Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Are we on the same page? Mental health literacy and access to care: a qualitative study in young Hazara refugees in Melbourne

Sahema Saberi https://orcid.org/0000-0002-5548-9507 A D , Caroline Wachtler B and Phyllis Lau https://orcid.org/0000-0002-0665-6348 A C
+ Author Affiliations
- Author Affiliations

A Deparment of General Practice, The University of Melbourne, Melbourne, Vic., Australia.

B Karolinska Institutet Department of Neurobiology, Care Sciences, and Society, Division of Family Medicine and Primary Care, Sweden.

C School of Medicine, Western Sydney University, Sydney, NSW, Australia.

D Corresponding author. Email: sahema.sab001@gmail.com

Australian Journal of Primary Health 27(6) 450-455 https://doi.org/10.1071/PY21017
Submitted: 29 January 2021  Accepted: 24 July 2021   Published: 22 November 2021

Abstract

Hazaras, mostly aged <30 years, constituted the greatest number of people resettled under Australia’s migration resettlement between 2009 and 2013. This group is at high risk of mental health issues due to pre- and post-forced migration experiences. This study explored the understanding of mental health and barriers to accessing primary mental health care in young Hazara refugees in Melbourne. Seventeen Hazaras aged 18–30 years were recruited for two sex-segregated focus groups; two individual semistructured interviews were also conducted (with one male and one female participant). Discussions were audiotaped, transcribed and analysed thematically. Participants had varied perspectives on mental health issues stemming from historical and current beliefs. Lack of knowledge and concerns over confidentiality within Hazaras were considered major barriers to seeking help. Community education through existing community groups and through the women could potentially help overcome barriers to mental health access by young Hazaras.

Keywords: mental health, community mental health service, health service delivery, youth health, primary health care, minority health, refugee health, asylum seeker, Hazara, culturally and linguistically diverse.


References

Ahmadzai SJ (2020) Afghanistan peace talks begin – but will the Taliban hold up their end of the deal? The Conversation 13 September. Available at https://theconversation.com/afghanistan-peace-talks-begin-but-will-the-taliban-hold-up-their-end-of-the-deal-146081

Alegría M, NeMoyer A, Falgàs Bagué I, Wang Y, Alvarez K (2018) Social determinants of mental health: where we are and where we need to go. Current Psychiatry Reports 20, 95
Social determinants of mental health: where we are and where we need to go.Crossref | GoogleScholarGoogle Scholar | 30221308PubMed |

Au M, Anandakumar AD, Preston R, Ray RA, Davis M (2019) A model explaining refugee experiences of the Australian healthcare system: a systematic review of refugee perceptions. BMC International Health and Human Rights 19, 22
A model explaining refugee experiences of the Australian healthcare system: a systematic review of refugee perceptions.Crossref | GoogleScholarGoogle Scholar | 31319819PubMed |

Australian Government, Department of Home Affairs (2018) Afghanistan-born Community Information Summary. Available at https://www.homeaffairs.gov.au/mca/files/2016-cis-afghanistan.PDF

Aydin C (2017) How to forget the unforgettable? On collective trauma, cultural identity, and mnemotechnologies. Identity 17, 125–137.
How to forget the unforgettable? On collective trauma, cultural identity, and mnemotechnologies.Crossref | GoogleScholarGoogle Scholar |

Betancourt JR, Green AR (2010) Commentary: linking cultural competence training to improved health outcomes: perspectives from the Field. Academic Medicine 85, 583–585.
Commentary: linking cultural competence training to improved health outcomes: perspectives from the Field.Crossref | GoogleScholarGoogle Scholar | 20354370PubMed |

Braun V, Clarke V (2012) Thematic analysis. In ‘APA handbook of research methods in psychology, Vol 2: research designs: quantitative, qualitative, neuropsychological, and biological’. pp. 57–71. (American Psychological Association)10.1037/13620-004

Byrow Y, Pajak R, Specker P, Nickerson A (2020) Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: a systematic review. Clinical Psychology Review 75, 101812
Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: a systematic review.Crossref | GoogleScholarGoogle Scholar | 31901882PubMed |

Cheng I-H, Wahidi S, Vasi S, Samuel S (2015) Importance of community engagement in primary health care: the case of Afghan refugees. Australian Journal of Primary Health 21, 262–267.
Importance of community engagement in primary health care: the case of Afghan refugees.Crossref | GoogleScholarGoogle Scholar | 25102862PubMed |

Coffey GJ, Kaplan I, Sampson RC, Tucci MM (2010) The meaning and mental health consequences of long-term immigration detention for people seeking asylum. Social Science & Medicine 70, 2070–2079.
The meaning and mental health consequences of long-term immigration detention for people seeking asylum.Crossref | GoogleScholarGoogle Scholar |

Colucci E, Minas H, Szwarc J, Guerra C, Paxton G (2015) In or out? Barriers and facilitators to refugee-background young people accessing mental health services. Transcultural Psychiatry 52, 766–790.
In or out? Barriers and facilitators to refugee-background young people accessing mental health services.Crossref | GoogleScholarGoogle Scholar | 25731986PubMed |

Commonwealth of Australia (2019) The Home Affairs Portfolio Annual Report 2018–2019. Available at https://www.homeaffairs.gov.au/reports-and-pubs/Annualreports/home-affairs-annual-report-2018-19.pdf

Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365, 1309–1314.
Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review.Crossref | GoogleScholarGoogle Scholar | 15823380PubMed |

