Good Practice Team day I Training 17/10/2010: Difference between revisions

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As the issue of the Medical Committee and referrals came about and an intense conversation as to the changes on the procedures by the government followed and it was agreed that more actions (apart from the report to the Ombudsman and UNHCR) should take place. Awareness is necessary and publications in order to put more pressure on the responsible authorities.
As the issue of the Medical Committee and referrals came about and an intense conversation as to the changes on the procedures by the government followed and it was agreed that more actions (apart from the report to the Ombudsman and UNHCR) should take place. Awareness is necessary and publications in order to put more pressure on the responsible authorities.


===UNHCR: Understanding the procedures - [[Corina Drousiotou]]===
===Case 2===


''Issues covered:''
Male Iranian, 35 years old, Single. Applied for asylum in 2008. Asylum Claim: He was arrested, imprisoned and tortured due to his political activities as a member of a political group against the Iranian government.


All members of the organization should have a clear idea of what the Humanitarian Affairs Unit and team are doing. Familiarization with procedures, priorities, networking, relations and projects.
'''Conflict analysis:'''
   
 
''Relevant articles:''  
'''Individual/family level:'''
• He is in detention
• Presenting Posttraumatic Stress Syndrome that reveals in repetitive phase symptoms, intense anxiety, and depression.
• Sleep disturbances, flashbacks episodes.
• Severe psycho-somatic symptoms such as headaches, not being able to concentrate
• Intrusive thoughts and paranoid ideation secondary to trauma; lack of trust to any human being. Hypervigilant and overreactive to external stimuli.
• Refused to see psychiatrist or take any kind of medication because of his past traumatic experiences 
• Negativistic thought pattern about the future and his life in danger.
• Constant feelings of fear, insecurity and helplessness. Stressed concerning his future, getting the status, making a family etc.
• Hepatitis C carrier – the client was not visiting a doctor for treating his disease.
• Osteo mascular pains as a result of torture.
• Limitation of choice and interest areas.
• Asylum seeker
• Asylum seeker
 
'''Cultural:'''
• Pressures from his family in Iran to get married
• Isolated, not involved in groups of people. He was only communicating with specific Iranians whom also didn’t trust.
• He doesn’t know Greek, and he speaks only basic English a fact which deters him from becoming a member a group of people from the host country.
 
'''Economic:'''
• Unable to work due to the psychological problems. He is depending on the welfare allowance as his only source of money. Was facing delays in receiving the monthly welfare allowance, resulting in sometimes not being able to cover his basic needs.
 
'''Political Participation:'''
• As an asylum seeker he has a temporary residence permit, which while allows him freedom of movement and access to basic needs and rights, these do not include any form of political participation in the local society.
• Also he has great fear in expressing his political views, as he feels threatened and target of the Iranian Embassy in Cyprus. He once participated in a protest outside the Iranian embassy which later caused him anxiety and stress….
 
 
''OBJECTIVES:''
 
• Be released from the detention center.
• Psychological: Reduce the somatic and psycho – somatic disturbances caused by the trauma.
• Reduce sleeping disturbances.
• Help the client realize that he needs medication in order to stabilize his psychological situation.
• Learn coping mechanisms to deal with the trauma.
• Stable treatment by the psychiatrist and the hepatology doctor in order to receive the right treatment for his disease and the paranoid ideation.
• Help him develop a more adequate ability to make decisions
• Encourage him to create realistic goals and remain positive.
• Strengthen client’s defenses; work on PTSD symptoms and trust issues.
 
Social: 
 
'''Legal:''' Release from detention, awareness that he an alleged victim of torture. Due to his severe psychological symptoms under which the first instance interview was conducted to repeat the interview, after he is psychologically stabilized. Expedite the refugee status determination procedures. Take into account URVT report on his case, in an effort to avoid go through the Medical Committee examination.
 
 
''METHODS:''
 
'''Psychological:''' Psychological support and Psychotherapy: Individual one hour sessions on a weekly basis, with the presence of an interpreter (except some times because of the client’s trust issues towards the interpreter). The therapist used cognitive restructuring.
 
'''Social:''' Social Counseling: Individual one hour sessions, follow-ups through phone conversations and counseling. Client’s walks-in in crisis situations.
 
'''Legal:''' Legal counseling – informing the client about the asylum procedures and acting on his behalf
 
'''Medical Doctor:''' Medical assessment – diagnosis of health problems. Referrals to governmental doctors for further examination and treatment
 
 
ACTIVITIES
Arranging interpreter to attend the sessions and to accompany the client to the governmental psychiatrist.
 
Psychological: Discussing with the client different techniques which could help his sleep improve.
 
'''Social:''' Contact with the detention’s psychiatrist, liaising to achieve his release. Arranging appointments for psychiatrist and other governmental doctors. Sending report to the Asylum Service, including the assessments of all the professionals of the Unit, in order to be taken into consideration during the examination of his claim. Being in search for available housing – contacting the landlords. Having constant communication with the Welfare officer to explain the severity of the case, resolve any issues appeared in order to avoid delays.Assistance in applying and acquiring medical card. Communication with various local organizations in order for the client to be provided with food and clothing, as well as accommodation during the periods that he was leaving his house as a result of the paranoid ideation.
'''Medical:''' Medical assessment – history. Referrals to governmental specialist doctors to address his medical problems. The medical director had contact with the hepatology doctor in order to agree on the treatment and how to proceed with dealing with the client’s health problems.
 
'''Legal:'''  Letter to the Asylum Service and Migration requesting his immediate release from detention, as he is an alleged victim of torture and the expediting of the procedures (namely interview, assessment). Letter of complaint to the Asylum Service regarding the interpreter during the first instance interview.  Letter to the Asylum Service requesting for a new interview, as in the first one the client was not in a stable psychological state.
 
 
''OUTCOMES''


* [[Support for Refugees and Asylum Seekers in Cyprus]]
Released from detention center. Built a trusting relationship with the professionals of the Unit.


'''Psychological:''' After being convinced to take medication, his paranoid ideation was controlled.
'''Social:''' The social counselor secured housing for the client.


'''Medical:''' Client’s health was generally assessed after being referred for specific examinations by the medical director of the Unit. Stable treatment for his health problems was managed. During the discussion of the two cases, Vicky and Corina mentioned that we should perhaps discuss very quickly a case of a client whose case went through all asylum procedures and was recognized. As there was not enough time left, this was decided to be presented by Corina in short and then discussed by the staff, in relation to their involvement on the case.


===Closing of the Session===
===Closing of the Session===
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