Foundation HouseAn integrated model of refugee mental health careJenny Adams

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

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

Complementary therapy modalities:

Herbal and nutritional medicines – fully funded dispensary

Massage

Yoga groups

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

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

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

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.

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!

Thankyou!Client and interpreter Colleagues at Foundation HouseJudy Singer