Monash led partnership awarded $1.1 m to deal with the unique healthcare needs of refugees

Professor Grant Russell

A team of internationally renowned researchers and refugee health industry experts, led by Monash University, has been awarded a $1.1 million NHMRC Partnership grant to improve primary health care delivery to refugees living in Australia.

Over 75,000 permanent resident visas were granted to refugees and asylum seekers between 2010 and 2015. The majority of these refugees have significant health issues, which have never been addressed in their homeland or en route to Australia. In addition, the lack of a national system for reviewing health needs of refugees and ensuring adequate follow up often means these new Australians end up in the hospital emergency departments with serious conditions that could have been alleviated by early intervention.

The project, called the OPTIMISE Partnership Project, brings together academics from Monash University, the University of New South Wales, La Trobe University and the University of Ottawa with 11 leading Victorian, NSW and national partner organizations*.

According to lead researcher, Monash University’s Professor Grant Russell, refugees have complex health needs arising from past trauma and sub-optimal care prior to arrival.  While all states and territories accept refugees for resettlement, the majority settle in NSW and Victoria.

Compared to the wider population, refugees are at greater risk of:

•      mental health conditions
•      infectious disease
•      nutritional deficiencies
•      obstetric complications
•      poor dental health
•     and disability

According to Professor Russell, complex physical and psychological problems are often addressed only for the first time in Australia. While specialist services provide initial care for refugees on arrival, their long term care is less assured with many refugees “struggling to access mainstream general practitioners, specialists, community health services and hospitals due to language and cultural differences, limited understanding of the Australian health system and socioeconomic disadvantage.”

Health providers are also under strain. “Despite best efforts, GPs and other service providers can struggle to provide appropriate care to refugees because of limited knowledge of refugee health needs and difficulties with providing interpreters and culturally responsive care,” he added.

While different states have different systems to integrate refugees into the mainstream health system, it is becoming increasingly clear that refugees struggle to access appropriate, high quality primary care.  Often the first point of call for new, often preventable problems, is the hospital emergency department, which adds to the burden on Commonwealth health budgets.

The OPTIMISE Partnership Project will focus on three Australian regions with high refugee resettlement: South East Melbourne, North West Melbourne and South West Sydney.

In the last 10 years alone, these regions received 51,000 humanitarian entrants equivalent to 36% of national intake.

Over the next four years (2016-2020), the OPTIMISE Partnership Project will identify pressure points in the current system of care relating to the accessibility of, transition between and quality within services caring for refugees and asylum seekers. Researchers and industry experts will work in close collaboration to design interventions to address these system gaps in an effective and sustainable way.

The vision of the OPTIMISE Partnership Project is to build health system capacity for ensuring that refugees and asylum seekers receive the primary care they need when they need it, thus reducing inappropriate use of hospital emergency departments.

MHTP collaborators include Professor Andrew Block, Professor Helena Teede, Professor Graham Meadows, Dr Joanne Enticott and Dr Sayed Wahidi.

* The national partner organizations are: Monash Health, cohealth, NSW Refugee Health Service, South Eastern Health Providers Association, North Western Melbourne PHN, South Western Sydney PHN, AMES Australia, Settlement Services International, Victorian Department of Health and Human Services, Victorian Refugee Health Network, Refugee Health Network of Australia and Royal Australian College of General Practitioners.