Health Resources and Cultural Competency

Hello Wonderful FAMs,

I just wanted to share some resources that I have been introduced to.


The San Diego Refugee Forum has added a Health Resources section to their website, it has a lot of helpful information, including information on selecting providers, cards that can be printed out stating what language a client might speak, accessing free interpretation services, and insurance information. This and more is available here: http://www.sdrefugeeforum.org/resources/refugee-health-resources/ 


This guidebook may be helpful for those trying to map local resources (we are still developing our list of resources for you-please look out for it in the near future!): http://www.ethniccommunities.org/wp-content/uploads/2011/09/Local-Resource-Mapping-Guide-Project-SOAR1.pdf


Julie and I are also working to create a Cultural Competency training. I was hoping some of our wonderful FAMs might take the time to answer some of the following questions to aid us in the development and structure of the training.

1. Initially, would you be interested?
2. What types of situations would this sort of training be helpful for?
3. What are the challenges you've experienced?
4. What sort of information would you like covered?
5. What would the goal of the training be? 

Please feel free to provide us with any further suggestions or feedback! If you need ideas or more resources around Cultural Competency, try checking out this site: http://www.refugees.org/resources/for-service-providers/cultural-competency.html

Thanks, as always, for all you do!

Mental Health Form

Alliance for African Assistance

Refugee Mental Health Services

for Family Advocates

Family advocates are sometimes the first to see that a refugee is suffering the emotional or psychological effects of migration, trauma, and personal loss as the challenging reality of resettlement becomes clear. Alliance for African Assistance provides psychological services for refugees.

It is critical that family advocates be respectful of the particular cultural assumptions that refugees may have about admitting to their suffering or to the suffering of members of their family or community. As for many Americans, there is often great stigma around being thought of as “crazy.”

That said, if you recognize that a member of the family you are supporting is suffering emotionally or is displaying a behavior that worries you, you could be a critical advocate to assist them.

First of all, it is fine to express your concern for the refugee. Talking about their suffering will not make it worst but generally better. This is particularly true for statements about wanting to be dead, of wanting to commit suicide, or of wanting to hurt someone else. Just listen to their concerns without feeling like you have to solve their problem. Let them know that Alliance can help them.

Second, talk to Julie or Joelle. They can assist you connect with our psychologist, Dr. Dehnel.

Your conversation with Dr. Dehnel will be confidential and together you and he can figure out the best way to intervene. If the refugee wants you to keep what they have said to you confidential, you can talk to Dr. Dehnel about the concerns you have without revealing the name of the refugee or identifying information. You have the right to be informed, to learn, and to discuss your concerns. That is part of your role as a member of our team. You can call Dr. Dehnel at (619) 402-7305 or stop in his office at Alliance. He is very approachable and is interested in what you have to say.

In general, be respectful, assure the refugee that you will keep their confidence, and let them know that you will assist them find the help they need. Here are some indications that a refugee needs our help.

□  Suicidal Thoughts

□  Homicidal Thoughts

□  Sadness, Crying

□  Depression

□ Difficulty Sleeping

□  Hopelessness

□  Lack of Motivation, Interest

□  Feelings of Worthlessness

□  Loneliness

□  Difficulty Concentrating

□  Nervousness, Fear, Worry

□  Panic Attacks

□  Anger, Violence

□  Hallucinations, Delusions

□  Traumatic Flashbacks

□  Traumatic Memories

□  Emotional Numbness

□  Chronic Physical Pain

□  Alcohol or Drug Abuse

□  Eating Disorder

□  Sexual Problems

□  Personality Change

□  Difficulty Parenting

□  Difficulty Learning

FAM meeting 5/18/12

Family Advocate and Mentor Meeting: May 18, 2012

FAM Updates

§  Andre’a: family from Iran, the father speaks English well, she is helping the mother with hers, the daughter is learning very fast! She has taken them hiking, baked them cookies, joined them for dinner, etc.

§  Erin: family from Russia, has been mentoring them since December, she has taken them to the beach, grocery stores. They are enrolled in all ESL classes offered during the day.

