1. Refugee Wellbeing Mental Health & Addictions Shah Wali Atayee Maureen Zaya Neelam Jani

2. A refugee is someone who has been forced to flee his or her country because of persecution, war, or violence. A refugee has a well-founded fear of persecution for reasons of race, religion, nationality, political opinion or membership in a particular social group. Most likely, they cannot return home or are afraid to do so. War and ethnic, tribal and religious violence are leading causes of refugees fleeing their countries. UNHCR, convention of 1951

3. In NZ, we follow a three stage settlement strategy  refugee camp  independent living  to becoming part of our communities

5.  needing more assistance -transition into a new life in a foreign country  Besides physical ailments resulting in their homeland,  mental illnesses that follow, range from depression to more serious ailments

6. What refugee people are experiencing?  Torture and Trauma Experiences physical and psychological witnessing death or killing disappearance of family members  Mental health issues in children and young people  Common mental health conditions sleep problem, depression, feeling anxious, sad and angry  Experiencing loss and grief

7. New homeland stress of adapting to beliefs & values of host nation Socioeconomic disempowerment due to inadequate financial resources limited social class standing encountering race related issues

8.  eating disorders /panic attacks poor memory/ behavioral responses poor relationships with other people children refusing to go to school Physical symptoms, like breathing difficulties, pain & dizziness tension Poor concentration Nightmares /Anger and poor temper control Family violence Emotional pain

9.  Social stigma  Unfamiliarity with western medicine  Health care-provider relationships  Different health systems (counseling)  Access to services  Culture  Language/interpreter  Immigration or settlement issues  Family member left behind and trying to bring him to NZ

10. Don’t talk about mental illness /Feelings of shame Not feeling confident to talk to health provider especially when using interpreter from the same ethnic group People don’t know about depression, stress and panic attacks People don’t have a definition for depression in their language Religion based treatments –prayers in churches/mosques/temples/ancestral graveyards Using some natural medicine like herbs to treat the sickness  Self medication

11. Self medication will lead to substance dependence Tobacco use, smoking Caffeine use Drugs and alcohol Gambling Religious

12.  Early intervention  Improve accessibility for mental health treatment  Concerns for misdiagnosis Awareness  of cultural practices  influencing their coping choices  social & economic differences  access to interpreters