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Foundation HouseAn integrated model of refugee mental health careJenny Adams
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Foundation HouseRefugee mental health organisation –
survivors of torture and trauma3 sites across Melbourne >130 staffOperating since 1988
◦Counsellors – social workers, psychologists◦Complementary therapies team - since1990◦Mental health clinic – psychiatrists and
psychologists under Medicare◦Schools team◦Research and policy
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Client groupsClients – refugees and asylum
seekers from 30 different countries◦Currently majority from Iran,
Afghanistan, Iraq, Sri Lanka, Burma, Bhutan, African countries – Ethiopia, Congo, Sudan
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Complementary therapy modalities:
Herbal and nutritional medicines – fully funded dispensary
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Massage
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Yoga groups
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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
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Case study – “Tenzing”Tibetan woman 48yoReferred by counsellorPH 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 depressionFrequent cryingConstipationNot receptive to counselling but grateful for advocacyDevout Buddhist with strong faith in traditional
Tibetan medicine
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Collaborative careRegular discussion with counsellor –
check that treatment goals consistent, compatible. Compare presentation.
Travel training by student on placementLiaison with GP to exclude medical
diagnoses and check prescribed medsReferred to Tibetan Buddhist centre
and arranged meeting with senior monk. Liaised with interpreter to assist her with transport
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Case study – CT treatmentHerbal 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.
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Case studyRegular appointments over 2 years –
fortnightly to monthly to 2nd monthlySleep improved. Reduced hyperarousalPain decreased – more manageable but
still dominant symptomFewer headaches (from 2/wk to
1-2/month)Less depressive symptomsConstipation chronic!
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Thankyou!Client and interpreter Colleagues at Foundation HouseJudy Singer