1 The Experiences of Refugee Children Resettling in New ZealandCaroline Judson Supervisors: Fred Seymour (Primary) Kerry Gibson (Secondary
2 Background: The BasicsA refugee is someone who “owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country” (United Nations Convention, 1951) Approximately 16million refugees and asylum seekers world-wide Approximately half of these are under the age of 18 This figure has been increasing since the second half of the 20th century
3 Background: The BasicsInternational research shows: That refugee children are more than 3x more likely to experience severe mental health disturbances, especially depression, PTSD and anxiety, than the general population Parental mental illness increases risk of child mental illness and poor acculturation Parental experiences and cultural expectations impacts on child’s ability to acculturate and mental health Poor acculturation can lead to inter-generational difficulties Long term literature suggests that the quicker someone accepts their new country and are able to acculturate the better the long term outcomes are
4 Background: NZ ContextArrival in NZ Mangere Refugee Centre English lessons, medical screening, psychological screening, NZ culture lessons, the practicalities of living in NZ (finances, bank accounts, transport etc) What happens after they leave Mangere? Mobile team Community Support Workers Volunteers Refugees may spend many years in refugee camps or transit countries. When they do arrive in New Zealand, they spend 6 weeks in Auckland at the Mangere Refugee Centre. RAS is the mental health centre in Mangere, where there are counsellers, psychologists, psychiatrists, and body therapists all working together. People can self refer, or if there are refugees who are thought to be at high risk of mental health complaints, RAS will seek them out for an assessment. Once the refugees leave Mangere, they are resettled around the country. Once in the community, each refugee family is assigned at least one volunteer who is responsible for helping them furnish their house, find their way around the community, register with a doctor and so on. There is also a social worker assigned to each family. The amount of time the volunteers and social workers spend with the family depends on the needs of the family as well as the time constraints of the worker. Each city in NZ has a different programme for looking after it’s refugee’s, and it is highly dependent on available resources and personnel. The one commonality is that most refugees will continue to attend English classes for at least a few weeks once the are in their new house, but this too depends on availability and cost. Currently in New Zealand, there are supports and interventions set up for adult refugee’s, adolescent refugee’s, and refugee families, but there is nothing specifically targeting children.
5 Research Background Importance:There appears to be an under-referral of children to community mental health facilities – why is this? No child orientated interventions in New Zealand International research indicates – High rate of mental illness in child refugees Better resettlement outcomes if needs are met early on in the resettlement process The important of the research comes from a number of reasons. There are a number of children that are assessed as “high risk” by Mangere that are not followed up in the community. This could be for a number of reasons including that the child is not having any difficulties, but may also be because the child or their family do not know how to get the help that they need. There are currently no child orientated protocols for refugee children in the children, and it would be helpful to know what interventions would these children respond to best.
6 Aims To explore the variety of pathways that child refugee’s take in their adaptation into New Zealand society, and to see how these pathways evolve over a ten month period Aims of the Research: Increase knowledge about this population Increase awareness of child refugee’s needs Look at factors that contribute to resettlement in NZ
7 Participants Participants:Quota refugee children and their mothers who arrived in New Zealand between July 2011 and December 2011 Age: 7 – 12 year olds (School Years 2 – 8) Number: 14 families (includes 19 children) Ethnicities: Bhutan – 2 families (2 children) Colombia – 2 families (3 children) Burma – 10 families (14 children)
8 Methodology InterviewsThree rounds of interviews with the mother and child separately at 5 weeks after arrival; four months later; and 6 months later Analysis Thematic analysis Parent and child interviews transcribed and analysed Language difficulties and limitations Thematic Analysis - language barrier, as all interviews are conducted through an interpreter. This means that other types of qualitative analysis is not appropriate as it is not strictly the participants words. Thematic analysis is able to capture the themes across participants and to convey an over all picture of what is happening in each of these families as well as themes across families.
