DEVELOPMENT OF INDEPENDENT LIVING SKILLS IN YOUNG PEOPLE. An analysis of outcomes for Unaccompanied Minor Asylum Seekers and Refugees in Australia

Transcription

1 DEVELOPMENT OF INDEPENDENT LIVING SKILLS IN YOUNG PEOPLE An analysis of outcomes for Unaccompanied Minor Asylum Seekers and Refugees in Australia

2 WE RE FOR INCLUSION

3 MESSAGE FROM CLAIRE ROBBS CHIEF EXECUTIVE LIFE WITHOUT BARRIERS Life Without Barriers has worked with refugee and asylum seekers since 2009, beginning our journey with a request to support unaccompanied minors in detention on Christmas Island. Since then, our involvement in immigration has expanded to include support services on mainland Australia and supported accommodation for unaccompanied minors and families in the community. We are now one of the largest national community service providers of the Commonwealth Government s Status Resolution Support Services. Everything we do, is centred on partnering with people to change lives for the better. So it is with great pride that we share with you this research and outcome data, which analysed the services we provided to children and young people who arrived in Australia as asylum seekers, unaccompanied by adult family members. Evidence, feedback and outcome data are crucial to us; our client voice provides opportunity for improvement in the quality of our services. Our young clients were generous with their time in sharing feedback about their experience across Settlement and Community Detention programs. These valuable insights motivate us with a greater passion and determination, to embrace our unique position as a large provider and to ensure we continue to contribute to research in this sector and ultimately, deliver the best possible supports to our clients. Claire Robbs Chief Executive, Life Without Barriers

4 MESSAGE FROM CINDY TURNER NATIONAL MANAGER NATIONAL IMMIGRATION SUPPORT SERVICES Life Without Barriers National Immigration Support Service (NISS) provides a broad range of supports to clients at varying stages of their visa application journey. Children and young people arriving in Australia without a legal guardian are especially vulnerable throughout this process, so gaining an understanding of their experience is a vital aspect of our approach. Thanks to the generosity of Health Outcomes International (HOI) and their pro bono contribution, we have been able to produce this report; an analysis of the feedback and outcome data of the children and young people we supported. This research is significant as it brings outcome data from both the Settlement and Community Detention programs, both are areas where greater knowledge will assist to further improve the lives of individuals receiving these services. The data analysed here collaborates with Life Without Barriers worker data, which further validates the impact of our work to support unaccompanied minors development of independent living skills. Importantly, it also provides us with insights to further improve our services for the future. It is evident that the outcomes are overwhelmingly positive; a result we are extremely proud of. The data provides evidence of significant improvements in critical life domains, that will set the tone for the lives these young people ensuring they are well prepared for life and the journey forward. It is highly gratifying that our service has played a significant role in their future. We thank Health Outcomes International for their support in analysing this data and providing us the opportunity to share our clients perspectives. This data will enable us to further improve our services, and continue providing a nurturing and culturally supportive environment for our clients. Cindy Turner National Manager, National Immigration Support Services

5 2 3 MESSAGE FROM DR TAHEREH ZIAIAN, PHD, MAPS I have great pleasure in writing this foreword for this research paper and recommending it to all those who work with individuals and communities from refugee backgrounds. While unaccompanied minor asylum seekers are not a large group in Australia, they do require particular attention because of their vulnerability as children, their rights as children and as potential refugees. If these needs are ignored, these children are at a great risk of adverse physical and emotional health with social outcomes that will affect them and their communities well into the future. Life Without Barriers works with unaccompanied minor refugees, provides support services to unaccompanied children, and are reputable for delivering these services to the highest satisfaction of their clients. The data presented in this research paper, provides strong evidence for a framework of good practice as well as a view to highlighting ways in which the situation could be further improved. This resource will equip allied health professionals with essential knowledge required to provide culturally competent care in an increasingly complex area of practice. The future costs to both individuals and the wider community will be substantial if the range of factors that impact children in Australian immigration detention centres and in community detention centres are not addressed. The consequences can include long-term mental and physical health problems if left unaddressed. In following the principles of social justice, it is indeed our obligation as service providers and or committed professionals to promote the recovery and integration of vulnerable children (including refugees and those in community detention) and young people into our society. As such, I have no doubt the positive outcome of the research reported in this document will become a standard reference for practitioners across a diverse range of disciplines, not only in Australia but also in other countries facing refugees and resettlement. Dr. Tahereh Ziaian Transcultural Community Health Psychologist, Senior lecturer and senior researcher Division of Health Sciences University of South Australia

