| dc.description.abstract | In this paper, I set out the challenges of care for refugees and
suggest approaches to assessment and intervention. I discuss
clinical interventions that can address the immediate concern of
the clinician in a bio-psycho-social framework, and the value of
considering eco-social and structural influences that can hinder
recovery and perpetuate inequalities. Refugees face multiple
adversities before, during and after escaping from life-threatening situations, political violence, torture and persecution. They
present with complex health needs and encounter hostility from
host countries and public services, which see their needs as an
additional demand on the public purse. Regrettably, existing care
practice and training of professionals do not often include skills
for working across cultures, including cultural formulations and
fair assessment, cultural adaptation of interventions, cultural
competence and cultural consultation methods, including clinical ethnography and exploration of cultural identity and
explanatory models. There are little data on effective and kind
models of interpretation and translation. Care systems are rarely
designed to fully address the needs of refugees. Health practitioners are not trained to address structural and institutional
racism and discrimination, which leads to exclusion of the most
marginalised, with little attention to social justice and fair
processes as part of appropriate healthcare. | en |
