- Title
- How do health beliefs of African refugees influence attribution of mental illness and help-seeking behaviour following resettlement in Australia?
- Creator
- Kewley, Christopher
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2018
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Refugees from Sub-Saharan Africa, including Ethiopia, Somalia, Sudan and South Sudan, constitute a significant percentage of refugees globally that continue to settle in Australia and other western countries. The dualism of African pluralistic medicine and western scientific biomedicine is no more obvious than when comparing beliefs concerning psychiatric aetiology. Ethno-culture, religion and spirituality are recognised to heavily influence indigenous beliefs concerning mental illness. However, there is minimal research addressing how this dualism and complex interface between phenomenologically constructed African belief systems, and scientifically rationalised conventional western medicine, influence African refugees’ help-seeking behaviour on settlement in a western country. Aim: The aim of this critical ethnographic study was to gain an understanding of how the health beliefs of refugees from Ethiopia, Somalia, Sudan and South Sudan influence attribution of mental illness and help-seeking behaviour on settlement in Australia. Method and analysis: The study used semi-structured interviewing, naturalistic participatory and non-participatory observation. Data were obtained from three sources: 1) African refugees that entered Australia via the offshore humanitarian program; 2) specialist workers in cross-cultural and refugee health; and 3) African diaspora registered health professionals practicing in Australia and native to one the aforementioned African countries. Data saturation was achieved at 35 interviews. Interviews were transcribed verbatim and subjected to a four-step process of thematic analysis using NVivo 10 software. Internal validity was addressed through triangulation of the data and the use of a cultural informants group of community leaders who advised on issues surrounding lexical, contextual and conceptual equivalence. Findings: The study identified four main themes and a number of sub-themes. Each theme constitutes a significant intercultural tension point that acts as a barrier to therapeutic engagement between African refugees and mainstream Australian mental health services. Collectively, the tension points create an impervious barrier to the penetration of western psychoeducation within the Ethiopian, Somali, Sudanese and South Sudanese refugee communities. The four major themes are: 1.Tension between African spiritual explanatory concepts and western theories of mental illness 2.Tension between faith-based and western biopsychosocial models of treatment and recovery 3.Tension between African culture, language and belief systems on the individual’s health literacy and engagement with western mental health services 4.Tension between African cultural collective and western individualistic orientation and effect on health and mental wellbeing. Discussion: The majority of refugees from Ethiopia, Somalia, Sudan and South Sudan were not engaging with mainstream mental health services until they are acutely unwell. Their explanatory models of mental illness were influenced by their traditional animistic and spiritual beliefs, regardless of length of residency in Australia or level of educational attainment. Traditional and faith-based treatment was the preferred option for many repatriated by family, including post-diasporic African/Australian youth, for traditional animistic and faith-based healing. Repatriation commonly resulted in violation of the individual's human rights through involuntary genital mutilation/cutting, forced marriage and other ritualistic practices.
- Subject
- Africa; refugees; Somali; traditional belief systems; animistic; mental illness; help seeking behaviour; resettlement; Ethiopian; Sudanese; South Sudanese
- Identifier
- http://hdl.handle.net/1959.13/1392682
- Identifier
- uon:33444
- Rights
- Copyright 2018 Christopher Kewley
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 2 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 326 KB | Adobe Acrobat PDF | View Details Download |