Creating a culturally-safe environment

Healthcare teams need to create an environment that fosters trust; where clients feel safe and they are viewed as individuals.

Everyone has a responsibility to support refugees, not just the designated services.

Eman B, Multicultural Health Worker, Illawarra Shoalhaven Local Health District

Practical considerations

It is useful to have a checklist of processes to ensure newly arrived people feel safe accessing the relevant information and health services to support their settlement. Providing too much information can be overwhelming. It is important to:

  • listen
  • provide relevant information about the experiences of being from a refugee background
  • talk about expectations of healthcare.
Belinda Crain (standing), CEO Multicultural Council, Wagga Wagga, welcoming a family to the local health clinic.
What you can do How it will help

Host a health information session with an interpreter and bicultural workers.

Provide multi-lingual resources, if appropriate.

  • Enables communities to meet key staff from the refugee health team and settlement service provider. Here, they can receive relevant information on Medicare, healthy eating and lifestyle, domestic and family violence, child protection, preventative care, and sexual and reproductive health.
  • Creates understanding about how to access services, an individual's health rights (including the right to access an interpreter) and waiting times.
  • Removes stigma associated with accessing services such as mental health.

Provide technology and explain digital appointments.

Provide letters and digital reminders.

  • Helps clients understand text messages about appointments, especially if they cannot read reminder letters.
  • The NSW Multicultural Health Communication Service provides an online Appointment Reminder Translation Tool. This allows you to translate appointment details into your client's language.
Hospital orientation
  • Introduces new community members to your health service, staff and hospital setting.
  • Shows people where they need to go; for example, where clinics are held.

Liaise with non-government agencies to run activities targeted to different community groups, such as parenting, art therapy or mums and bubs sessions

  • Enables communities to gather and feel connected while doing activities not aligned to clinical intervention.
Partner with the refugee community to run health events.

Consider hosting barbeques and picnics to engage the community outside the hospital or healthcare setting in a relaxed friendly environment.
  • Enables the community to connect with refugee health workers.
  • Provides information in the relevant language on healthcare issues specific to men and women.
Engage with general practitioners (GPs).

Provide an opportunity for LHDs to work with their primary health network to ensure they navigate culturally specific care for people from a refugee background.
  • Share information about the specific cultural needs of newly-arrived groups.
  • Provide guidance on how to manage cultural challenges, such as language.
  • Discuss partnerships, mutual supports and the referral processes.
Ensure staff have access to relevant cultural resources and training
  • Builds knowledge and understanding of the unique health needs of people from refugee backgrounds, beyond a clinical assessment.
  • Ensures health staff have the right skills to meet their clients’ cultural needs.
  • See Staff training and wellbeing.
Consider having co-located services.

Ensure refugee health teams have access to other services nearby, such as settlement services.
  • Supports holistic service delivery and encourages communication.

It is important to understand and know your community - their demographics, age, country of origin, and considerations around age, access to technology, dialects and cultural conflicts.

Patricia O, Interpreter Services Manager, Hunter New England Local Health District

Building a relationship

While healthcare teams need to learn about the cultural needs of their newly-arrived community, it's important to recognise that each individual has unique health needs.

A culturally safe environment requires building trust

If a refugee has experienced traumatic events or been persecuted, they may feel anxious about using state and government services. Refugee health and support services need to enable people to feel safe and welcome.

Emma and Karinne used to visit us at our house and give us vaccines. They were friendly and nice people. When we told them our story, they began to cry. We don't look at them like medical staff. They made us feel comfortable. They felt like they were our friends.

Fryal, community member

Resources

Cultural Atlas – information on the cultural background of Australia’s migrant populations.

Source: SBS, International Education Services (IES), and Multicultural NSW

Refugees, Asylum Seekers and Trauma – resources and training videos covering the impact of trauma on refugees and asylum seekers.

Source: NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS)

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