Brave in their new world: service provision for refugee youth with comorbidity in northern metropolitan Adelaide

Abstract

Northern metropolitan Adelaide, South Australia is an area which experiences considerable social disadvantage. It is also an area in which a significant number of (predominantly young) refugee background individuals have resettled. Research indicates that refugee youth may be at elevated risk of mental health (MH) and alcohol and other drug (AOD) problems. These factors, combined with the low socio-economic status of northern Adelaide, the number of refugee youth residing there, and the added complexity of treating comorbid MH and AOD problems (comorbidity) prompted this research. This thesis explored the experiences and needs of young people from refugee backgrounds with comorbid MH and AOD disorders living in northern metropolitan Adelaide. The first aim was to identify risk factors which lead to the development of comorbid MH and AOD disorders among refugee youth living in this region. The second aim was to explore the challenges refugee youth experience once they develop comorbid MH and AOD disorders and how these may impact on the provision of MH and AOD services. The third and final aim was to identify the barriers and facilitators to effective, culturally responsive service provision for refugee youth with comorbid MH and AOD disorders. This research employed a sequential exploratory mixed-methods design drawing on principles of Participatory Action Research (PAR) and with theoretical underpinnings in critical theory and constructionism. Qualitative interviews were conducted with refugee youth aged 12-25 years from African, Bhutanese, and Afghan backgrounds (n = 15) and with service providers from MH, AOD and refugee support services (n = 15). Interview data were analysed using a thematic approach. The findings from the interviews then informed development and analysis of the quantitative online survey which was conducted with managers of MH, AOD and other services (n = 56). Overall, this research highlighted significant difficulties which impact on the ability of a young person from a refugee background with comorbidity to access and receive adequate service provision. This thesis discussed ways of overcoming these challenges in order to improve the service response to this client group in this region. It is hoped that the findings presented in this thesis are of value to both policy makers and clinicians.