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Transcript
KETHEA MOSAIC Supporting drug addicted emigrants: Visible and Invisible particularities DIMITRIS GIANNATOS Head of KETHEA MOSAIC Unit (Cross-cultural Center of KETHEA) In the Beginning… Low rate of approach in therapeutic structures for drug-addiction emigrants faced difficulties to follow up the therapeutic process. • Different view in the streets: increase of population of depended immigrants /refugees with intense and different needs compared to the locals. KETHEA MOSAIC Since 2003… 1. Supporting drug addicted - Harm reduction services - Motivation for drug addiction treatment - Psychological support and relapse prevention - Counselling for relatives and "important others“ - Educational activities - Street work activities - Self help groups in prison KETHEA MOSAIC Since 2003… 2. Psychosocial support for emigrants/refugees related to : - Social intergration problems - Family problems - Drop out from educational process - Emotional crisis management - Adults and juvenile delinquency Important points… • The drug users consist a special group among the emigrants/refugees • Case of “double exclusion” : drug addiction’s stigma and stigma of being “stranger” • Apart from the social exclusion, two other facts that increase the percentage of drug addicts (emigrants & refugees), are: a. The availability of substances and alcohol in the places where they live or spend their time b. The connection between trafficking and (illegal) market of drugs Important points… • They are a vulnerable population and dependable on trafficking networks or other “groups” : exploitation from co-patriots, lawyers who promise “legalization”, affinity and exchange with delinquent people • They are a high risk population. They need services of Prevention, Harm Reduction and Therapy. Supporting the population… • Essential point : the “integration” of cross-cultural care in the “cultural” system of health Organizations • Very intensive and “deep” intervention • The information for Mosaic spread among them • New-comers addicted refugees – multilevel needs – “invisible” population • Emigrant’s Communities are difficult to be motivated (fear, “stigma”, other priorities, “profits” expectation, etc) Supporting the population… • Many of the emigrants start using drugs after they left their country or they used to do occasional use of drugs without passed to addiction • The treatment related to the total improvement of life. • Covering financial needs is or the preparation for a new immigration is the first priority and affect to the therapy perspective and time investment in this process. • The “paradox” of problem and trauma : addiction and sensitization of health system – services and DIGNITY Clinical remarks… • Many times, the use of substances and alcohol is a way of self healing and self empowerment , helping these people to be relieved from the emotional pain and the difficult conditions they experience (uprooting, fear, loss & nostalgia of beloved people, homesick, trauma, uncertain legal status, etc). • Psychic trauma - three phases : a. difficult conditions before immigration b. traumatic roaming c. relocation in the reception country Clinical remarks… • Mental dipole : Oblivion – Memory Use of substances = self-healing “Help me to forget - help me to remember without pain” Various substances and alcohol • Drug addiction seems to act as a latent effort of incorporation or as an expression of bereavement or as a resistance to the family system after the emigration. Clinical remarks… • Political asylum seekers – intensive action for freedom and justice – often weaker motive for therapy- they focus in the change of their political status as solution in the problem. • Some emigrants want to change without realize the need of therapy - self control, move to other town, find job, medical help from the homeland, etc • Some structural and cultural issues make the wounds invisible : drug addiction as a medical problem – seeking help from co-patriots leads often in provisional solutions, Clinical remarks… • Many drop-outs from motivation process : - Seeking for medical treatment - Deprival syndrome - Language - Cultural differences in the groups ( in groups with people from many different nationalities) Clinical remarks… • Families : - guilt – wounds from their uprooting – protect the drug user as a weak member of the system – avoid make changes helping the therapy - Many times, “send” the drug addicted back to homeland (symbolic correction of trauma) AND WHAT HELPS ? • The therapy from drug-addiction seems difficult – but is not unrealistic. • Trauma has the emotional material for the therapy • «O τρώσας και ιάσεται» (Τηλέφεια τραύματα) • It’s necessary to exist a safe environment, that pay attention in different needs and respects their cultural differences • Essential condition of support : The transition ( access – approach – empowerment – motivation). • Efficient in therapy context the interaction with local culture Supporting strategies… • • • • • • • • • Familiar space – Home Multi-ethnic Therapeutic Staff Individual Therapeutic Planning Cross-Cultural approach Networking Counselling Cross-cultural education Volunteers – Interpreters – Cultural Mediators Welfare networking Cross-cultural evaluation of treatment reference