6 INTRODUCTION PURPOSE OF THIS PAPER In 2013 Life Without Barriers and Health Outcomes International (HOI) formed a partnership to undertake analysis of data in relation to children and young people who arrived in Australia as asylum seekers unaccompanied by adult family members. The data analysed selected outcome measures of the services provided to these children and young people who were referred into the Community Detention or Settlement Programs. Specifically, this paper presents analysis and discussion of the data from two Life Without Barriers sources: the Life Skills Assessments (LSAs) and Exit Surveys from unaccompanied minors in either the Community Detention or the Settlement Program. LIFE SKILLS AND MEASUREMENT For any community member, the development of life skills is critical to everyday functioning, meaningful social and economic contribution, and independence. In conjunction with other broader program aims, Community Detention and Settlement Services activity programs are designed to increase skills, abilities and community connections. The programs also promote the development of life skills that will enable effective transition into the community, as well as the maintenance of independence. Life Without Barriers developed three main domains to measure desired outcomes: Social participation and community connection This relates to evidence of social and community connections through education, employment and recreation, appropriate to immigration status. Wellbeing This encompasses three aspects, namely: Emotional: clients report feeling safe, happy with their support, respected and able to talk to someone about significant emotional issues. Health: clients are aware of how to maintain optimal physical health and access medical support when needed. Accommodation: clients are safe and satisfied with their living arrangements (within the scope of the program). Preparation for independence Clients have the skills for independent functioning in the Australian community. DATA COLLECTION TOOLS The data sources for this study included Life Skills Assessments (LSA) and Client Feedback Exit Surveys: A total of 133 exit surveys were analysed, representing clients exiting the programs in the 18 month period leading up to 12 March Data from the Life Skills Assessment completed by 116 clients, was also collated and reviewed The ability of the LSA to collect information from both the client and worker perspective is an additional strength of the tool itself. Importantly, the reliability of the LSA data to produce dependable and repeatable information is validated by the research presented in this paper, as the scoring provided by both clients and workers were consistent across measures. Exit Surveys Across jurisdictions, feedback derived from client exit surveys demonstrated a high level of client satisfaction with the services provided by Life Without Barriers. This feedback was in regards to both the Community Detention and Settlement programs. Of the five domains captured within the exit surveys, client satisfaction was highest for the ability to: practice their religion spend time with other people from their own culture understand the cultural support worker eat healthy food whilst in the program feel safe while in the program gain important skills and abilities for independent living.

7 4 5 Life Skills Assessments Analysis of the data obtained through the Life Skills Assessment (LSA) tool indicated that over time there was an overall improvement across all LSA domains reported by program participants and workers for both the Community Detention and Settlement services. LSA results for Community Detention Clients reported the highest average improvements in: banking and credit awareness of community resources understanding of alcohol, drugs and tobacco implications education relationships transportation. Workers reported the highest average improvement in: volunteering transportation awareness of community resources. Statistical analysis of the average scores at a domain level identified that 13 of the 16 domains reported a statically significant improvement in either the client or worker ratings. Despite three domains not reporting statistically significant results, levels of satisfaction in respect to these particular outcome areas were highly regarded in the client exit surveys. UAM ratings correlated these results; the same three domains did not report a statistically significant change. However, within the worker ratings, 10 of the 16 domains showed a statistically significant improvement. LSA results for Settlement Services Clients reported the highest average improvements for measurements in: education banking and credit employment relationships Workers reported the highest average improvement in: banking and credit education personal development relationships. Statistical analysis of the average scores at a domain level identified that all but one of the domains in the young persons ratings and one of the domains in the workers ratings, showed a statistically significant improvement over time.

