kethea mosaic supporting drug addicted emigrants: visible and invisible particularities dimitris...
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KETHEA MOSAICSupporting drug addicted
emigrants: Visible and Invisible
particularities
DIMITRIS GIANNATOSHead of KETHEA MOSAIC Unit
(Cross-cultural Center of KETHEA)
In the Beginning…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 MOSAICSince 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 MOSAICSince 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…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…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…Supporting strategies…
• Familiar space – Home Familiar space – Home • Multi-ethnic Therapeutic Staff Multi-ethnic Therapeutic Staff • Individual Therapeutic PlanningIndividual Therapeutic Planning• Cross-Cultural approach• Networking Counselling • Cross-cultural education • Volunteers – Interpreters – Cultural Mediators • Welfare networking • Cross-cultural evaluation of treatment reference
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