§  Diane: family from Columbia, tutoring kids, teaching the father how to drive, she has also been helping advocate for childcare.

Staff Comments

§  Gerald: FAMs are a blessing, he presented in Washington in regards to the work we’re doing here and how integral volunteers are to our programs. Sees us as transformers, as a way to help refugees forget about the persecution they lived through. It is so important to have people here to help them through the process. He is happy when his mentored families say they don’t need him anymoreJ

Mental Health- Russell Dehnel

§  Refugees are expected to be on their feet in 6-8 months after arrival, yet they don’t always have the support needed to get there.

§  75% suffer from PTSD

o   -civil wars in Africa

o   Iraq/Iran/Afghanistan wars.

o   Dealing with things no human being is wired to deal with

§  On top of that: having to learn English, get jobs, adjust to new culture/environment/way of life, figuring out school systems here for their children, dealing with raising kids; needs of children-health, welfare, schools.

§  Upon Arrival, refugees are focused are resettling. After the first month or so, reality sets in; a whole other set of obstacles arises. They realize the economic and cultural state they are in.

§  FAMs act as community, support network: this is very similar to what a lot of our clients are used to in their home countries where “it takes a village to raise a child”: it takes a community to resettle!

§  Symptoms are listed on the referral sheet-related to trauma

§  If you notice anything, you can let any staff member know.
Questions…

§  If don’t see symptoms and don’t know their history, how do you address mental health?

o   Russell: just ask, ask about their lives. Listen to your gut, follow your heart. Find the right moment to ask and feel out the situation. You may want to let it be. Always feel free to alert me or any staff member to your hunch and we can discreetly handle it from there.

§  What if there is a problem with the wife and the husband doesn’t want her to come in?

o   Russell: in the US, independent health services are a right. Offer for her to come in and talk to a female nurse practitioner, if that’s helpful. Can use poor sleep as a reason for referral, etc. Alert us (Russell, Joelle, Julie, a Case Manager, etc) to the issue, especially if you are worried about losing trust. As a team we can develop a strategy-a way to include the family/husband to make sure the wife receives help. Respect roles, redefine roles so family gets what they need and acknowledge the need to maintain a sense of self worth for the husband. Although, he doesn’t have the right o refuse medical treatment for his wife. There are sensitive ways to address the issue.

Other Comments

§  Gerald: factors for choosing and making matches:

      They look for open families who want help, giving reserved families more time to adjust and realize they might need help.

      Language-consider where they are coming from and who can easily communicate with.

      Tells FAMs to do as much as they can/ feel comfortable with-don’t get burnt out and leave!

§  Erin: her own goal: for the family to become self sufficient. Connect to community, DMV, bank accounts, online banking, stores, government checks, ESL, school, job searching, park-fun!

      Erin can help clients set up bank accounts, learn online banking if you need help!

§  Andre’a: Use what you’ve got! All family’s needs are different!

§  Gerald: wants the clients he serves to get the best! Volunteers motivate him!

Resettlement: Domestic Service Provider Toolkit

Hello wonderful FAMs!

I just wanted to share this resource that was sent our way from the Cultural Orientation Resource Center: http://www.cal.org/co/domestic/toolkit/index.html

It looks like it has some really helpful resources, I suggest everyone take a look! Thanks for all your help and support!

warm regards,
Joelle

Thank you very much Joe for setting this blog up!

One thing Joe said to me on my way out after meeting that stuck with me: "Connecting refugees their particular culture's community in San Diego will help them more than we could ever individually. Maybe finding ways to connect refugees to those who are best equipped to help may be the most beneficial act of service we could make for our families."

One more plug for Mary Pipher's book The Middle of Everywhere: Helping Refugees Enter the American Community (this is the newer version of her book The Middle of Everywhere: The World's Refugees Come To Our Town)

If anything I said during our meeting last friday resonated with you (or even if it didn't. haha:), I highly encourage you to pick this book up as probably more than half of what came out of my mouth was paraphrasing Mary Pipher's words from this book

link to free fix-it service for any households with occupants 60+ years old http://www.jfssd.org/site/PageServer?pagename=programs_older_fix_it

link to free car-seat 2 hour class and booster: http://www.pscsd.com/car-seat-safety/car-seat-program.html

looking forward to a fruitful collaboration.

