Domain – Migrant, refugee and asylum seeker health(guiding topics)

Provide culturally safe and trauma-informed care

• Identify the need for professional interpreters and use them effectively, including for patients who are more comfortable discussing health issues in their primary language.
• Identify useful resources, including multilingual patient information, online explanatory videos, and visual aids to assist in communication about health issues and management.
• Provide culturally safe care, including undertaking a cultural assessment, and understand:
  • the meaning of culturally safe care and the skills and knowledge required to support this
  • the role of a cultural assessment in establishing rapport and informing future shared decision-making and improved communication
  • the barriers to care for people from culturally and linguistically diverse communities and specifically for those who have had refugee experiences or are seeking asylum.
• Understand the terms ‘cultural bias’ and ‘cultural lens’ and be able to reflect on own cultural lens and bias and how these affect consultations.
• Identify and respond to a disclosure of torture or trauma.
• Use reflective practice to identify when you have found a consultation challenging; seek help from colleagues and practise self-care.

Provide preventive care and conduct screening

• Consider risk factors and screen for high prevalence communicable diseases common in particular geographical regions:
  • hepatitis B
  • hepatitis C
  • helicobacter pylori
  • human immunodeficiency virus (HIV) and other sexually transmissible infections
  • tuberculosis
  • intestinal parasites.
• Consider risk factors and conduct age-based screening for high prevalence non-communicable conditions common in countries of origin:
  • vitamin D deficiency
  • age and ethnicity-appropriate cardiovascular, type 2 diabetes, and renal disease risk assessment
  • dental disease.
• Identify common health conditions and understand referral pathways, if required:
  • nutritional disorders (eg iron, B12 and folate deficiencies)
  • inherited anaemias (eg thalassaemia, G6PD deficiency, haemoglobinopathies)
  • mental health conditions (eg post-traumatic stress disorder, somatisation, complicated grief)
  • female genital cutting or circumcision, particularly in prenatal and antenatal settings
  • visual and hearing assessments
  • low immunisation rate/catch-up immunisation
  • in children and adolescents consider impacts of disrupted schooling, assessment of developmental delay and lead exposure, where appropriate.

Identify and address barriers to care

• Identify Medicare item numbers that may assist in provision of holistic care to people from culturally and linguistically diverse communities (eg refugee health assessment).
• Identify online multilingual resources and local community referral pathways that might be appropriate for your patients from culturally and linguistically diverse communities and/or who have had refugee-like experiences.
• Identify whether your practice demonstrates that it is ‘migrant, refugee and asylum seeker friendly’; for example, through displaying posters about availability of interpreters and provision of multilingual resources.