Asylum Seeker and Refugee Health Hub

Date: 19/02/2019

Cabrini’s Asylum Seeker and Refugee Health Hub in Brunswick is helping some of the most vulnerable in our community.

Since opening in 2016, the Hub has received more than 500 referrals of patients and currently has 320 active clients.

The operation is twofold, with a nurse-led primary care service and a specialist mental health service, largely staffed by pro bono health professionals.

Medical Director for the Hub, Dr Gillian Singleton, said the service filled an unmet need in the community.

“There aren’t many health services in the north-eastern corridor with the capacity to meet the needs of the individuals and families we see, so we are filling a huge gap,” Dr Singleton said.

“More than half of the people we see have no access to Medicare and more than 80 per cent have no source of income or financial support and so have barriers to accessing other medical services.  Referrals to our service are increasing every month and the demographics of our clients are shifting, with increasing numbers of women and children presenting to the Hub.” 

“At the primary care service, we see a lot of complexity, more than 60 per cent of our patients have at least one chronic disease, 18 per cent have multiple chronic diseases and 22 per cent have concurrent mental health issues such as post-traumatic stress disorder (PTSD). Other common conditions managed at the Hub include chronic pain, hepatitis B, nutritional deficiencies, diabetes and latent tuberculosis.”

Of those patients presenting to the mental health service, more than 50 per cent have experienced torture and trauma and 18 per cent have been transferred from offshore detention.

“It is very hard to maintain your resilience when you have received so many setbacks,” Dr Singleton said.

“The evidence is clear that the longer people are living in uncertainty, the more likely they are to experience significant physical and mental health issues.

“Generally speaking, people seeking asylum who arrive in Australia are incredibly resilient people and there is good evidence that if they are well supported, they have enormous potential but detention and prolonged processing times can impact their ability to maintain that resilience. It’s important to recognise that people who arrived by boat and are awaiting resolution of their claims, even if successful, will not be eligible to settle in Australia permanently, at best they may be able to access a three or five-year temporary visa.”

“The most common thing we see in individuals presenting to our service, is a sense of hopelessness and injustice, they feel unsupported and can’t see any potential for respite in the future, which impacts their mental state and their sense of self. This can lead them to give up on life because they feel they are out of options.” 

Dr Singleton said recent changes to Federal Government legislation meant many people who were previously eligible for income support and other services, such as torture and trauma counselling and casework support, are now ineligible.

“Most of the asylum seekers we see are on temporary bridging visas and are learning English. They are expected to find a job but this can be very difficult if you are on a temporary visa with minimal English,” she said.

“Unlike permanent residents, they have no access to Centrelink so most of them have no income at all to support themselves.”

Most of the asylum seekers are reliant on charitable organisations to provide housing, food and other vital resources.  

The Hub also offers pharmaceutical waivers, which enable asylum seekers to access essential medications they require.

Hub clients have come from 37 different countries, but the majority are from the Middle Eastern region, particularly Iran, Pakistan and Iraq.

Dr Singleton said many of the individuals who consult her at the Hub had been in detention centres and faced waits of more than five years for processing in Australia.

“Most are fleeing persecution, which in itself can cause significant mental health problems,” she said.

“Some are very severely affected by what they have experienced.”

“Living in uncertainty for years makes it very difficult to plan for the future because individuals don’t know what it holds for them, if they will see their families again or where they will eventually be settled.”

Dr Singleton said for many of the asylum seekers, Australia was not the fresh start they had been expecting.

“They have come here in the hope of a better life and have instead faced further hardship including detention, destitution and many years waiting for their visa applications to be processed. Many lose contact with their relatives back home as they are ashamed that their new life has not turned out as expected.”

However, for many who come through the doors of the Hub it is just the help they needed.

“We have had some patients who have been granted permanent residency, though that is rare,” Dr Singleton said.

“For others, we have been able to provide access to services they would never have otherwise been connected with. We have provided a safe, compassionate and respectful therapeutic space for them, so it feels like we are making a difference.”

“We often see individuals at their most vulnerable, when they first present, and then, months later, when you can see the small positive changes in their lives and an improved sense of self and hope, which can be incredibly rewarding.”

“Everyone we see is extremely grateful for the assistance they receive.”

Aside from a small number of paid staff, the majority of the clinicians provide their services pro bono, including GPs, psychiatrists and a physiotherapist.

“It is really inspiring that there are so many health professionals who are dedicated and passionate about these issues and are willing to regularly give up their own time to provide this care to people in need,” Dr Singleton said.

“Personally, I have been passionate about refugee and asylum seeker health for a long time and I’m privileged to be able to provide care to those who otherwise couldn’t access it.”

Cabrini’s Asylum Seeker and Refugee Health Hub is located in Sydney Road in Brunswick and is open Monday to Friday as well as some Saturdays.

The Hub has been receiving large numbers of referrals, particularly to the specialist mental health service, and is currently in need of psychiatrists who are willing to provide pro bono care. To express your interest in being involved, phone Tracey Cabrie at the Hub on 8388 7874.