Refugees and asylum seekers need better continuity of care to deal with complex health needs

Many refugees who are living in the Australian community are missing out on appropriate healthcare due to problems such as fragmented services and poor continuity of care, according to a series of papers in Public Health Research & Practice, published by the Sax Institute, today.

Professor Mark Harris, from the Centre for Primary Health Care and Equity at the University of New South Wales, said that although good services exist, there was a lack of integration between specialist services and the primary healthcare system, making it difficult for patients to transition from one service to another.

“Many refugees and people seeking asylum have very complex health needs – including PTSD, chronic disease and, in some cases, torture – and there are a number of specialist services that people can access,” said Professor Harris, who is also a volunteer medical officer at the NSW Asylum Seekers Centre. “The challenge often comes when people need to transition into mainstream general practice.”

“Our research has identified a series of systematic and individual challenges during transition, including disrupted access to Medicare, fragmented care, mainstream GPs being unable to cope with the complex social needs and entitlements of refugees, and difficulties ensuring the proper transition of medical records.

“For individual refugees, there can often be a lack of understanding of how to navigate a complex and unfamiliar health system, a lack of specialist medical experience for their complex needs, and the fact that more pressing concerns such as visa, housing and employment stresses often take precedence over medical needs.

“A combination of some or all of these factors can prevent refugees and people seeking asylum successfully transitioning into general practice care – some will return to overloaded specialist care providers but others simply fall through the cracks of the healthcare system. This can mean some patients may not have optimal treatment of their mental health conditions. They may then lie dormant and become reactivated at times of stress,” he said.

Professor Harris said that better integration between specialist and mainstream services was key, as was better education for newly arrived asylum seekers and refugees.

“Between 2006 and 2015, Australia welcomed an estimated 140,000 refugees, and there are an estimated 30,000 people seeking asylum currently waiting for their applications to be processed –  we have a very good story to tell of supporting those in need here in Australia,” he said.

“What we need to do is re-evaluate the transition process. That’s why we are recommending that refugees are supported at every step on the transition process, including identifying an appropriate GP/medical services, ensuring Medicare coverage and patients records are transitioned in a timely manner and ongoing liaison with refugees and asylum seekers to ensure their needs are being met,” Professor Harris said.

Please acknowledge Public Health Research & Practice as the source for any stories on our papers.

Download articles on refugee health:

Other papers in this issue of Public Health Research & Practice:

Rates of assault, harassment and bullying against paramedics continue to rise in Australia, with new research showing that violence-related injuries among paramedics have doubled from 6 to 12 per million ambulance calls per year over the past decade.

Health-related problems associated with psychostimulants have increased in inner-city medical units and emergency departments in NSW, suggesting the increased use of these drugs locally, according to new research.

Improving access to Australia’s rich cross-jurisdictional data can improve understanding of the interplay between hospital and community care, researchers find.

Public Health Research & Practice is a peer-reviewed, Medline-listed quarterly online journal published by the Sax Institute. Subscribe for free at 

Find out more