeker services at: www.refugeecouncil.org.au/services-nsw
Bilingual mental health professionals
Australian Association of Social Workers (AASW) The AASW Directory for Social Workers can be searched by language preference. www.aasw.asn.au/find-a-social-worker/search Australian Psychological Society Find a psychologist. Search for a psychologist using issue, name, location or area of practice, then refine result by selecting from ‘Preferred Language’ www.psychology.org.au/Find-a-Psychologist
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Psychology Today Directory Directory of psychologists in NSW select Language from ‘More’ www.psychologytoday.com/au/counselling/nsw/sydney Royal Australian and New Zealand College of Psychiatrists Find a Psychiatrist directory can be searched using location, language, problem area and practice details. www.yourhealthinmind.org/find-a-psychiatrist
References
Australian Army (2021) Australian Army in Afghanistan, Army https://www.army.gov.au/our-heritage/history/history-focus/australian-army-afghanistan <viewed 20 August 2021> Australian Government, Department of Home Affairs Settlement Reports https://www.data.gov.au/dataset/ds-dga-8d1b90a9-a4d7-4b10-ad6a-8273722c8628/details?q= <viewed 17 August 2021> Australian Bureau of Statistics (2016) Census of Population and Housing. Census Table Builder. https://www.abs.gov.au/websitedbs/censushome.nsf/home/tablebuilder <viewed 17 August 2021> Australian Bureau of Statistics (2016) Census QuickStats Country of Birth: Afghanistan, Location: NSW. https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/6101_036 <viewed 17 August 2021> BBC News. Who are the Taliban? https://www.bbc.com/news/world-south-asia-11451718 <viewed 16 August 2021> Handley, E. & Tomevska, S. (2021) ‘Australian Afghan and Hazara communities in shock and fear as Taliban take Kabul’ ABC News https://www.abc.net.au/news/2021-08-17/darkest-day-afghan-australian-taliban-takes-kabul-hazaras/100380746 <viewed 17 August 2021> Human Rights Watch (2020) “You Have No Right to Complain” Education, Social Restrictions, and Justice in Taliban-Held Afghanistan. https://www.hrw.org/report/2020/06/30/you-have-no-right-complain/education-social-restrictions-and-justice-taliban-held <viewed 16 August 2021>
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Hurst, D. & Doherty, B. (2021) Afghans in Australia won’t be sent back while security situation remains dire, minister says. The Guardian - Australian Edition 17 August 2021. https://www.theguardian.com/australia-news/2021/aug/17/afghans-in-australia-wont-be-sent-back-while-security-situation-remains-dire-minister-says <viewed 18 August 2021> Rasheed, Z (2021) ‘Taliban says Afghanistan war over as president flees’ Aljazeera 16 Aug 2021 https://www.aljazeera.com/news/2021/8/16/taliban-says-afghanistan-war-over-as-president-diplomats-flee <viewed 16 August 2021> Raz Mohammad, A. & Sapiano, J. (2021) ‘As the Taliban returns, 20 years of progress for women looks set to disappear overnight’. The Conversation August 16, 2021 4.07pm AEST https://theconversation.com/as-the-taliban-returns-20-years-of-progress-for-women-looks-set-to-disappear-overnight-165012 <viewed 16 August 2021>
Note on culture
This profile has been prepared by the Transcultural Mental Health Centre. It aims to provide general information about Afghan people and culture. It is not prescriptive and cannot be applied to every individual born in Afghanistan or with Afghan heritage. It is important to remember that culture is more than a set of inherited traditions and beliefs. Culture is shaped by historical, political, social and economic circumstances and is constantly evolving and changing as it circulates across nations and geographic boundaries.