The History of the Auckland Refugees As Survivors (RAS) Centre

The Auckland RAS Centre?s history began way back in 1988, when a Mental Health Conference specifically focussing on refugee mental health was held in Auckland. From this conference much debate occurred by mental health professionals, educationalists, social workers and the refugees themselves about the trauma refugees experienced and the impact it has on their lives including resettlement and education. As a result of the discussion remits were drafted - one of which was that there should be a specific torture and trauma service for refugees in Auckland.

An advisory committee consisting of Sue Elliott, Max Abbott, Jenni Broom, Dr Rasalingham, Elizabeth Hoffman and Dr Peter McGeorge was formed to pursue this cause.

For the next five years the advisory committee met frequently to plan the strategy for planning a refugee mental health service. The question has always arisen as to why the need for such a centre and this can be answered by following statements:
1995 ?1999 the early days:

The New Zealand Red Cross (Northern Region) generously offered a room at their main office in Wakefield Street. This room became the office of the Auckland RAS Centre. The Centre so named because of emphasising the positiveness about refugees surviving against all odds ? they are not victims but truly survivors. This is the philosophy of the Centre. The centre was officially opened on February 14th 1995 by Cath Tizard ? a host of dignitaries attended the opening, including the advisory committee, staff of the RAS Centre, refugee communities and service providers including other non-governmental agencies who work in this area of resettlement. The Centre was open Monday to Friday and saw clients by appointment for assessment and counselling.
The RAS Centre logo depicts the mature fern which illustrates that with the right conditions (external) and the right ingredients (internal) the frond will blossom into a fern. This is how the RAS Centre sees its work ? a safe and trusting environment for traumatised refugees, which allows each person to develop and grow restoring meaning and purpose to their life.

The motto is "Where there is hope ? there is life".

The mission statement formulated six years ago has not changed and is "to assist refugee who have experienced torture/ trauma to access mental health services and other facilities, minimising the impact on their lives".

In 1997 the RAS Centre was seen to be developing into its next phase and the decision was made by the Mental Health Foundation Board and the advisory committee for the RAS Centre to become a charitable trust. In October of 1997 ? interested people were invited to attend a luncheon where the Manager Chris Jane introduced the work of the RAS Centre. From this, people were encouraged to apply for positions as Board members. Interviews were undertaken by members of the Mental Health Foundation and Advisory Committee ? 5 people were selected and they were the first Trust Board members of the Auckland RAS Centre. They were: Dr Nick Argyle, Ravi Rudra, Peter Greener, Peter O?Connor and Trish Fordyce.

A formal ceremony on November 18th 1997 was the official "handing over" of the RAS Centre to the Trust. During this time the MHF also set up a Trust for the Wellington RAS centre in Wellington -this service started in November 1997. In September 1997 a new Manager was appointed to replace Chris Jane (who had moved to a position within MHF) ? Tina Mullard a nurse/ midwife who had an in-depth knowledge of refugee health, having worked for a number of years in a variety of refugee camps around the world.

Staff at this time included a full-time manager and two part-time psychologists (1.5 fte). Counselling took place in the one room at Red Cross. It was soon realised that another counselling room was required and so the Centre moved downstairs to a larger area that had two counselling rooms, a meeting room and waiting room. This enabled the RAS Centre to increase its service in seeing clients, as well as teaching interpreters about refugee mental health and holding workshops for service providers. Whilst the venue in the early days was acceptable, it was not accessible for most of the refugee clients, in particular the newly arrived quota refugees (refugees that have been accepted by New Zealand Government and United Nations) at Mangere Refugee Resettlement Centre (MRRC). The opportunity to move to MRRC became a reality and so the RAS Centre moved there in February 1999. The building was redesigned, redecorated and spacious ? the centre had 8 counselling rooms, a waiting room, a meeting room and its own facilities including kitchen. The centre was formally blessed by a Mullah and then opened by the Chairperson of the Board and invited guests.

Marie Sullivan, Manager of the Refugee Quota Branch, New Zealand Immigration Service was one of the main supporters for the RAS Centre?s move to the Resettlement Centre. Funding was still limited and staffing at this time was the same as of 1995/6 (1.5 fte). Later that year extra funding became available because of the Kosovo refugee emergency, new staff were employed (4 fte) which increased the range of work the Centre could offer to the newly arrived Kosovo refugees as well as the others from refugee backgrounds. This was the first time the staff had to work with newly traumatised clients and this presented a challenge in the way the staff and Centre operated ? offering alternatives to one to one counselling such as support groups, art groups.

In May 2000 the RAS Centre celebrated its fifth birthday and was fortunate to have the Minister of Immigration Lianne Dalziel as guest speaker for the luncheon. She spoke of the work of the centre and reinforced the continuing need for the specialised services its offers. An olive tree was planted by the Minister at the RAS Centre, with representatives from the refugee communities placing soil over the tree roots. The olive tree was chosen for its symbolism of peace and hope.


Funding:

Funding was finally approved by the Regional Health Authority (Public Health portfolio) in December 1994 with the Mental Health Foundation of New Zealand agreeing to oversee the setting up of a torture/trauma service in Auckland.

