Housing and health for people from refugee and asylum-seeking backgrounds: findings from an Australian qualitative longitudinal study.

BACKGROUND: For people from asylum-seeking and refugee backgrounds, housing and the re-establishment of home are key social determinants of health. Research highlights the inequities faced by asylum seekers and refugees in the housing markets of high-income resettlement countries, resulting in their overrepresentation in precarious housing. There is also emerging evidence of the relationship between housing and health for this population relating to lack of affordability, insecurity of tenure, and poor suitability (physical and social). The mechanisms by which housing impacts health for this group within these housing contexts, is however, understudied - especially overtime. This qualitative longitudinal study aimed to address this gap. METHODS: Semi-structured interviews were conducted with 25 people from asylum-seeking and refugee backgrounds in South Australia, recruited through a community survey. Thematic analysis of interview data across three time points over three years identified four material and psychosocial mechanisms through which housing contributed to health outcomes via psychological and physical stressors - physical environment; stability; safety; and social connections, support and services. The study also identified additional health promoting resources, particularly elements of ontological security. The dynamics of these indirect and direct mechanisms were further illuminated by considering the impact of international, national and local contexts and a range of intersecting social factors including gender, country/culture of origin, family circumstances, immigration status, language skills, income, and health status. CONCLUSIONS: Rebuilding a sense of home and ontological security is a key resettlement priority and crucial for wellbeing. More comprehensive strategies to facilitate this for refugees and asylum seekers are required.

Exploring the Role of Migration Status in Pregnancy Loss Attributions, Experiences, and Support in Australia.

While previous research has explored the impact of migration status on experiences and attributions about pregnancy loss, less common is comparative research examining similarities and differences between migrants and non-migrants. This paper reports on a cross sectional comparative study of 623 culturally and linguistically diverse (CALD) or non-CALD people living in Australia. Participants completed a survey that asked about experiences of pregnancy loss, support, and attributions about pregnancy loss. There were no differences between the two groups in terms of rates of pregnancy loss, though CALD participants reported greater distress following a loss. CALD participants reported greater reliance on partners and faith communities, and found healthcare professionals to be less supportive. CALD participants were more likely to attribute pregnancy loss to spiritual reasons (among others), and non-CALD participants to fetal abnormalities. The paper concludes by calling for awareness campaigns and professional upskilling to better ensure the needs of CALD communities.

Wellbeing Outcomes and Risk and Protective Factors for Parents with Migrant and Refugee Backgrounds from the Middle East in the First 1000 Days: A Systematic Review.

The First 1000 Days (the period from conception to a child's second birthday) is an important developmental period. However, little is known about experiences of parents with refugee and migrant backgrounds during this period. A systematic review was conducted according to PRISMA guidelines. Publications were identified through searches of the Embase, PsycINFO, PubMed, and Scopus databases, critically appraised, and synthesised using thematic analysis. A total of 35 papers met inclusion criteria. Depressive symptomatology was consistently higher than global averages, however maternal depression conceptualisations differed across studies. Several papers reported changes in relationship dynamics as a result of having a baby post-migration. Consistent relationships were found between social and health support and wellbeing. Conceptualisations of wellbeing may differ among migrant families. Limited understanding of health services and relationships with health providers may impede help-seeking. Several research gaps were identified, particularly in relation to the wellbeing of fathers, and of parents of children over 12 months old.

"I *know* all the things I should be doing ": accounting for mental health and illness in an online mental health discussion forum during the COVID-19 pandemic.