Ganesan S, Mok H, McKenna M (2011) Perception of mental illness: preliminary exploratory research at a cross-cultural outpatient psychiatric clinic. The International Journal of Social Psychiatry 57, 81–89.
Perception of mental illness: preliminary exploratory research at a cross-cultural outpatient psychiatric clinic.Crossref | GoogleScholarGoogle Scholar | 21252358PubMed |

Khawaja NG, Ibrahim O, Schweitzer RD (2017) Mental wellbeing of students from refugee and migrant backgrounds: the mediating role of resilience. School Mental Health 9, 284–293.
Mental wellbeing of students from refugee and migrant backgrounds: the mediating role of resilience.Crossref | GoogleScholarGoogle Scholar |

Kirmayer LJ, Jarvis GE (2019) Culturally responsive services as a path to equity in mental healthcare. Healthcare Papers 18, 11–23.
Culturally responsive services as a path to equity in mental healthcare.Crossref | GoogleScholarGoogle Scholar | 31596698PubMed |

Kronick R (2018) Mental health of refugees and asylum seekers: assessment and intervention. Canadian Journal of Psychiatry 63, 290–296.
Mental health of refugees and asylum seekers: assessment and intervention.Crossref | GoogleScholarGoogle Scholar | 29207884PubMed |

Maley W (2020) On the return of Hazaras to Afghanistan. (Asia Pacific College of Diplomacy, Australian National University) Available at https://www.refugeecouncil.org.au/wp-content/uploads/2021/05/Maley-Hazaras-19.5.21.pdf

Murray Primary Health Network (2019) Our Hazara Communities, The Hazara Report. Available at https://www.murrayphn.org.au/portfolio-view/hazara/ [Verified 17 September 2021]

Nickerson A, Byrow Y, Pajak R, McMahon T, Bryant RA, Christensen H, Liddell BJ (2020) ‘Tell your story’: a randomized controlled trial of an online intervention to reduce mental health stigma and increase help-seeking in refugee men with posttraumatic stress. Psychological Medicine 50, 781–792.
‘Tell your story’: a randomized controlled trial of an online intervention to reduce mental health stigma and increase help-seeking in refugee men with posttraumatic stress.Crossref | GoogleScholarGoogle Scholar | 30973115PubMed |

NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) (2019) Hazara Mental Health Consultation Report. Sydney, NSW, Australia. Available at https://www.nswmentalhealthcommission.com.au/sites/default/files/old/starrts_hazar_report_sept_2019.pdf

Salami B, Salma J, Hegadoren K (2019) Access and utilization of mental health services for immigrants and refugees: perspectives of immigrant service providers. International Journal of Mental Health Nursing 28, 152–161.
Access and utilization of mental health services for immigrants and refugees: perspectives of immigrant service providers.Crossref | GoogleScholarGoogle Scholar | 29984880PubMed |

Shannon PJ, Wieling E, Simmelink-McCleary J, Becher E (2015) Beyond stigma: barriers to discussing mental health in refugee populations. Journal of Loss and Trauma 20, 281–296.
Beyond stigma: barriers to discussing mental health in refugee populations.Crossref | GoogleScholarGoogle Scholar |

Slewa-Younan S, Yaser A, Guajardo MGU, Mannan H, Smith CA, Mond JM (2017a) The mental health and help-seeking behaviour of resettled Afghan refugees in Australia. International Journal of Mental Health Systems 11, 49
The mental health and help-seeking behaviour of resettled Afghan refugees in Australia.Crossref | GoogleScholarGoogle Scholar | 28855961PubMed |

Slewa-Younan S, Guajardo MGU, Yaser A, Mond J, Smith M, Milosevic D, Smith C, Lujic S, Jorm AF (2017b) Causes of and risk factors for posttraumatic stress disorder: the beliefs of Iraqi and Afghan refugees resettled in Australia. International Journal of Mental Health Systems 11, 4
Causes of and risk factors for posttraumatic stress disorder: the beliefs of Iraqi and Afghan refugees resettled in Australia.Crossref | GoogleScholarGoogle Scholar | 28053660PubMed |

Smith LA, Reynish T, Hoang H, Mond J, Hannah C, McLeod K, Auckland S, Slewa‐Younan S (2019) The mental health of former refugees in regional Australia: a qualitative study. The Australian Journal of Rural Health 27, 459–462.
The mental health of former refugees in regional Australia: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 31650648PubMed |

Transcultural Mental Health Centre (2021) Afghan Community Mental Health Profile. Available at https://www.dhi.health.nsw.gov.au/transcultural-mental-health-centre-tmhc/health-professionals/afghan-community-mental-health-profile [Verified 17 September 2021]

UNESCO (2001) UNESCO Universal Declaration on Cultural Diversity. Adopted by the General Conference of the United Nations Educational, Scientific and Cultural Organization at its thirty-first session on 2 November 2001. Available at https://adsdatabase.ohchr.org/IssueLibrary/UNESCO%20Universal%20Declaration%20on%20Cultural%20Diversity.pdf

World Health Organization (WHO) (2003) Investing in Mental Health. Available at http://www.who.int/mental_health/en/investing_in_mnh_final.pdf

Wylie L, Corrado AM, Edwards N, Benlamri M, Murcia Monroy DE (2020) Reframing resilience: Strengthening continuity of patient care to improve the mental health of immigrants and refugees. International Journal of Mental Health Nursing 29, 69–79.
Reframing resilience: Strengthening continuity of patient care to improve the mental health of immigrants and refugees.Crossref | GoogleScholarGoogle Scholar | 31478332PubMed |