School of Psychology

A Study of Australian Refugee Advocates - Summary 2006

What is the political context of the issue?

The Australian Government has adopted the policy of mandatory detention and temporary protection toward unauthorised arrivals in order to deter people arriving in Australia and seeking asylum. However, prolonged detention, the conditions of temporary protection visas and bridging visas E, and deportation among other things have negatively impacted, and are continuing to impact, on the physical and mental well-being of refugees1 (see Steel et al., 2006). Many Australians, concerned with and angered by these adverse effects of the onshore refugee policy, formed alliances to support distressed and disadvantaged people.

What was the general aim of the study?

As noted above, there is strong evidence of the negative effects of Australia’s onshore refugee policy on refugees’ levels of trauma. Furthermore, it has been argued that advocates may suffer vicarious trauma in helping such refugees (Gosden, 2005). However, the specific stresses and coping strategies associated with assisting such refugees have not been studied empirically. Therefore, we examined how working with this group of refugees affected their advocates. Given the stress relating to caring roles generally, it is important to examine how refugee advocates deal with the pressures associated with assisting refugees.

What were the primary research questions?

1. Had advocates engaged in social justice work previously? If so, did they find refugee advocacy more or less stressful, or was there no difference? If indeed there were differences, why may this be the case?
2. What were the psychological effects of working with traumatised refugees on advocates? Specifically, what were advocates’ coping strategies, and how effective were they?
3. Were there positive experiences for advocates; did their personal relationships change as an outcome of their involvement with refugees?

What did we do to answer the primary questions?

• We used the Critical Incident Technique (Flanagan, 1954) to obtain advocates’ recollection of a stressful event from their advocacy work, and then examined their stress levels relating to this. Specifically, advocates were asked whether there was a significant event from their refugee work that contributed to any experiences of stress. If there was such an experience, they briefly described it.
• We then asked advocates to respond on a five-point scale as to how often they experienced certain feelings or symptoms to measure stress (for example, “did you feel stressed at the time of the Critical Incident”) and vicarious trauma symptoms (for example, crying episodes, outbursts of anger at the time of the Critical Incident). Stress and vicarious trauma may have similar symptoms. However, stress is a more general reaction to traumatic or disturbing events, whereas vicarious trauma is a more specific emotional and psychological effect of working with traumatised people. Vicarious trauma can also be defined as involving symptoms of posttraumatic stress disorder, such as re-experiencing others’ trauma, avoidance, numbing, and persistent arousal (Hesse, 2002), and specific symptoms arising from involvement in trauma work, such as cynicism, despair, loss of hope, feeling unsafe and exhausted (Sexton, 1999).
• We then asked advocates to indicate on a five-point scale to tell us:
  • How they coped with stress at the time of the Critical Incident. In other words, we asked advocates what strategies they used. For example, emotional support (i.e., getting moral support, sympathy, or understanding) and instrumental support (i.e., seeking advice, assistance, or information).
  • How successful these strategies were in helping combat stress; in other words, their effectiveness.
• We also asked open-ended questions about the ways of changes in relationships with friends, family and work colleagues, and positive experiences during refugee work.
• We analysed the data using a mixed methods approach. Specifically, to analyse the qualitative data, we used thematic analyses of common themes to form categories of reasons for perceiving refugee work as more stressful, critical incidents, changes in relationships, and positive experiences. With respect to the quantitative data, we used descriptive statistics of stress and vicarious trauma levels, and use and effectiveness of coping strategies, as well as inferential statistics to examine significant differences/correlations between variables.

Who were the participants in the study, and what was socio-demographic impact of advocacy?

• Participants were 84 refugee advocates who completed an on-line questionnaire, which was submitted over eight weeks from May to July 2006.
• A total of 76% of advocates had been involved in refugee advocacy for more than three years, and 91% were still involved at the time of the survey.
• Most advocates were female (87%), middle-aged (average age 46 years), well-educated (80% held a degree or postgraduate qualification), and most (86%) favoured left-wing politics.
• Three-quarters of the advocates worked with refugees as volunteers.
• The involvement in the refugee movement had significantly impacted on the finances of 62% of the advocates. Some chose no pay or low paid work, while other advocates responded to the situation of needy refugees by providing them with money, housing them, giving them presents, sending parcels, and visiting them at detention centres.
• Only 7% of the advocates were involved in political action only. Most of the advocates either supported refugees (47%) or were involved in both support and political activism (46%).
• Three-quarters of the advocates felt close or very close to a refugee they supported.

How different was stress relating to refugee advocate work compared to previous social justice work?