BACKGROUND: Mental health is highly correlated with a person's social and economic circumstances, and the recent COVID-19 pandemic made this connection uniquely visible. Yet a discourse of personal responsibility for mental health often dominates in mental health promotion campaigns, media coverage and lay understandings, contributing to the stigmatisation of mental ill-health. METHODS: In this study, we analysed how the concept of 'mental health' was discursively constructed in an online mental health peer-support forum in Australia during 2020, the period of the first two waves of the COVID-19 pandemic. An approach informed by Critical Discursive Psychology was employed to analyse all posts made to a discussion thread entitled "Coping during the coronavirus outbreak" in 2020, a total of 1,687 posts. RESULTS: Two main interpretative repertoires concerning mental health were identified. Under the first repertoire, mental health was understood as resulting largely from the regular performance of a suite of self-care behaviours. Under the second repertoire, mental health was understood as resulting largely from external circumstances outside of the individual's control. The existence of two different repertoires of mental health created an ideological dilemma which posters negotiated when reporting mental ill-health. A recurring pattern of accounting for mental ill-health was noted in which posters employed a three-part concessive structure to concede Repertoire 1 amid assertions of Repertoire 2; and used disclaimers, justifications, and excuses to avoid negative typification of their identity as ignorant or irresponsible. CONCLUSIONS: Mental ill-health was commonly oriented to by forum posters as an accountable or morally untoward state, indicating the societal pervasiveness of a discourse of personal responsibility for mental health. Such discourses are likely to contribute to the stigmatisation of those suffering from mental ill-health. There is a need therefore for future communications about mental health to be framed in a way that increases awareness of social determinants, as well as for policy responses to effect material change to social determinants of mental health.

Quality of life among people living with mental illness and predictors in Africa: a systematic review and meta-analysis.

INTRODUCTION: Quality of life (QoL) of patients with mental illness has been examined internationally but to a lesser extent in developing countries, including countries in Africa. Improving QoL is vital to reducing disability among people with mental illness. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of QoL and associated factors among people living with mental illness in Africa. METHODS: Using the PICOT approach, Scopus, MEDLINE, PsycINFO, CINAHL, Embase, the Web of Science, and Google Scholar were searched. A structured search was undertaken, comprising terms associated with mental health, mental illness, QoL, and a list of all African countries. The Joanna Briggs Institute Quality Appraisal Checklist is used to evaluate research quality. Subgroup analysis with Country, domains of QoL, and diagnosis was tested using a random-effect model, and bias was assessed using a funnel plot and an inspection of Egger's regression test. A p value, OR, and 95% CI were used to demonstrate an association. RESULTS: The pooled prevalence of poor QoL was 45.93% (36.04%, 55.83%), I2 = 98.6%, p < 0.001). Subgroup analysis showed that Ethiopia (48.09%; 95% CI = 33.73, 62.44), Egypt (43.51%; 95% CI = 21.84, 65.18), and Nigeria (43.49%; 95% CI = 12.25, 74.74) had the highest mean poor QoL prevalence of the countries. The pooled prevalence of poor QoL by diagnosis was as follows: bipolar disorder (69.63%; 95% CI = 47.48, 91.77), Schizophrenia (48.53%; 95% CI = 29.97, 67.11), group of mental illnesses (40.32%; 95% CI = 23.98, 56.66), and depressive disorders (38.90%; 95% CI = 22.98, 54.81). Being illiterate (3.63; 95% CI = 2.35, 4.91), having a comorbid medical illness (4.7; 95% CI = 2.75, 6.66), having a low monthly income (3.62; 95% CI = 1.96, 5.27), having positive symptoms (0.32; 95% CI = 0.19, 0.55), and having negative symptoms (0.26; 95% CI = 0.16, 0.43) were predictors of QoL. Thus, some factors are significantly associated with pooled effect estimates of QoL. CONCLUSIONS: The current systematic review and meta-analysis showed that almost half of patients with mental illness had poor QoL. Being illiterate, having a comorbid medical condition, having a low monthly income, having positive symptoms, and having negative symptoms of mental illness were independent predictors of poor QoL. This systematic review and meta-analysis emphasize that poor QoL of people with mental illness in Africa needs attention to reduce its negative consequences.

Grandparents' pregnancy and neonatal loss network: Designing a website for grandparents bereaved by the perinatal loss of a grandchild.