8 EXECUTIVE SUMMARY The data in this paper provides evidence of the extremely positive outcomes for the clients of the Community Detention and Settlement Services. The improvement in scores also show the programs are delivering services to young people that increase their skills and ability to live independently within the community. These outcomes have been reported by clients and workers alike, and are in line with the central purpose of Life Without Barriers; to provide a nurturing and culturally supportive environment for clients. Exit Surveys During the review period there were 133 completed exit surveys, representing clients who exited the Community Detention and Settlement programs in the 18 month period leading up to 12 March The clients indicated a high degree of satisfaction with the services and approach provided by Life Without Barriers. The exit survey asked clients to consider their overall impression of the service with 92% indicating they were either very happy or mostly happy. Only 8% indicated they were uncertain or unhappy. Community Detention Life Skills Assessment Analysis was completed for 52 clients presenting both the Unaccompanied Minor s (UAM) self assessment, as well as the respective assessment completed by the support worker at Life Without Barriers. The average time between first and last reviews was days (approximately 4.5 months), with a range of 68 to 219 days. UAMs self assessments indicated improvement across all LSA domains, similarly, workers assessed that the UAMs improved across all LSA domains. Statistical analysis of these average scores across the 16 LSA domains in Community Detention has identified that overall, 13 of the 16 domains reported a statistically significant improvement in either the UAM or worker ratings.

9 6 7 Settlement Life Skills Assessment Analysis was completed for 51 clients, reporting both the Unaccompanied Humanitarian Minors (UHMs) self assessment, as well as the respective assessment completed by the support worker at Life Without Barriers. The average time between first and last reviews was days (approximately 5 months), with a range of 62 to 331 days. On average, UHMs self assessment indicated improvement across all LSA domains and similarly, workers indicated the UHMs improved across all LSA domains. Statistical analysis of these average scores has identified that 14 of the 15 domains showed a statistically significant improvement. Settlement Capture Analysis of the LSA data also provided valuable insights into areas of opportunity. There are a small number of sub domains within both the Community Detention Support and Settlement Service programs that could have an increased focus to further increase levels of improvement in the future. The data highlighted in this paper also shows very strong evidence of an extremely positive outcome for the clients of the Community Detention and Settlement Services. This is a clear indication that the placement of children and young refugees in community settings can reduce the risk factors in their lives.

10 RESULTS CLIENT EXIT SURVEYS During the review period there were 133 completed exit surveys, representing clients who exited the Community Detention and Settlement programs in the 18 month period leading up to 12 March The majority of the client exit surveys analysed relate to the Settlement program (70%) and exit surveys by state were relatively evenly distributed. Exit survey domains The exit survey is structured around five domains which are: 1. Daily care and supervision in the program 2. Health support in the program 3. Respect and support for your personal identity 4. Education support in the program 5. Safety in the program. OVERALL IMPRESSION OF LIFE WITHOUT BARRIERS PROGRAM Clients indicated a high degree of satisfaction with the services and approach provided by Life Without Barriers. The exit survey asked clients to consider their overall impression of the Life Without Barriers service with 59% indicating they were very happy and another 33% indicating they were mostly happy. Only 8% indicated they were uncertain or unhappy. Of those who reported being unhappy (n=4), one respondent used the free text response to indicate that they really enjoyed my time in the program and really appreciate their help and support. The other three respondents offered little commentary to explain their response, though increasing sports and recreational activities were offered by two respondents as ways to improve the program. Further analysis of clients overall impressions of the program indicates that the high degree of satisfaction is equally represented over all States, Territories and programs. FIGURE 3.1 When I think about Life Without Barriers program, I feel (n=132) 59% Very happy 33% Mostly happy 5% Undecided/unsure 3% Unhappy 0% Very unhappy

