Introduction
A new report looks at the problems of people with disabilities from a refugee background in northern Melbourne. The difficulties of those in need of disability support in getting appropriate support are made even more challenging for those from a refugee background. These challenges are the focus of a report by the Victorian Refugee Health Network, Service responses for people with disabilities from refugee backgrounds in northern Melbourne. In 2018, the Victorian Refugee Health Network received funding from the Victorian Government “to complete a needs assessment of the responsiveness of the disability and refugee health service system in northern Melbourne” as part of the Absolutely everyone: State disability plan 2017-2020.
Refugees often come to Australia with conditions that have not been treated or even recognised, or conditions unfamiliar to Australian doctors. They find it even more difficult to get appropriate care because of the challenges new arrivals face. These include gaining access to basic things such as housing, transport, income support, employment, and education, as well as struggles with language.
The report
Many refugees and people seeking asylum settled in Melbourne’s north in 2016-17. Many more are expected to continue settling there, because the quota of the Australia’s Refugee and Humanitarian Programme will increase. Northern Melbourne (defined by the Department of Health and Human Services) is comprised of the Local Government Areas of Hume, Whittlesea, Nillumbik, Moreland, Darebin, Banyule and Yarra. Most humanitarian arrivals who came to Victoria in 2016-17 settled in Hume (3121 of 7539).
The report notes it is difficult to get robust data about people from culturally and linguistically diverse backgrounds. Despite this, health services across Australia have been reporting more people coming from a refugee background with significant impairments and disabilities.
In identifying key issues and potential solutions, the report draws mostly upon interviews with service providers.
Findings
Caseworkers
Caseworkers were found to be crucial. Longer-term case work is needed. This is very important to children in need of extra care, such as special schools, kindergartens, and school holiday programs.
Consumer-driven care
The focus of the National Disability Insurance Scheme (NDIS) and aged care reforms on consumer-driven care may cause problems for those from refugee backgrounds. They often cannot create an appropriate NDIS plan. They can become confused and fearful at the prospect of older adults being placed in aged care facilities. Recently, projects with a focus on service literacy have been funded to improve the understanding of these programs for refugee families. In addition, some families do not understand the needs of family members with disabilities, with some impairments remaining undiagnosed.
Mobility
For those with disabilities, it is important that they are able to move around so they can attend appointments or even school. There may be significant problems in doing so if they do not have suitable support equipment. Even for those who don’t face difficulties in moving around, the public transport system is confusing.
Interpreters
Refugee communities often struggle with English, so it is important that they have access to and use interpreters. The report found that health professionals with funded access to interpreters sometimes did not use them, making things more difficult for clients. Families, in part because of a lack of awareness, did not always use interpreters for the education planning of disabled children, another area in which they are key.
Application process
It is also very challenging to gather and provide evidence to prove a disability and/or lack of functionality. This can cause a lot of stress for those from a refugee background, and even make them give up on applying. Health conditions get worse during the long process of applying. The results of improper assessment or delayed diagnosis can be severe, ranging from hospital admission to lifelong impairment.
Recommendations
The government, health and refugee sectors should ensure that:
- Disability care schemes are available to and inclusive of all those from refugee and asylum backgrounds.
- Interpreters are freely available to all those in need of them when trying to access disability services.
- There is a strong emphasis on identifying whether an interpreter is needed.
- There is greater education about the specific needs of refugees with disabilities, particularly relating to education and language.
- Helpful and relevant health information is gathered and shared efficiently in adherence with privacy laws.
- Mobility options, including transport, for those with disabilities are reviewed and funded appropriately.
- The needs of special schools and refugee children with disabilities are reviewed and supported.
- Other strategies for employment for those with disabilities are considered.
- Stigma relating to disabilities is addressed.