Objectives: When a child dies during the perinatal period, grandparents lack the resources to navigate their loss. We applied principles of co-creation and consumer-informed design to seek grandparents' expertise in determining (1) whether an internet-based resource would be suitable/beneficial for grandparents, (2) if so, what design features and content should be included and, (3) any barriers to utilising an internet-based resource. Method: In Stage One, 152 grandparents responded to a survey regarding health and eHealth literacy and website design and content. In Stage Two, a draft website was developed, with 21 grandparents providing feedback about the website's design, content and navigability. Results: Health and eHealth literacy measures indicated that >60% of participants had adequate literacy, and over 70% considered an internet-based resource useful. Grandparents provided design and content preferences, valuing diversity and peer support, and offered recommendations to optimise the website. Directing grandparents to public internet facilities would reduce barriers to access. Conclusion: A website is a suitable resource for grandparents seeking information and support following the loss of a grandchild in the perinatal period. Innovation: Grandparents see benefits in internet-based resources and can contribute to co-design. Further work could explore cultural differences.

Internalised stigma among people with mental illness in Africa, pooled effect estimates and subgroup analysis on each domain: systematic review and meta-analysis.

BACKGROUND: Internalisation of stigma occurs when people with a stigmatised attribute, such as a mental illness, supress negative but accepted societal attitudes. However, as far as is known, there is no comprehensive picture of the prevalence of and factors associated with, internalised stigma among people living with mental illness in Africa. This systematic review and meta-analysis provide new knowledge by examining the evidence on the prevalence of internalised stigma and associated factors among people living with mental illness in Africa. METHODS: Using the population, intervention, comparison, outcome, and type of study (PICOT) approach, PubMed, Scopus, MEDLINE, PsycINFO, CINAHL, ScienceDirect, and Google Scholar were searched using a structured search comprising terms associated with mental health, mental illness, internalised stigma, and a list of all African countries. To evaluate paper quality, the Joanna Briggs Institute Quality Appraisal Checklist was used. Subgroup analysis with country and diagnosis was tested using a random-effect model, and bias was checked using a funnel plot and an inspection of Egger's regression test. A p-value, OR and 95% CI was used to demonstrate an association. RESULTS: The pooled prevalence of internalised stigma was 29.05% (25.42,32.68: I2 = 59.0%, p ≤ 0.001). In the subgroup analysis by country, Ethiopia had the highest prevalence of internalised stigma at 31.80(27.76,35.84: I2 = 25.6%, p ≤ 0.208), followed by Egypt at 31.26(13.15,49.36: I2 = 81.6%, p ≤ 0.02), and Nigeria at 24.31(17.94,30.67: I2 = 62.8%, p ≤ 0.02). Based on domains of internalised stigma, pooled prevalence was stigma resistance: 37.07%, alienation: 35.85%, experience of discrimination: 31.61%, social withdrawal: 30.81% and stereotype: 26.10%. Experiencing psychotic symptoms (1.42(0.45,2.38)), single marital status (2.78(1.49,4.06)), suicidal ideation (2.32(1.14,3.49)), drug nonadherence (1.5(-0.84,4.00)), poor social support (6.69(3.53,9.85)), being unemployed (2.68(1.71,3.65)), and being unable to read and write (3.56(2.26,4.85)) were identified as risk factors for internalised stigma. CONCLUSIONS: Internalised stigma is common among people suffering from mental illnesses in Africa. This review determined that 29% of the sample population had elevated internalised stigma scores, and there were variations by country. People experiencing mental illness who have a single marital status, suicidal behaviours, poor social support, unemployed and have poor literacy levels were at a higher risk of internalised stigma. The finding points to populations that require support to address internalised stigma and improve the mental health outcomes.

Capturing parents' and health professionals' experiences of stillbirth bereavement photography: A systematic review and meta-synthesis.

PROBLEM: Evidence-informed, best-practice recommendations concerning bereavement photography following stillbirth have yet to be proposed. BACKGROUND: Previous research has highlighted the general importance of memory-making following pregnancy loss; however, scarce studies have specifically examined bereavement photography experiences. AIM: To examine parents', healthcare professionals' and photographers' perspectives and experiences of stillbirth bereavement photography. METHODS: Guided by JBI Collaboration methods, we conducted a systematic review and meta-synthesis (using a meta-aggregative approach) of 12 peer-reviewed studies conducted predominantly in high-income countries FINDINGS: Two overarching synthesised findings were generated: Bereavement photography as a helpful tool for the present and Bereavement photography as a helpful tool for the future. The proactive recommendation of memory-making influenced parents' decisions, and some parents not offered bereavement photography post-stillbirth expressed their desire for this opportunity retrospectively. Most parents who utilised bereavement photography were positive about their experiences. In the acute stages of loss, photographs supported meaningful introductions of the baby to their sibling(s) and validated parents' loss. Longer-term, the photographs validated the stillborn child's life, maintained memories and enabled parents to share their child's life with others. DISCUSSION: Bereavement photography appeared beneficial, even though some parents felt conflicted about it. Parental views about photography appeared to fluctuate; many parents who rejected the offer of stillbirth photography described regret about their decision later. Conversely, parents who reluctantly accepted photographs were grateful. CONCLUSION: Our review shows compelling evidence that bereavement photography should be normalised and offered to parents in the wake of stillbirth, with tactful, personalised approaches needed to assist with bereavement.