9 Framework for AnalysisReflexivity Relative power differential Language and cultural barriers Own background Flexibility Pragmatic approach Use all sources of information available: Interpreter RAS Social workers Mangere Refugee Centre staff
10 Preliminary Analysis: 1st RoundChild Interviews Felt unsafe in the transit country “Like in Malaysia, it is not safe, we can go to school, but we were not allowed to play outside or go anywhere by ourselves” (FR, age 9) “There was lots of tension and stress because the system was not good and people have to work really really hard...it is scary and some people might be dead or someone would kill family members, or something would happen” (NB, age 12) Resettlement as a “normal” part of life “My best friend has already gone to America” (KS, age 9) Feelings of being unsafe in the transit country with many of the them speaking about not being able to go outside and play, of witnessing violence in the camps, and feeling stressed. Many of the children also spoke about resettlement as part of their lives, with stories of saying goodbye to many of their friends, and always knowing that they would not live in the transit country for ever. There was a feeling that they were never at “home”, though many of them did report having friends and attachment to the transit country. For most of my participants, the transit country was the only country they knew as they had been born there, so it speaks to growing up in under a constant level of stress and being an “outsider”.
11 Preliminary Analysis: 1st RoundChild Interviews Domestic violence “My Dad was good but not anymore. He would hit Mum” (LR, age 10) “Mum and Dad fight with their arms and body as well [as yelling]” (NA, age 8) Mother is their main support “I tell Mum when things are bad...she takes all of my bad dreams away” (KV, age 7) Happy to be in New Zealand “I’m very happy, and happy to go to school” (MN, age 10) Just over half also reported seeing or hearing violence between their parents, and family violence was seen as a normal part of their upbringing.\ Support from mother - While this is expected from this age group, it is important as mother is also under a lot of stress and they are new to New Zealand without the knowledge to guide their children, so there could be fractures in this relationship. When asked about how they felt about being in New Zealand, nearly all of them said happy and they were looking forward to going to school and making friends. So there was a quite hopeful feel to these interviews.
12 Preliminary Analysis: 1st RoundParent Interviews Violence and lack of safety in past “It’s like a horror movie” “The people in the armed groups, you can’t even call them people, they are like machines – they will kill your best friend then come into your house and tell you all of the details” Mental health problems “I don’t know what’s wrong with me, I want to cry and scream, I think I am crazy, I don’t know what’s wrong with me” Domestic violence “My husband would beat me quite badly when we got to Ecuador, but my life had no value and I couldn’t do anything” “In the camp he would often hit me and I had lots of bruises and swollen lumps” Nearly all of the parents that I spoke to told stories of violence and persecution in the past, both in their country of origin, as well as in the transit country. The time that my participants had spent as displaced people or refugees ranged from 4 years to 20 years, with the majority having spent more than 11 years as a refugee. With the amount of insecurity that this status gives, the disconnection to home and family, and the constant struggle for survival and persecution it is not surprising that there were very high levels of stress and anxiety in nearly all of my adult participants when I first met them. Their main mental health complaints were severe anxiety and psychosomatic symptoms including flashbacks. Many of them also reported domestic violence which appeared to be related to the length of time spent as a refugee, with people who had spent longer in refugee camps reporting higher levels of spousal abuse. This was also related to high levels of alcohol abuse, poverty and lack of power to change their situation.
13 Preliminary Analysis: 1st RoundParent Interviews Future: Scared to hope Living for the children Religion “I can’t have high hopes for the future” “I thought about my children and that they needed me, so I didn’t do it (commit suicide)” “We have been going to church here and it has been wonderful, and everyone has been so good to us, I feel very happy” When asked about the future, a common response was that they were able to keep going because of their children and wanting to give their children a better life. For themselves they were quite afraid to hope.
