The meaning and the story: reflecting on a refugee's experiences of mental health services in Australia.
Year: 2010
Type: article
Abstract: As the medical profession struggles to move into an evidence‐based world there are many areas where the evidence for success is scanty and doctors need to listen to stories from their patients and colleagues to find ways of dealing with difficult issues. One of these areas is that of transcultural mental health and in particular the mental health of patients who come from a refugee background. The use of the patient's narrative of their illness as a means of diagnosis is championed by authorities from the field of narrative medicine,1 but also by those who are developing the cultural formulation guidelines of the DSM‐IV.2 These writers discuss the importance of ‘narrative competence’ and of listening to patients' stories about what is happening to them,1 including listening for information about their ‘world‐view, perspectives on self and body, and related mental health and social problems’2 so as to obtain a deeper understanding of the patient's presentation from within their own cultural and societal context. The aim is to ‘complement the multiaxial diagnosis of a person's health problems with a review of his or her cultural identity, experience of illness and help‐seeking behaviour, social functioning and social supports based on cultural constructs and standards, and the potential cultural conflicts of the clinician–patient relationship’.2 For refugees, who not only have cross‐cultural hurdles to overcome but who also struggle with a higher burden of mental health issues, narrative can offer ‘a method for addressing existential qualities such as inner hurt, despair, hope, grief, and moral pain which frequently accompany, and may even constitute, people's illnesses’.3 Listening to Tarik's reflections about the difficulties he had as a refugee from Iraq negotiating the Australian mental health system and the solutions he suggests to overcome those difficulties is one way of beginning to develop this narrative competence.
Source: PubMed
Authors: Jill Benson, Tarik Al Haris, Borhan Saaid
Institution: The University of Adelaide
Language: English
Topic: Migration, Health and Trauma
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W177739182