Housing in Place: Housing, Neighbourhood and Resettlement for People from Refugee and Asylum Seeker Backgrounds in Australia.

Housing is an important part of building a new life for people from refugee and asylum seeker backgrounds. However, relatively little is known about how housing and neighbourhood experiences affect resettlement and integration. This paper explored experiences of housing and neighbourhood for refugees and asylum seekers in South Australia, Australia. A survey was completed by 423 participants, recruited through service providers, community networks and snowball sampling. Data was analysed using frequencies, chi-square analyses and multivariate logistic regression. The study identified aspects of housing and neighbourhood that were important to participants, as well as highlighting key problems. Housing satisfaction and neighbourhood satisfaction were positively associated, but housing satisfaction was lower than neighbourhood satisfaction. Both were significantly associated with overall satisfaction with life in Australia, although only neighbourhood satisfaction remained significant in the final multivariate model (alongside region of origin, visa and financial situation). Overall, the findings suggest that where housing is situated may be more important for resettlement satisfaction and integration than the housing itself. Policy and practice implications of the findings are discussed, alongside considerations for conceptualising integration.

"It's important to manage our stress": Mental health advice in the Australian print news media during the COVID-19 pandemic.

The COVID-19 pandemic has heightened existing concerns about mental health and illness in Australia. The news media is an important source of health information, but there has been little research into how advice about mental health is communicated to the public via the news media. In this study, we examined how advice about building and maintaining mental health was discursively constructed in the news media during the COVID-19 pandemic. A discourse analytic approach informed by critical discursive psychology was employed to analyse 436 articles published in daily newspapers in Australia between 1 January and 31 December 2020, which contained references to mental health and the COVID-19 pandemic. Three main interpretative repertoires were identified - negative emotions are a risk to mental health and must be managed; risky emotions should be managed by being controlled (based around a 'border control' metaphor); and risky emotions should be managed by being released (based around a 'pressure cooker' metaphor). This study demonstrates that, amid the COVID-19 pandemic, advice constructed negative emotions as risky and problematic; and normalized the habitual management of emotions by individuals through strategies of control and release. Potential implications of such discourses for goals of improving population mental health are discussed.

Culturally and Linguistically Diverse Men's Grief Experiences Following Perinatal Death in Australia.

To explore the grief experiences of men from culturally and linguistically diverse (CALD) backgrounds following perinatal death in Australia. Qualitative analysis of interview data using thematic analysis. Participants were health service providers (n = 6), and CALD community members (n = 10) who were either community leaders with experience working with CALD men following perinatal death in Australia (n = 6), or were CALD men who had lived experience of perinatal death (n = 4). Thematic analysis identified four themes related to CALD men's grief. These included the role of religion and rituals, grief as stoic, the partner- and family-centred nature of men's grief, and finally grief as ensuring and changeable over time. This research points to the strong need for CALD men's specific needs to be included in the development of policy and practice surrounding perinatal death.

Culturally and linguistically diverse men's experiences of support following perinatal death: A qualitative study.

