Mental Health Care for Immigrants, Refugees and Visitors
Good mental health is when we are in balance within ourselves and others. When we have good mental health, we manage to deal with negative and disappointing events.
Immigrants and refugees
Immigrants and refugees may experience some challenges in adjusting to their new environment. Difficulties can include language barrier, loss of family and community support, lack of recognition of professional qualifications and trauma, experienced before or after migration.
Many things can make you feel sad; this sadness might come unexpectedly. The different climate and nature, different food, or even a song you hear on the radio, or the smell of coffee could sometimes bring memories of your country, your family and your life back home. This could make you overwhelmingly sad.
When this happens, be gentle and kind to yourself. It is good to acknowledge these events and your feelings, and if you need to talk to someone you trust.
How we understand mental health in Australia
‘Consumers’ is a widely used term in Australia. It refers to people who seek help because of their mental health issues. In Australia consumers have choices and rights concerning their treatment.
Signs of mental illness
Some of the most common mental illnesses and the signs how to recognise them are:
- Depression – this is when you feel sad and lose interest in things you usually love. You might feel bad about yourself, not sleeping well, not enjoying life, feeling tired or crying most of the time.
- Anxiety – some of the most common signs that you might have an anxiety disorder are constant worries, racing heartbeat, thoughts or behaviours that you feel you cannot control.
- Psychosis – this is when the person is confused between what is real and what is not. People might have false beliefs that are not common for their culture. Some early signs of psychosis are wanting to be alone all or most of the time, not able to sleep, less expression of emotions, neglected personal hygiene, being suspicious even when around friends and family members, magical thinking, such as not being sure if a dream was a dream or if it really happened etc.
- Schizophrenia – it disturbs the life of the person and the people around them. Some of the signs of schizophrenia are: believing things that are not true (delusions), seeing or hearing things that others do not see or hear, feeling agitated, having confused speech.
NOTE: the signs listed above are only very brief indicators. If you think that you or someone else might have signs of mental illness, contact your local doctor.
Cultural context and mental health
Different cultures think differently about mental illness. In some cultures it is a good sign if a person is hearing voices as this is being understood as quality of a shaman, i.e. a healer. You have to feel comfortable with your treating doctor and make sure they understand your cultural and spiritual beliefs.
It can often take a while to realise that you need help but once you do, you need to know where help is available.
Where to go first and things to know
If you are concerned about your mental health and wellbeing, the first place to go to is your doctor, also known as General Practitioner (GP).
In Australia some GPs have special training in mental health care. you can call Beyondblue: 1300 22 4636 and ask for a doctor in your local area.
People who are entitled to Medicare can usually pay a small amount to see a GP, and in some cases nothing (this is called ‘bulk billing’).
Medicare and ‘Welcome Kit’
Medicare is Australia’s public health insurance scheme.
To get a Medicare card:
- Ring 132 011 and ask for your nearest Medicare office.
- Go to the Medicare office and ask for the Welcome Kit.
The Welcome Kit is in Arabic, Bosnian, Chinese, Croatian, English, Greek, Indonesian, Italian, Macedonian, Serbian, Spanish and Vietnamese.
People who reside in Australia, excluding Norfolk Island, are eligible for Medicare if they have one of the following:
- Australian citizenship
- Permanent residents
- New Zealand citizenship
- An application for certain permanent resident visas and holds a valid work visa
- A valid visa and are the parent, spouse or child who is an Australian citizen or permanent resident status
- Are covered by a Reciprocal Health Care Agreement with another country
Reciprocal Health Care Agreement
The Australian Government has signed Reciprocal Health Care agreements with other countries. This covers Australians for the cost of medical treatment while they are overseas. This countties are:
New Zealand, United Kingdom, Ireland, Italy, Sweden, Norway, Belgium, Finland, Netherlands, Malta, Slovenia.
If you are visiting Australia on a student visa you are not covered by Medicare. You should take out your own health insurance cover, otherwise you will be required to pay the full cost of any treatment that you need.
If you are on a working holiday visa, you may be covered by a ‘reciprocal agreement’ where you can obtain basic medical care, such as seeing a GP.
Residents of Ireland or New Zealand are:
- entitled to free treatment at a public hospital
- entitled to subsidised medicine during your visit
- NOT entitled to Medicare benefits for treatment provided through private hospitals and community health centres.
Residents of the United Kingdom, Sweden, Finland, Norway or The Netherlands are:
- covered by Medicare for the duration of their approved visit to Australia.