• Two-thirds of advocates had been active in other social justice areas; in particular, Indigenous issues, environmental issues, Amnesty International, and unionism.
• Four-fifths of advocates viewed their refugee work as more stressful than previous social justice work. The major categories cited as to why this was the case were: “past refugee trauma or current suffering”, “higher personal involvement or closeness”, and “critical nature or life and death”. As one participant noted, “So many times my refugee friends faced deportation and possible death, torture, imprisonment. This was a lived, real possibility for them, and greatly affected me. They also faced despair and hopelessness by continuing incarceration. Once released, they were emotionally fragile as well”.
• Other advocates similarly noted the difficulties involved in fighting the system with respect to the stressful nature of refugee advocacy. When asked why refugee work was more stressful for her, one participant answered, “Obduracy of the present Liberal Government. Their refusal to take seriously not only reputable research on immigration and deportation issues but Government sponsored Inquiries and Senate Hearings.” This comment regarding the role of the Federal Government supports previous research finding that anti-asylum seeker sentiment in Australia was linked with incorrect and inflammatory statements made by politicians (Pedersen et al., 2006). Advocacy work may well be harder when advocates are fighting both a political system and negative attitudes of many other Australians (again, see Pedersen et al. on this latter point).

What were advocates’ stress and vicarious trauma levels?

• Approximately four-fifths of respondents recalled experiencing at least one stressful event from their refugee involvement. The closer the advocates were to the refugee they supported, the more likely they were to have experienced a Critical Incident.
• Only a very small minority (3%) of advocates reported low stress levels. For 58% of advocates, stress levels were moderate, and for 39% of advocates, levels were high at the time of the Critical Incident. It is not possible for us to make direct comparisons with previous research as different scales and categorisations have been used. However, judging by average stress scores, it would appear that our advocates’ stress levels (average=3.44 where 1=low stress and 5=high stress) were higher than stress levels experienced by AIDS workers (average=2.60) (Demmer, 2002) and physicians (average = 2.40) (Linzer et al., 2002). In the Demmer study, service providers reported a lack of support, societal attitudes toward AIDS, poor salary, and deaths of their clients to be major triggers of stress. Similarities can be found within our own sample. Refugee advocates do not experience much structural support for their position, societal attitudes toward refugees are negative (Pedersen et al., 2006), their finances are depleted, and they often fear that the refugees they support may be deported and face death. In another study Raviola et al. found that AIDS carers reported feeling highly stressed because of the absence of a cure for the disease. Again, similarities can be found within our own sample. It is possible that advocates had little hope for positive outcomes for the refugees they supported at the time of their Critical Incident (as there was ‘no cure’ for AIDS patients), which added to their stress levels. Most Critical Incidents occurred in 2003 and 2004 when there didn’t seem to be very much likelihood of political change eventuating.
• Similarly, only a small minority of advocates reported low levels of vicarious trauma: low (11%), moderate (66%) and high (23%). This result is not surprising given the high relationship between vicarious trauma and stress (r=.77). In other words, the higher the stress levels, the higher the vicarious trauma levels were reported by advocates. We could not compare vicarious trauma levels with previous research; no published work exists in this regard. Therefore, we interpreted the results in terms of stress levels only from this point on.
• Considering some of the reported Critical Incidents in the qualitative data, these high figures of stress are not surprising. For example, one advocate noted the distress of one family during a lip-sewing incident. She was told the experiences of one detained boy “in a very animated and agitated manner and culminated the story by telling me he did not want to sew his lips together at that time like everyone else because he wanted to be able to cry FREEDOM through the fence. He was 8 or 9 years old”. It is difficult to imagine an advocate not feeling stressed and traumatised by this experience.
• 87% of advocates noted that their stress was due to ongoing work with refugees rather than a single Critical Incident (e.g., detainee’s self-harm, suicide, or deportation, and changes to refugee policy).
• As noted, although no empirical work has been done on Australian refugee advocates’ stress and trauma levels that we are aware of, it has been noted elsewhere that many advocates appear traumatised by the whole refugee situation (Gosden, 2005; People’s Inquiry Into Detention, 2006). In the words of one member on the panel of the People’s Inquiry into Detention, Ailsa Watkinson, the advocates are “unsung heroes” (p.71).

How did refugee advocates cope?

• Emotional support (e.g., getting moral support) was the main used coping strategy. Both emotional support and instrumental support (e.g., getting advice from others) were equally the most successful coping strategies. Given the success of instrumental support, why was it not used as much as emotional support? It may be that if people feel that the problem causing stress is beyond their control, they seek moral support and understanding, as emotion-focused coping is used more often when the situation is one that must be endured (Lazarus & Folkman, 1984). Also, it may be that there were not many people who were capable of providing instrumental support, given the fact that advocates stood outside of society on the issue of refugees, the Government’s hard-line stance and the Australian public’s support of such stance.
• A quarter of the advocates obtained professional help for combating stress, which was helpful for all of them. Given that professional help was a useful strategy, why might it be that most advocates didn’t seek help? It may be that advocates have never had other crises of this magnitude in their lives and, in a sense, were “learning on the job”. It also may have been that they felt they had enough support within their networks, or they did not have the spare cash (as noted above, many advocates’ finances were depleted). Or perhaps the advocates who did not seek professional help believed they did not have the right to feel stressed while refugees were in a far worse state. As one advocate noted, “There is the shadow of guilt we have probably all felt for those inside - we can visit but we can also walk away”. Another felt “overwhelmed, exhausted, everything in my life appeared trivial and absurd compared with the problems suffered by my clients”. Another said, “I feel I was stressed but, of course, one cannot look at one’s situation in the face of what these people have endured and feel sorry for oneself…”. However, the neglect of negative psychological symptoms may lead to ongoing distress for advocates. As noted by Hesse (2002), self-care is the primary key for working successfully with trauma victims.