AIMS AND OBJECTIVES: To explore culturally and linguistically diverse men's experiences of support after perinatal death, including barriers and facilitators to support and how healthcare providers, systems and policies can best support families. BACKGROUND: Many groups of culturally and linguistically diverse families in Australia are at higher risk of experiencing perinatal death. Culturally sensitive bereavement services are essential; however, there has been no previous research specifically examining culturally and linguistically diverse men's experiences of support following perinatal death. DESIGN: Individual semi-structured interviews were completed with healthcare providers, community leaders and culturally and linguistically diverse men who had experienced a perinatal death in Australia (n = 16). Data were analysed using Thematic Analysis and COREQ guidelines were followed. RESULTS: Men's need for support following perinatal death was associated with stigma, and shaped by culturally-relevant religion and ritual, and connection to community and family. Significant barriers to men seeking and gaining support included challenges with self-advocacy and navigating the woman-centred nature of perinatal care in Australia. CONCLUSIONS: Culturally and linguistically diverse men's specific needs should be included in the development of policy and practice surrounding perinatal death. While perinatal bereavement care guidelines acknowledge the importance of culturally informed care following perinatal death, there remains a lack of culturally specific supports available, particularly for culturally and linguistically diverse men. RELEVANCE TO CLINICAL PRACTICE: Specific recommendations from this research include increasing community liaison officers or cultural consultants in hospitals and support organisations; providing culturally and linguistically diverse support groups; adopting family-centred and father-inclusive language in all perinatal death support services and ensuring clear communication and targeted assistance for culturally and linguistically diverse men to self-advocate for their baby and access to support. PATIENT OR PUBLIC CONTRIBUTION: This study came out of consultation with community members and member checking of results was conducted to ensure adequate representation of participants' views.

Perinatal care for women with refugee backgrounds from African countries: a qualitative study of intersections with psychological wellbeing.

BACKGROUND: Experiences with healthcare services, including perinatal healthcare services, contribute to psychological wellbeing for refugees post-resettlement. To address the paucity of literature examining the relationship between perinatal healthcare and psychological wellbeing in women with refugee backgrounds from African countries this study aimed to: (1) understand the relationship between psychological wellbeing and perinatal care amongst this population, and; (2) identify areas for improved perinatal healthcare services to ensure positive wellbeing outcomes in this population. METHODS: A total of 39 participants were included in the study. Nineteen women from seven African countries participated in interviews - seven both prior to and after having their babies, two only while pregnant and ten only after their baby had been born. In addition, interviews were conducted with 20 service providers. Interviews were thematically analysed. RESULTS: Four key themes were identified, covering continuity of care, cultural safety of care, agency in decision making, and ongoing impacts of perinatal care experiences. CONCLUSIONS: The results highlighted the need for changes to perinatal healthcare provision at the systems level, including implementing a continuity of care model, and ensuring women's access to individualised, trauma-informed perinatal services which attend to the cultural and psychosocial resettlement needs of this population. These findings informed recommendations for improving perinatal healthcare services and better psychological outcomes - and in turn broader health outcomes - for African-background refugee mothers.

The relationship between employment and health for people from refugee and asylum-seeking backgrounds: A systematic review of quantitative studies.

Background: For the general population, the positive effects of paid employment on health and wellbeing are well established. However, less is known for people from refugee and asylum-seeking backgrounds. This review aims to systematically summarise the quantitative literature on the relationship between employment and health and wellbeing for refugees and asylum seekers. Method: A search strategy was conducted in online databases, including MEDLINE, PsychINFO, EMCARE, SCOPUS, CINHAL, ProQuest and Web of Science. Articles were screened against inclusion and exclusion criteria. Studies published in English between 2000 to October 2021 were included if they used quantitative methods to consider the relationship between employment and health for refugees and asylum seekers in resettlement countries. Study quality was assessed using The Joanna Briggs Institute's Critical Appraisal Tools. Findings were synthesised using a narrative approach. Results: Seventy-two papers were identified. The majority of papers (N = 58, 81%) examined the association between employment and mental health outcomes. Overall, while there were inconsistencies in the findings, employment had a positive effect on mental health particularly in reducing levels of psychological distress and depression. Though more limited in number, the papers examining physical health suggest that people who are employed tend to have better physical health than unemployed persons. There was some evidence to support the bi-directional relationship between employment and health. Poor mental and physical health negatively impacted the odds of employment and occupational status of refugees. Conclusion: Good quality employment is an essential component of refugee resettlement and this review found that in general employment is also beneficial for refugee health, particularly aspects of mental health. More research regarding the effects of employment on physical health is required. The effects of refugee-specific factors such as gender roles, torture, and trauma on the relationship between employment and health also require further investigation.

