Transcript KETHEA MOSAIC Supporting drug addicted - SMES

KETHEA MOSAIC
Supporting drug addicted emigrants:
Visible and Invisible particularities
DIMITRIS GIANNATOS
Head of KETHEA MOSAIC Unit
(Cross-cultural Center of KETHEA)
In the Beginning…
 Low rate of approach in therapeutic structures
for drug-addiction
 emigrants faced difficulties to follow up the
therapeutic process.
• Different view in the streets:
increase of population of depended immigrants
/refugees with intense and different needs
compared to the locals.
KETHEA MOSAIC
Since 2003…
1. Supporting drug addicted
- Harm reduction services
- Motivation for drug addiction treatment
- Psychological support and relapse prevention
- Counselling for relatives and "important
others“
- Educational activities
- Street work activities
- Self help groups in prison
KETHEA MOSAIC
Since 2003…
2. Psychosocial support for
emigrants/refugees related to :
- Social intergration problems
- Family problems
- Drop out from educational process
- Emotional crisis management
- Adults and juvenile delinquency
Important points…
• The drug users consist a special group among the
emigrants/refugees
• Case of “double exclusion” :
drug addiction’s stigma and stigma of being “stranger”
• Apart from the social exclusion, two other facts that
increase the percentage of drug addicts (emigrants &
refugees), are:
a. The availability of substances and alcohol in the
places where they live or spend their time
b. The connection between trafficking and (illegal)
market of drugs
Important points…
• They are a vulnerable population and
dependable on trafficking networks or other
“groups” : exploitation from co-patriots, lawyers who
promise “legalization”, affinity and exchange with
delinquent people
• They are a high risk population. They need
services of Prevention, Harm Reduction and
Therapy.
Supporting the population…
• Essential point : the “integration” of cross-cultural care
in the “cultural” system of health Organizations
• Very intensive and “deep” intervention
• The information for Mosaic spread among them
• New-comers addicted refugees – multilevel needs –
“invisible” population
• Emigrant’s Communities are difficult to be motivated
(fear, “stigma”, other priorities, “profits” expectation, etc)
Supporting the population…
• Many of the emigrants start using drugs after they left
their country or they used to do occasional use of drugs
without passed to addiction
• The treatment related to the total improvement of life.
• Covering financial needs is or the preparation for a new
immigration is the first priority and affect to the therapy
perspective and time investment in this process.
• The “paradox” of problem and trauma : addiction and
sensitization of health system – services and DIGNITY
Clinical remarks…
• Many times, the use of substances and alcohol is a way
of self healing and self empowerment , helping these
people to be relieved from the emotional pain and the
difficult conditions they experience (uprooting, fear, loss
& nostalgia of beloved people, homesick, trauma,
uncertain legal status, etc).
• Psychic trauma - three phases :
a. difficult conditions before immigration
b. traumatic roaming
c. relocation in the reception country
Clinical remarks…
• Mental dipole : Oblivion – Memory
Use of substances = self-healing
“Help me to forget - help me to remember
without pain”
Various substances and alcohol
• Drug addiction seems to act as a latent effort of
incorporation or as an expression of bereavement
or as a resistance to the family system after the
emigration.
Clinical remarks…
• Political asylum seekers – intensive action for freedom
and justice – often weaker motive for therapy- they
focus in the change of their political status as solution in
the problem.
• Some emigrants want to change without realize the need
of therapy - self control, move to other town, find job,
medical help from the homeland, etc
• Some structural and cultural issues make the wounds
invisible : drug addiction as a medical problem – seeking
help from co-patriots leads often in provisional solutions,
Clinical remarks…
• Many drop-outs from motivation process :
- Seeking for medical treatment
- Deprival syndrome
- Language
- Cultural differences in the groups ( in groups
with people from many different nationalities)
Clinical remarks…
• Families :
- guilt – wounds from their uprooting – protect
the drug user as a weak member of the system
– avoid make changes helping the therapy
- Many times, “send” the drug addicted back to
homeland
(symbolic correction of trauma)
AND WHAT HELPS ?
• The therapy from drug-addiction seems difficult – but is
not unrealistic.
• Trauma has the emotional material for the therapy
• «O τρώσας και ιάσεται» (Τηλέφεια τραύματα)
• It’s necessary to exist a safe environment, that pay
attention in different needs and respects their cultural
differences
• Essential condition of support : The transition
( access – approach – empowerment – motivation).
• Efficient in therapy context the interaction with local
culture
Supporting strategies…
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Familiar space – Home
Multi-ethnic Therapeutic Staff
Individual Therapeutic Planning
Cross-Cultural approach
Networking Counselling
Cross-cultural education
Volunteers – Interpreters – Cultural Mediators
Welfare networking
Cross-cultural evaluation of treatment reference