11 8 9 DAILY CARE AND SUPERVISION IN THE PROGRAM Clients reported high levels of satisfaction with their daily care and supervision, specifically regarding their support worker (Figure 3.2), understanding of the language used (Figure 3.3) and satisfaction with place of accommodation (Figure 3.4). FIGURE 3.2 I was happy with the Life Without Barriers Cultural Support Worker from my program (n=128) 66% Definitely agree 26% Mainly agree 5% Undecided/unsure 3% Not really 0% Definitely not FIGURE 3.3 I understood my Cultural Support Worker s words and language when they spoke to me (n=130) 74% Definitely agree 22% Mainly agree 3% Undecided/unsure 1% Not really 0% Definitely not FIGURE 3.4 I liked the place where I was living (n=132) 73% Definitely agree 18% Mainly agree 3% Undecided/unsure 2% Not really 4% Definitely not

12 RESULTS HEALTH SUPPORT IN THE PROGRAM Clients reported high level of satisfaction with their health support, specifically regarding access to doctors (Figure3.5) and consumption of healthy food (Figure 3.6). FIGURE 3.5 I was able to see a doctor when I needed to (n=129) 69% Definitely agree 19% Mainly agree 6% Undecided/unsure 5% Not really 1% Definitely not FIGURE 3.6 I ate healthy food when I was in my program (n=131) 72% Definitely agree 24% Mainly agree 2% Undecided/unsure 0% Not really 2% Definitely not

13 10 11 RESPECT AND SUPPORT FOR YOUR PERSONAL IDENTITY Clients reported high levels of satisfaction with the respect and support to cultural identity, specifically regarding ability to practice their religion (Figure 3.7), time with people of the same culture (Figure 3.8) and other activities (Figure 3.9) FIGURE 3.7 I was able to practice my religion in the way I wanted to (n=132) 87% Definitely agree 11% Mainly agree 2% Undecided/unsure 0% Not really 0% Definitely not FIGURE 3.8 I spent time with other people from my culture (n=131) 80% Definitely agree 18% Mainly agree 2% Undecided/unsure 0% Not really 0% Definitely not FIGURE 3.9 I liked the activities and sports that I did while I was here (n=132) 61% Definitely agree 20% Mainly agree 7% Undecided/unsure 8% Not really 4% Definitely not

14 RESULTS EDUCATION SUPPORT IN THE PROGRAM Clients reported high levels of satisfaction with the education support, specifically regarding access to classes (Figure 3.10), assistance with English (Figure 3.11) and attainment of independent life skills (Figure 3.12). FIGURE 3.10 I was able to go to education classes/ school (n=132) 78% Definitely agree 13% Mainly agree 4% Undecided/unsure 2% Not really 3% Definitely not FIGURE 3.11 I received help to practice my English skills everyday (n=132) 62% Definitely agree 21% Mainly agree 6% Undecided/unsure 11% Not really 0% Definitely not FIGURE 3.12 I gained important skills and abilities for my independent living (n=131) 67% Definitely agree 27% Mainly agree 4% Undecided/unsure 1% Not really 1% Definitely not

15 12 13 SAFETY IN THE PROGRAM Clients reported high level of satisfaction with their safety in the program, specifically regarding feeling safe (Figure 3.13), and having access to support (Figure 3.14). FIGURE 3.13 I felt safe while staying here (n=131) 83% Definitely agree 15% Mainly agree 1% Undecided/unsure 0% Not really 1% Definitely not FIGURE 3.14 I had someone to talk to if I was worried or nervous (n=130) 67% Definitely agree 22% Mainly agree 7% Undecided/unsure 2% Not really 2% Definitely not