14 Round 2: First ImpressionsChild Interviews School bullying Racism Miss friends in transit country Low mood Some general impressions from the children’s interviews is the general influence and importance of the school environment to their own feelings of well-being. Many of them have encountered bullying and racism at school and this has lead to a lower mood and more thoughts about wanting to return to the transit country. Those children who had been able to make friends, especially with the local population, were much more hopeful and settled. There wasn’t a lot of formal support for the children at school, so everything was highly dependent on the teachers, the other school children, the and the family’s volunteers to how well supported the child was.
15 Round 2: First ImpressionsParent Interviews Money concerns On-going anxiety Lack of power/knowledge Need to learn English In the interviews with the parents, there were still on-going anxiety levels, though this was more about needing to learn English, money difficulties and figuring out their new community. There were fewer reports of domestic violence, and higher rates of feelings of hope overall. One of the biggest difficulties the mothers are facing is a feeling of not being able to defend, guide or support their children, especially if the child is being bullied at school, as they can’t speak English and don’t know how to protect them.
16 Implications Language difficulties Lack of powerParents of limited help to children Difficulties accessing services On-going mental health and family concerns More resources needed for English classes Interventions in the school/Training for teachers Improved information about available services/community programmes Increased access and resources to mental health agencies with specialist skills While these findings are very preliminary, they do have a few implications. There appears to be a huge need for affordable English classes that last over a long period of time. With the acquisition of the language many of the other difficulties will decrease. With the parents feeling powerless and unable to help their children, there is a need for other people to be able to support the children, as well as the parent through this time. There could be room for improved services and training in schools as this is a dominant areas in the child’s life. More information about services available in the community, not just mental health agencies, but also community groups that parents and/or children can join feel supported and make connections with people could be helpful. And, finally, increased resources for mental health agencies working with these populations, as well as training for clinicians not familiar with this area could be invaluable. Remember, that international literature strongly suggests that the sooner you can help clients from forced migration backgrounds through their mental health complaints, the better their resettlement, and the better the long term outcomes.
17 Challenges Working through interpreters Accuracy of dataConfidentiality concerns Cross cultural work Trust and engagement Interpreters Working through interpreters means that you can’t pick up on subtleties in language and some of the meaning can be lost. I couldn’t rely on my normal communication skills and it was actually quite difficult at times to respond appropriately to the participant’s story as they would often swing and change and my response would be delayed by a few minutes. Furthermore, not all of the interpreters were qualified. While all of them worked full time as interpreters, not all of them had been through an interpreting course. The reason for using unqualified interpreters at times, is that there simply aren’t enough people who speak some of the languages in new Zealand and you need to rely on who ever is available. This means that at times you cannot be sure of the how either my questions were being translated, or how the answers were being translated. In addition, as there are small communities of these ethnicities, some of the interpreters knew the pariticpants socially by the time I met them in the community. This raises concerns about confidentiality, and may have curbed some of their answers. Cross Cultural Work Cross cultural work is always a challenge, as there are numerous cultural idiosyncracies that you cannot be aware of unless you are part of that culture. This can create barriers to communication, understanding, trust and engagement. I did my best to be knowledgeable about the different cultures in my study, but also took a position of genuine curiousity and asked the participants about their beliefs and ways of life. This not only increased my understanding, but also helped to join me with the participant. I also asked my interpreters for their knowledge and advice and about cultural practices and what was appropriate and not to decrease the risk of offense. My time spent at RAS prior to the interviews also helped, as it meant that the participants were familiar with me. I also tried to give them as much choice about what they wanted to discuss and whether or not they wanted other family members involved, and I have always left room in the interviews for general talk, so that it is not all business, and it is more of a genuine relationship.
18 Where to from here? Full analysis of first and second round of interviews Third round of interviews – July/August Highlighting areas of strength and difficulties for the refugee children and their families Addressing gaps in the current services provided to this population
19 Thank You To all of my wonderful participants for sharing their stories with me; and to my supervisors Fred Seymour and Kerry Gibson