Warmly,

mitchell hambley
(831)601-7484

Family Advocate and Mentor Meeting, February 3, 2012

Staff who attended:

Basima, Gerald, Joelle and Julie

FAM’s who attended:

Mitchell, Erin, Bryan, Krit, Kira, Jessica, Heidi, Dara, Diane, and Kirk

I. Basima and Gerald introductions

a. Very busy with clients, stretched very thin

b. Greatly appreciate everyone wanting to help, the one-on-one support provided by FAM’s, no matter how big or small you may see it, is essential to them-Thank you!

c. Wanting to work with you, establish lines of communication, creating a support group for each other

II. Mitchell

a. Case by case basis, however jotted down a few things that have occurred to him

b. Balancing learning and teaching

c.  Learning basic words in your family’s language

                                   i. Showing respect, managing age differences, cultural differences, etc

d. Knowing resources in SD; encouraging collaboration, sharing obstacles, finding support groups/communities

                                   i. San Diego Refugee Forum

                                   ii. Elder home repair

                                   iii. Booster seats; instruction, free booster seats

                                   iv. Free tutoring, lap tops

                                    v. SD volunteer lawyers

e. Don’t have to reinvent the wheel

                                    i. A book he found helpful: The Middle of Everywhere: Helping Refugees Enter the American Community by Mary Pipher

                                    ii. Informative films from the IRC, Survivors of Torture

f. Teaching use of google maps, bargain shopping; craigslist, etc

g. Letting family know the tap water is ok to drink!

h. Remembering to take care of you as well!!!

III. Erin

a. Bus passes, free resources to explore

b. Russian to English phrases-trying to meet halfway

c. Exploring San Diego: the park, the beach-fun things!

d. Finding out logistics of family: now enrolled in ESL classes, in all available sessionsJ

IV. Bryan

a. Tutoring/helping with homework

b. Dynamics of working with all Somali women

c.  Learning Somali, being humble, a learner

d.  City Heights connections-Mosque

e.  Although you may not know everything, you are a lot more capable of finding the answers and helping

V. Krit

a. Figuring out what resources they need; his case-father is blind, probably not going to be able to work, what about his daughters?

                                    i. Center for the Blind, next to the Alliance, will they help with transportation?

b. Bringing in your resources: daughter in law helping fix computer

VI. Logistics

a. Goals: self sufficiency, rebuilding lives and communities

b. Income support:

                                     i. Types: Refugee Cash Assistance, Food Stamps

                                     ii. Adults, without children, through Catholic Charities Wilson Fish program; receive income support for 8 months

                                     iii. Can last longer for families with children, through Welfare

                                     iv. Matching grant program (also with Sam, our Job Developer): lasts 3 months

c. Where are various cultural/ethnic communities located throughout San Diego?

d. PTSD-building trust

e. Make no assumptions, try to empower, connect to resources-find out who else is involved in their lives-work with them!

                                       i. Mitchell: a single stick can be broken, a bundle of sticks cannot

Welcome to the Family Advocate Forum

Welcome AFAA Members!

I'm sure you all feel the same sense of adventure I do, and you are excited to get started. Some of you already started and shared valuable advice in our Friday afternoon meeting; thank you very much. We will all have different challenges and unique experiences with our refugee families in the coming days, weeks, and months. Overcoming those challenges will require us to generate creative, logical, and resourceful solutions. Some solutions will be family specific, but others we can all use. This blog is intended for us -- to share those common solutions -- that we likely can all utilize.

I know we will want to share our stories with each other, but for the sake of organization and efficiency, let's stick to posting advisory content here. I will create a second blog for us to share our stories, because I know they will be amazing! I wish you all good luck and look forward to reading your posts.

- Joseph Tilseth