Overwhelming and unjust: A qualitative study of fathers' experiences of grief following neonatal death.

Limited research has examined the grief experiences of fathers following neonatal death. Using a qualitative research design, ten fathers were interviewed, and thematic analysis resulted in three overarching themes: 'A complicated grief experience: Neonatal death is highly emotional', 'Grief is multidimensional' and 'Sense of injustice'. Overall, results showed that grief was a multidimensional experience for fathers, with expressions of grief including strong feelings of anger and guilt and the manifestation of grief in physical symptoms. In addition, the findings also indicated a sense of injustice that contributed to the disenfranchisement of grief for fathers. The results of this study contribute to developing a better understanding of the grief that fathers experience following neonatal death, and can inform improvements in healthcare practices after the death of a baby in the neonatal period, including father-specific programs and adequate provision of information.

Supporting (or not) the career development of culturally and linguistically diverse migrants and refugees in universities: insights from Australia.

The present study used a mixed-methods approach to understand the challenges faced by Australian higher education institutions in supporting the career development of students from culturally and linguistically diverse migrant and refugee backgrounds. Specifically, this project included a desktop audit of all Australian universities, data from a survey (n = 32) and interviews with staff in various functions (n = 10). Four main challenges were identified: (1) difficulties in identifying and engaging with students; (2) a lack of targeted resources and programs; (3) difficulties faced by students in engaging with employers; and (4) a lack of work-readiness and unfamiliarity of Australian work culture.

Soutenir (ou non) le développement de la carrière des personnes migrantes et des réfugiées culturellement et linguistiquement différentes dans les universités: aperçu de l'Australie La présente étude a utilisé une approche à méthodes mixtes pour comprendre les défis auxquels sont confrontés les établissements d'enseignement supérieur australiens pour soutenir le développement de carrière des étudiantes issues de milieux migrants et réfugiés, culturellement et linguistiquement divers. Plus précisément, ce projet comprenait un audit de documentation de toutes les universités australiennes, des données provenant d'une enquête (n = 32) et des entretiens avec le personnel de diverses fonctions (n = 10). Quatre défis principaux ont été identifiés: (1) des difficultés à identifier les étudiantes et à nouer le dialogue avec eux; (2) un manque de ressources et de programmes ciblés; (3) des difficultés rencontrées par les étudiantes pour entamer le dialogue avec les employeurs; et (4) un manque de préparation au travail et une méconnaissance de la culture professionnelle australienne.

Apoyando (o no) el desarrollo de la Carrera de los emigrantes y refugiados cultural y llinguísticamente diversos en las universidades: percepciones desde Australia El presente studio usó un enfoque de métodos mixtos para entender los desafíos afrontados por las instituciones de educación superior australianas en el apoyo al desarrollo de la Carrera de estudiantes provinentes de contextos migración y refugio linguisticamente diversos. Específicamente, este proyecto incluyo una aditoria de escritorio para todas las universidades autralianas, los datos del estudio (n = 32) y las entrevistas a trabajadores en distintas funciones (n = 10). Cuatro grandes desafíos fueron indentificados: (1) dificultades en la identifcación e involucración con los estudiantes; (2) falta de recursos y programas específicos; (3) difcultades afrontadas por estudiantes para involucrarse con los empleadores y (4) una falta de preparación para el trabajo y una falta de familiarización con la cultura del trabajo autraliana.

Barriers and facilitators to engaging individuals and families with autism spectrum disorder in mindfulness and acceptance-based therapies: a meta-synthesis.