Residents of Malta or Italy, you are:
- covered for a period of six months from the date they arrive in Australia.
- are entitled to free treatment at a public hospital, and subsidised medicines during your visit to Australia.
- entitled to Medicare benefits for out-of-hospital medical treatment provided by doctors through private surgeries and community health centres.
You can enrol at Medicare offices throughout Australia as soon as you arrive.
If you receive treatment before you enrol, Medicare benefits will be back paid for eligible visitors.
Health Care Cards
Low income earners and people on some benefits and pensions from the government may be entitled to a Health Care Card. A Health Care Card or Pensioner Concession Card helps to pay for medicines prescribed by doctors, and some doctors will bulk bill for patients with this card.
You might not be eligible for Medicare if you:
- Have a current parent visa application being considered or have a current application for a protection visa and have previously applied for a parent visa
- Have a temporary prospective marriage visa (fiancé visa subclass 300) – you are not eligible for Medicare until you have had an application for a permanent resident visa accepted by the Department of Immigration and Multicultural and Indigenous Affairs (DIMIA).
Where else can you go for help?
A psychiatrist is a medical doctor who specialises in treating mental illness. Many psychiatrists focus on assessment and medication, although they can do other types of therapy as well. Psychiatrists’ fees are partially
covered by Medicare but there will be a ‘gap’ that you need to pay. If this is difficult, try the community mental health service in your area. Your GP can refer you to a local psychiatrist.
a Psychologist can not prescribe medication but they offer assessment and treatment for mental health problems. They offer counselling and psychotherapy, depending on the needs of the client. Medicare covers some of the cost of psychologists’ fees when you are referred by your GP.
The NSW Transcultural Mental Health Centre
The NSW Transcultural Mental Health Centre provides clinical services which include: multilingual psychosocial assessment, counselling, individual, family and group psycho-education, and language specific outreach
clinics to complement existing mental health services and to assist consumers and carers to access these services more effectively.
Community Mental Health
In addition to your GP, some community health centres may offer help with mental health and welfare problems. Some centres provide social workers or psychologists who give counselling and social support and all have links to local psychiatrists.
Community health centres often have multicultural health workers to help people from local ethnic groups, whilst Neighbourhood Centres often provide social support and programs for people living locally. There may be a small fee for some services. You do not usually need a referral.
Counsellors talk to people about their problems and feelings, and help them to find ways of coping. This can be useful if you have a mental health problem or when you have other difficulties such as bereavement, relationship breakdown, employment worries, etc.
Support groups provide safe place where people with similar issues meet to discuss and share personal stories. Many people think that support groups are very helpful.
The Asylum Seeker Assistance Scheme (AMES)
AMES is for people who are already on the Asylum Seeker Program.
AMES can help you with settlement by providing you with various services.
Not everyone is eligible to receive this service. You will need to call the Red Cross to find out more information.
The NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS)
STARTTS offers a range of services for refugees who have experienced torture and trauma. These services include assessment, counselling, family therapy, group therapy, support groups and youth programs.
Health Care Interpreters in NSW are available over the phone 24 hours 7 days a week.
A person can be admitted to hospital under the NSW Mental Health Act as a voluntary or involuntary patient. This happens when a person is considered to be mentally ill or mentally disordered and at risk of serious harm to themselves or others. This includes physical harm, harm to reputation, relationships, finances and self-neglect and no other care of a less restrictive kind is available.
If you are concerned about yourself or someone else, contact your local area mental health service.
Voluntary Admission – occurs when a person feels mentally unwell and admits themselves to hospital for a period of treatment.
Involuntary Admission – occurs when a person is taken to hospital or treatment facility against their wishes.
Once they get to hospital they are assessed by at least two doctors and a decision is made whether hospital treatment is appropriate. A person is given a Statement of Rights under these circumstances and can seek independent advice if they believe they are being unjustly detained.
Where do I go for help?
Mental Health Information Line
1300 794 991
Anxiety Disorders Information Line
1300 794 992
Your local doctor (GP)
Translating & Interpreting Service
(TIS) 131 450
Please call the Mental Health Information Line through the Telephone Interpreter Service (TIS). Free to Australian citizens or permanent residents.
This information is for educational purposes. As neither brochures nor websites can diagnose people it is always important to obtain professional advice and/or help when needed.
This information may be reproduced with an acknowledgement to WayAhead – Mental Health Association.
The Association encourages feedback and welcomes comments about the information provided.