Were there also positive experiences and changes in personal relationships?

• Four-fifths of advocates reported experiences affecting their lives in a positive way (e.g., developed strengths, grew personally, found new friends, began appreciating life and humanity to a greater degree). This supports previous research finding that significant and positive relationships develop between refugees and their Australian supporters (Reynolds, 2004).
• Yet for over two-thirds of advocates, the high personal involvement with traumatised refugees resulted in both positive and negative changes, resulting in both in the improved relationships with some people and more distance with others, as in the case of this advocate: “I couldn't speak to a lot of my friends. I just felt I no longer had things in common. My circle of friends shrunk. Also - I didn't have as much time to see them. Some family members grew to hate me for my views on and support for refugees. We no longer speak. Other family members joined me to actively support refugees - and we have become closer because of this.”

What can we conclude?

For advocates, there were many negative effects of the refugee policy: financial, emotional and interpersonal. Regardless of the negatives, most advocates saw some beneficial outcomes. As one participant noted, “We have made some fantastic friends, both in the Australian community and amongst the refugees”. However, we would argue that the situation should not have arisen in the first place. If a more balanced and humane treatment of refugees were implemented, refugee advocates would not need to get involved and unnecessarily suffer high psychological distress and vicarious trauma. As the political situation stands at the moment, the detention centres are still open, although they are relatively empty. If more refugees arrive unauthorised, Australia may end up with the same situation again, resulting in both stress and trauma for the refugees themselves and stress and vicarious trauma for their advocates. The past decade has shown serious human rights violations with respect to refugees; we do not want a continuation of this situation.

References

Demmer, C. (2002). Stressors and rewards for workers in AIDS service organizations. AIDS Patient Care and STDs, 16(4), 179–187.

Flanagan, J. C. (1954). The critical incident technique. Psychological Bulletin, 51(4), 327–359.

Gosden, D. (2005). What can ordinary people do? Reflections on advocacy. Migration Action, XXV11, 26-32.

Hesse, A.R. (2002). Secondary trauma: How working with trauma survivors affects therapists. Clinical Social Work Journal, 30, 293-310.

Lazarus, R., & Folkman, S. (1984). Stress appraisal and coping. New York: Springer.

Linzer, M., Gerrity, M., Douglas, J. A., McMurray, J. E., Williams, E. S., & Konrad, T. R. (2002). Physician stress: Results from the physician worklife study. Stress and Health, 18, 37–42.

Pedersen, A., Watt, S., & Hansen, S. (2006). The role of false beliefs in the community's and the federal government's attitudes toward Australian asylum seekers. Australian Journal of Social Issues, 41, 105–124.

People’s Inquiry Into Detention (2006). We’ve boundless plains to share: The first report of the People’s Inquiry into Detention. Melbourne: Australian Council of Heads of Schools of Social Work.

Raviola, G., Mackoki, M., Mwaikambo, E., & Delvecchio Good, M. J. (2002). HIV, disease plague, demoralization and “burnout”: Resident experience of the medical profession in Nairobi, Kenya. Culture, Medicine and Psychiatry, 26, 55–86.

Reynolds, M. (2004). The untold story: A report to the 60th session of the United Nations Commission on Human Rights. ACT: unpublished document.

Sexton, L. (1999). Vicarious traumatisation of counsellors and effects on their workplaces. British Journal of Guidance and Counselling, 27, 393–404.

Steel, Z., Silove, D., Brooks, R., Momartin, S., & Alzuhairi, B., & Susljik, I. (2006). Impact of immigration detention and temporary protection on the mental health of refugees. British Journal of Psychiatry, 188, 58–64.

¹For the purpose of the present study, the term ‘refugee’ was used as a general labelling of the people who seek refuge in Australia, as opposed to the distinguishing between a ‘refugee’, who was accepted as one offshore, and an ‘asylum seeker’, whose claim for a refugee status is yet to be determined.

Author Notes:

Correspondence should be addressed to Anne Pedersen at the School of Psychology, Murdoch University, Murdoch, WA 6150 (A.Pedersen@murdoch.edu.au). The authors gratefully thank Paul Bain, Helen Davis, Sue Hoffman and Mary Anne Kenny for their useful comments on an earlier draft, although the authors take full responsibility for their views stated herein. We also thank Stuart Carr for his advice regarding the Critical Incident Technique, Brian Griffiths for his statistical advice along the way, and Christina Ballantyne and David Nicholson for their technical assistance.