Chris Jane was appointed as the first RAS Centre Manager and she organised the type and scope of the service, based on Australian Torture/ Trauma centres and the Medical Foundation in London. A volunteer psychologist initially assisted for one day a week and then became a part-time worker. In 1996 some extra funding enabled the Centre to have a social worker and another counsellor for a period of six months ? this increased the availability of the service. Funding was initially by way of six month contracts, which did restrict the long term planning of the RAS Centre as only 1.5fte staff could be employed. Contracts for two years did not become available until 1999, although extra funding was made available for the Kosovo refugee emergency. Subsequently in the year 2001-2003 funding has increased so that the RAS Centre can offer a more culturally appropriate and holistic service. This has meant staffing has increased to the equivalent of eight full-time staff. Funding is for the mental health service is from the mental health portfolio whilst the training and education service comes from the public health portfolio.


Therapeutic Models 1999-2001:

The RAS Centre initially started with the psychological model (because psychologists were working at the Centre) and then progressed towards the psychotherapeutic model. In March 2001 the Board and manager were instrumental in planning a vision for the future which was towards a holistic model with more cultural input by the Interpreters and Cultural Brokers. In June 2001 the Centre restructured and a multi-disciplinary team was formed. This team comprised of a psychiatrist, child psychologist, family therapist, psychotherapist, occupational therapist, body therapist/ physiotherapist, massage therapist and counsellors. Interpreters are an integral part of the Centre and several have had intensive training enabling them to facilitate and run support groups in their own culture. The centre is continuing to train interpreters to become Cultural Brokers ? empowering them to work with people from their own culture in a holistic culturally appropriate way.


Service Description 1999-2001

Mental Health Service
Funding since 1995 was for a mental health service which comprised purely of assessment and counselling for individuals, this has continued up to 2001 where the emphasis is now on assessment and short-term therapy (individual counselling, body therapy, group therapy). Initially clients 17 years and over were seen and in 2000 this was changed in the contract so that children and adolescents could be seen. Referrals come from individual themselves or service providers ? health, education, social services, community mental health and legal services.

Entry criteria is twofold in that the client must be from a refugee background (quota refugee, asylum seeker or refugee who has joined their family) and who has suffered torture or trauma. Clients with a major mental health disorder or drug/alcohol addiction are not accepted into the service. The service has developed strong networks with many agencies in Auckland ? such as health, resettlement and social services as well as with similar centres in Australia and USA. This aspect of the centre is becoming more important as funding becomes tighter and also enables case management of refugee clients who have complex problems.

Training and Education
The Centre has offered training and education for both refugee communities and service providers. The RAS Centre has provided many workshops, seminars and lectures to service providers who work with refugee clients over the years. As well the Centre has been working with refugee communities on specific projects such as train the trainers programmes, and refugee community profiles (RAS Centre publication). The training/ education aspect has increased in the last year with the Centre publishing a newsletter three times a year, publishing a Refugee Service Directory for service providers, Refugee Community Profile, launching a website www.aucklandras.org.nz and further developing the train the trainers programme - training refugee women to teach basic health messages in their own language.


Programmes

In 1999 the RAS Centre set up the Early Intervention Programme, which is where staff / interpreters meet with the newly arrived quota refugees. The meeting is a social one and staff/ interpreters introduce the role of the Centre and explain how they can help. This gives refugees a chance to talk about some of their stresses as well as have an understanding of feeling ?lost in a new environment?. Appointments are given to those who want to be seen. Therapy is of mainly of short duration and can be either individual counselling or support group therapy. This programme still continues and has been modified with three trained interpreters (Bicultural facilitators) running these information groups.

In early 2000 the RAS Centre was fortunate to have a psychiatrist working ? this was an asset to the service, which meant clients could be seen by a psychiatrist as opposed to being referred on to a community mental health service. Also an art therapist and play therapist joined the staff and again they offered another dimension to the service. Both therapists worked with children and adults as well as running groups as part of the early intervention programme. To the centre?s knowledge this was the first time that play therapy and art therapy had worked in this environment of traumatised refugees and judging by the art work produced was a success. Play therapy groups were attended by both children and adolescents alike!

In the early years approximately 100-150 new clients were seen for assessment with up to 400 clients attending follow-up appointments. In the latter years the Centre sees up to 200 new clients for assessment and between 750 ?1?000 clients for follow-up therapy per year. This does not include clients seen as part of the early intervention programmes or the body therapy programmes ? these numbers in the past year have been 400 and 600 respectively. This demonstrates that there is a real need for the service. Feedback from clients state "that they are listened to ? they gain some skills to cope with their issues and sometimes feel they have been able to unburden themselves of their trauma and start living again".

The Centre in 2001 has also started offering some of its programmes (support group therapy for asylum seekers, child therapy and body therapy) in the community at Mt Roskill. This has proved very popular with the refugee clients because of the accessibility ( a majority of the resettled refugees live in the Mt. Roskill, Sandringham and Kingsland area).

Early 2003 RAS developed a Community Development section to provide continuous health promotian, prevention and social information in the community through language specific groups. Ten key refugee members from different refugee communities joined the RAS Community Facilitator programme. They all became the refugee group facilitators to develop the support groups in the different refugee communities.

It is satisfying to see from 1988 that there was a vision for such a service and in a short few years the service has developed to what it is now ? a credible respected service which continues to meet the demands of the refugee clients. The staff at the Centre are ever mindful of the clients its serves and in the next phase of the Centre?s development it is looking to encourage more input from the refugee communities themselves.