PURPOSE: Third-wave psychological therapies can benefit individuals and families living with autism spectrum disorder (ASD). To date, little is known about individuals' perceptions and experiences of therapy. This meta-synthesis aimed to capture participants' own reflections of mindfulness and acceptance-based therapies, including potential barriers and facilitators to therapy engagement. MATERIALS AND METHODS: Database searches identified 10 independent studies targeting caregivers (Nstudies = 3), dyadic parent-child interventions (Nstudies = 6), or adults with ASD (Nstudies = 1). Studies were subject to quality assessment and thematically analysed. RESULTS: Caregivers highlighted a need to adapt the length and frequency of daily mindfulness practice around busy lifestyles. Adults with ASD also identified therapy barriers, although these data were less robust. Children with ASD focused on therapy benefits. CONCLUSIONS: All three participant groups commented on the importance of mindfulness as a method to enhance self-awareness, self-regulation and self-care. Peer support provided in group-based therapy was also seen as beneficial. Future research should examine the application of mindfulness therapies to adults with ASD, with little currently known about this cohort's therapy experiences. Whether traditional mindfulness approaches can be effectively modified to accommodate ongoing, cumulative daily demands these families experience also requires investigation.Implications for rehabilitationIndividuals with autism spectrum disorders (ASD) and their caregivers often experience high levels of anxiety and stress.Mindfulness and acceptance-based therapies can enhance an individual's self-awareness and self-regulation, thereby reducing distress - with benefits extending to familiesGroup-based therapy is an important adjunct to the support of caregivers developing mindfulness-awareness.

Practitioner competencies for working with refugee children and young people: A scoping review.

Research indicates that refugee and asylum seeker children and young people often require specialised psychological support. Competencies have been established as helpful in guiding the training, education and ongoing professional development of practitioners working in specialised areas. To date there has been no comprehensive review of the literature concerning practitioner competencies for working with refugee or asylum seeker children and young people. This scoping review therefore aimed to synthesise all literature regarding practitioner competencies that are considered important for working in the area of mental health with refugee and asylum seeker children and young people. Literature was sourced from PsycINFO, Scopus, and PubMed. Studies were included if they: a) were published in peer-reviewed journals, b) were published in English, c) were published in the last 25 years, d) collected primary data, e) related to children and/or young people (defined as aged under 25) with refugee or asylum seeker backgrounds, and f) discussed practitioner competencies (in relation to refugee or asylum seeker children or young people). Nine articles met criteria and a deductive thematic analysis identified six key competencies: 1) knowledge of the complexity of needs of refugees; 2) use of holistic approaches; 3) ability to work in co-ordination with others in the child's network; 4) ability to build therapeutic relationships; 5) seeking feedback; and 6) cultural competency. Further empirical research that directly aims to identify practitioner competencies, from both the practitioner and client perspective, will support the challenging work done by practitioners working with refugee and asylum seeker children and young people.

Grandfathers' Experiences of Grief and Support Following Pregnancy Loss or Neonatal Death of a Grandchild.

Pregnancy loss and neonatal death are recognized as distressing experiences for parents and other family members. However, no research has specifically addressed the experiences of grandfathers. This study aimed to understand grandfathers' grief experiences, and to identify supports they provide, receive, and desire following the loss of a grandchild in pregnancy or the neonatal period. Semi-structured interviews with 10 Australian grandfathers were analyzed, applying principles of thematic analysis. Three themes related to grief and three themes related to support were identified. Findings indicated that grandfathers expressed grief in a range of ways, and emotional expressiveness did not reflect the extent of their grief. Grandfathers typically provided extensive support to their child and family; however, few supports were available to help grandfathers. Recognition and validation of grandfathers' grief, early access to information, and guidance to a variety of supports including written materials, peer and professional support, is required.

Australian fathers' experiences of support following neonatal death: a need for better access to diverse support options.

OBJECTIVE: To explore fathers' experiences of support following neonatal death, including the availability and perceived adequacy of support, barriers and facilitators to support and desired support. STUDY DESIGN: Semi-structured interviews were conducted with ten Australian fathers who had experienced the death of a baby in the neonatal period at least 6 months previously. Data were analysed using thematic analysis. RESULTS: Two overarching themes were identified: From hospital to home: Continuity of care and Self and community barriers to support. Fathers who could access the support they required found this to be beneficial. Overall, however, supports were perceived as inadequate in variety and availability, with more follow-up support from the hospital desired. Fathers highlighted limited opportunities to form emotional connections with others and a strong desire to talk about their baby. CONCLUSION: Healthcare professionals and support organisations can more effectively assist fathers by increasing the variety of supports available and facilitating follow-up or referrals after hospital discharge.