16 RESULTS COMMUNITY DETENTION The analysis provided in Table 3.6 presents average scores for each of the 16 domains in the Community Detention program LSAs for the 60 matched clients in the period reviewed. However, for a small number of matched clients the time between consecutive LSAs was less than 60 days, and for the purposes of this analysis, these clients have been removed from the data. As a consequence the table presents analysis for 52 clients presenting both the Unaccompanied Minors (UAM) self assessment, as well as the respective assessment completed by the support worker at Life Without Barriers. The average time between first and last reviews was days (approximately 4.5 months), with a range of 68 to 219 days. The rating matrix for the LSA is as follows: 1 Can complete independently/not applicable 2 Can complete with assistance 3 Working towards becoming independent The analysis indicates that: UAMs self assessments indicated improvement across all LSA domains Similarly, workers assessed that the UAMs improved across all LSA domains Volunteering was the domain with the highest average score reported in final LSAs, with an average of 1.79 on UAM assessment and 1.72 on Worker assessment The domain with the lowest average scores reported in final LSAs was Education (UAM assessments of 1.19; Worker assessment of 1.32) On average, Community Detention scores were higher than the Settlement program scores at both LSA collection periods. This may be a consequence of higher levels of anxiety, generally, as a result of their uncertain Settlement status. Scored from 1-3. Lower score indicates higher functioning/independence. These results are further illustrated in figures 3.17 and 3.18 opposite:

17 14 15 FIGURE 3.15 Analysis of Community Detention Unaccompanied Minors LSA ratings, by domain (n=53) Alcohol, Drugs and Tobacco Banking and Credit Community Resources Consuming Cultural Awareness Education Employment Health Home Safety Household Management Money and Budgeting Nutrition, Cooking and Meal Planning Personal Development Relationships Transportation Volunteering FIGURE 3.16 Analysis of Community Detention Workers LSA ratings, by domain (n=53) Alcohol, Drugs and Tobacco Banking and Credit Community Resources Consuming Cultural Awareness Education Employment Health Home Safety Household Management Money and Budgeting Nutrition, Cooking and Meal Planning Personal Development Relationships Transportation Volunteering First LSA Final LSA AVE LSA RATING First LSA Final LSA AVE LSA RATING

18 RESULTS Statistical analysis of these average scores across the 16 LSA domains in Community Detention has identified that: Overall, 13 of the 16 domains reported a statistically significant improvement in either the UAM or worker ratings. The three domains that were not statistically significant in either UAM or workers ratings (despite reporting improvements), were: Cultural Awareness; Household Management; Nutrition, Cooking and Meal Planning. In respect to UAM self-assessed ratings, 13 of the 16 domains showed a statistically significant improvement. Those domains that did not were: Cultural Awareness Household Management Nutrition, Cooking and Meal Planning. In respect to worker ratings, 10 of the 16 domains showed a statistically significant improvement. Those domains that did not were: Cultural Awareness Education Home Safety Household Management Nutrition, Cooking and Meal Planning Personal Development. Some domains did not report statistically significant results, however all domains showed levels of improvement. These levels of satisfaction, in respect to these particular outcome areas, were highly regarded in the exit surveys reported earlier. The effect size (as measured by Cohen s d) indicates that, statistically, the program explains 60% of the change in average scores of the UAM and Worker ratings. This is considered to be a medium/large effect. The ratings of both UAM and worker were consistent with each other and highly correlated. This high correlation validates the internal reliability of the assessments made and the conclusions that can be drawn from the LSA data.

19 16 17 LIFE SKILLS ASSESSMENT Of the 586 LSAs available, it was determined that 116 clients had completed two or more consecutive LSAs that provided sufficient data for statistical analysis. These surveys were completed manually and have been entered into a survey database as part of this review, to facilitate analysis. SETTLEMENT PROGRAM The analysis provided in figure 3.15 and 3.16 show side by side, average LSA scores for each domain in the Settlement program, from the first and final LSA respectively. 56 clients had completed two or more consecutive LSAs in the period reviewed. However, for a small number of matched clients the time between consecutive LSAs was less than 60 days, and for the purposes of this analysis, these clients have been removed from the data. As a consequence we present analysis for 51 clients, reporting both the Unaccompanied Humanitarian Minors (UHMs) self assessment, as well as the respective assessment completed by the support worker at Life Without Barriers. The average time between first and last reviews was days (approximately 5 months), with a range of 62 to 331 days. The rating matrix for the LSA is as follows: 1 Can complete independently/not applicable 2 Can complete with assistance 3 Working towards becoming independent The analysis indicates that: On average, UHMs self assessment indicated improvement across all LSA domains Similarly, workers indicated that the UHMs improved across all LSA domains Employment was the domain with the highest average score reported in final LSAs, with an average of 1.72 and 1.75 on UHM and worker assessments respectively The domains with the lowest average scores reported in final LSAs were Personal Development (UHM assessments of 1.12) and Nutrition, cooking and meal preparation (worker assessment of 1.14) Scored from 1-3. Lower score indicates higher functioning/independence These results are further illustrated in figures 3.15 and 3.16 opposite:

20 RESULTS FIGURE 3.17 Analysis of Settlement UHM LSA ratings, by domain (n=51) Alcohol, Drugs and Tobacco Banking and Credit Community Resources Consuming Cultural Awareness Education Employment Health Home Safety Household Management Money and Budgeting Nutrition, Cooking and Meal Planning Personal Development Relationships Transportation FIGURE 3.18 Analysis of Settlement worker LSA ratings, by domain (n=51) Alcohol, Drugs and Tobacco Banking and Credit Community Resources Consuming Cultural Awareness Education Employment Health Home Safety Household Management Money and Budgeting Nutrition, Cooking and Meal Planning Personal Development Relationships Transportation First LSA Final LSA AVE LSA RATING First LSA Final LSA AVE LSA RATING

21 18 19 Statistical analysis of these average scores across the 15 LSA domains has identified that: In respect to UHM self-assessed ratings, 14 of the 15 domains showed a statistically significant improvement. The Home Safety domain, despite an improvement, was not statistically significant (however, exit survey responses indicted a high level of satisfaction with safety in the program. Similarly, in respect to worker ratings, 14 of the 15 domains showed a statistically significant improvement. The Transportation domain, despite an improvement, was not statistically significant The effect size (as measured by Cohen s d) indicates that, statistically, the program explains 34% and 38% of the change in average scores of the UHM and worker ratings respectively. This is considered to be a small/medium effect. The ratings of both UHMs and workers were consistent and highly correlated with each other. A bivariate Pearson s correlation analysis between consumer and support ratings shows that for all domains there was a strong, positive, statistically significant relationship (between , P<0.05) for every domain and for the average of all domains. This high correlation validates the internal reliability of the assessments made and the conclusions that can be drawn from the LSA data.

22 SUMMARY The data demonstrates a significant improvement in clients life-skills and ability to live independently within the community. The consistency of this improvement reported by both clients and workers is very impressive and highlights extremely positive outcomes for the clients of the Community Detention and Settlement Services. This is well supported by the existing research literature that recovery from trauma is possible via reduction of risk factors through interventions. With appropriate therapies and training, protective factors can be built to support the development of resilience. The outcome data is a clear demonstration that Life Without Barriers Settlement and Community Detention Programs are well-facilitated development programs that support recovery and build resilience for these young unaccompanied asylum seekers. This placement can establish protective factors such as sense of belonging and feeling embraced by a community that values and protects them, leading to enhancing protective value of learning life skills and being exposed to positive life experiences to build optimism for a more fulfilling life. Reducing risk factors and building resilience is vital to ensuring that these young minors feel confident to realise their full potential and maximise their contribution to the Australian society. These outcomes also provided valuable insights into areas of opportunity. There are a small number of sub domains within both the Community Detention Support and Settlement Service programs that could have an increased focus to further increase levels of improvement in the future. Overall, the programs are in line with the central purpose of Life Without Barriers; to provide a nurturing and culturally supportive environment for clients.

23 22 23 Overall, the programs are in line with the central purpose of Life Without Barriers; to provide a nurturing and culturally supportive environment for clients.

24 Life Without Barriers 352 King Street Newcastle NSW 2300 T E. W /company/life-without-barriers/ LWBAustralia 18/09/2015 LWB 10482