The issues facing people with disabilities from refugee backgrounds are multi-faceted. The service pathways for people living with a disability can be complex when accessing supports needed; discussing concerns with a general practitioner, maternal and child health nurse or teacher; seeking and negotiating services for diagnosis and other assessments; and accessing ongoing support services as required. Services in Victoria are typically organised across the life stages – early intervention, school years, adulthood and older adulthood – for most conditions, and/or a service pathway that starts with hospitalisation following an accident or major illness.
For people born with a disability-related condition there is a focus in the early years – and sometimes in primary school – on identification of concerns, assessment and then access to required services. For those who acquire a disability through a major accident or illness, the pathway to disability supports typically starts with hospital-based care, with discharge predicated on access to aids and equipment and rehabilitation services as needed.
For the broader Victorian community, there are significant barriers to service access, including long wait times for some services, and sometimes multiple appointments for diagnostic and other assessments to access the necessary ongoing supports.
These challenges are compounded for new arrivals from refugee backgrounds who may:
- arrive with a condition that is undiagnosed or not formally diagnosed, or which may or may not be familiar to Australian practitioners
- arrive with a poorly managed condition, which may or may not be familiar to Australian practitioners
- be an adult presenting with a condition that is typically diagnosed in childhood
- arrive without necessary aids and equipment (for example, a wheelchair or walking aids).
These challenges are in addition to the broader settlement challenges facing new arrivals from refugee backgrounds. These include negotiating access to housing, transport, income support, education and employment in a new country; typically trying to learn a new language; and communicating via interpreting services. Settlement is further complicated by the impact of torture and other traumatic events (such as exposure to war and conflict) and the complexities of negotiating access to services cross-culturally.
This report has been written at a time when there have been significant changes in service arrangements with the progressive roll-out of the National Disability Insurance Scheme (NDIS) and the suite of aged care reforms that has accompanied the introduction of My Aged Care (such as changes to home support, including Home Care Packages and the Commonwealth Home Support Programme).
At a population level, there has been an increase of new arrivals from refugee backgrounds in the outer northern metropolitan region of Victoria, in particular the Hume local government area. The welcome introduction in 2012 of a waiver of visa health requirements (the health waiver) for humanitarian visa holders has also led to an increase in numbers of humanitarian entrants who are living with a disability.
The focus of this report is on:
- service provision to people from refugee backgrounds arriving on humanitarian visas, who have a disability or impairment before they reach Australia
- access to services for people who have a disability or impairment and who are seeking asylum while living in the community.