Quota refugee increase puts pressure on mental health provider

Māngere Refugee Centre's mental health support service is under pressure as it faces an increase in demand and an expected influx in coming years.

While news of the refugee quota increase from 1000 to 1500 in 2020 and the offer to resettle 150 refugees per year from Australian offshore detention has been welcomed by advocates, it has left non-profit NGO Refugees as Survivors New Zealand (RASNZ) facing difficulties planning for the demand.

The organisation provides mental health support at the Māngere Refugee Centre, and offers a range of clinician therapy and support on-site as well as facilitating off-site groups.

"We are the only group providing a specialist national mental health service [at Mangere Refugee Resettlement]," chief executive Ann Hood said. "Referrals in our community team have increased significantly - we now have a wait list and have to prioritise clients based on the level of need."

About 47 percent of quota refugees access individual one-to-one psychological support each year at Mangere's centre. In addition, an increase in demand for their mobile team service has resulted in a waiting list, and Dr Hood said they did not have the ability to fund extra staff to provide assessment or treatment.

"We have worked hard to build a reputable and reliable service but without extra support may now have to close referrals."

In a statement, Immigration NZ's national manager of the refugee division Andrew Lockhart said with the quota increase, additional funding would be given to services in Māngere.

However, two months after the quota increase announcement RASNZ says it has yet to receive any information about plans for extra support to deal with this intake.

Adding to the problem is the possibility of Nauru refugees being resettled in New Zealand.

Immigration Minister Iain Lees-Galloway previously said the first cohort of 150 offshore detained refugees would be resettled this year.

A spokesperson for the minister said New Zealand has the capacity to deal with Nauru refugees in accordance to the terms of the offer if it is accepted by the Australian government.

However, Dr Hood said its service was significantly under resourced to meet the needs of Nauru refugees if they were to arrive under its current system.

"We are not currently funded to see 1000, let alone have the resources to meet the needs of a highly traumatised group of children and their families from Nauru.

"We are not at all [resourced] for the arrival of such high and complex need cases. We are very concerned about the significant trauma and mental health concerns of this group."

Refugee Council of Australia's report released in September states that experts assessing people on Nauru say the refugees are among the "most traumatised they have seen, even more traumatised than those in war zones or in refugee camps around the world."

Psychologist Caroline Judson said bringing in Nauru refugees would add a lot of pressure if the system remained in its current state.

"We do have moral and ethical responsibility to help those on Nauru if we are able to… however, the key of that is if you can do something about it. We need to be able to provide really strong support if they come, otherwise they risk re-traumatisation, and that's not fair on anybody."

The New Zealand Red Cross also provide refugees settlement support for up to 12 months in the community and link them to the services they require.

Six-week programme cut down

In September, Mr Iain Lees-Galloway said Māngere centre's six-week reception programme for refugees would be cut down to five weeks in 2020.

However, this would mean RASNZ would have to assess more people in less time, Dr Hood said.

"If the government want the quality of this resettlement programme, if they want that to continue to be at the same level, at the same standard, absolutely, they have to resource it.

"In practice, we'll be seeing more people in less time [and] that is only possible if we are resourced."

Dr Judson said one of the concerns of resettling into a community quickly was not getting enough time to be assessed or being comfortable to open up.

"One of the benefits of having the six-week programme is that there's more opportunity to, in terms of mental health, capture the people that might be most at-risk so that they have potentially more people looking out for them in the community or at least aware of them," she said.

In a statement, national manager of the refugee division Andrew Lockhart said changes were made to the reception and orientation programmes after a review was undertaken in March 2018.

"We are considering undertaking more of the medical screening offshore and reducing the reception programme to five weeks.

"There would be no changes to the content of the reception programme or the scope of the health screening and assessment."

During the six-week programme, a settlement plan is also developed with families which outlines services they would be connected with to aid their resettlement, he said.