Feature

The Status Resolution Support Service and the ‘Legacy Caseload’: A primer for GPs


Amanda Lyons


18/07/2019 2:42:30 PM

Dr Gillian Singleton, a GP with a special interest in refugee health, discusses the impacts of cuts to the Status Resolution Support Service on the lives of asylum seekers in Australia.

Status Resolution Support Service.
Cuts to the Status Resolution Support Service have seen many asylum seekers in Australia facing poverty and mental health issues.

Earlier this week, the Australian Human Rights Commission (AHRC) released a report investigating the plight of the ‘Legacy Caseload’ – 30,000 asylum seekers who arrived in Australia by boat before the implementation of strong boat-deterrent policy from 2014.
 
Five years on, many of the Legacy Caseload remain in a holding pattern, awaiting the processing of their visa claims with no access to working rights, social services or Medicare. In the absence of other options, many have been relying on a government payment called the Status Resolution Support Service (SRSS), but its funding was recently cut from $139 million to $56 million.
 
Lives on hold, the AHRC report, has found delays in processing and service cuts have put many of these asylum seekers at risk of homelessness, poverty and deteriorating mental health. The AHRC has made a number of recommendations to improve the situation, including boosting mental health services and re-expanding eligibility for the SRSS program, but these have been rejected by the Department of Home Affairs.
 
Dr Gillian Singleton is Medical Director of the Cabrini Asylum Seeker and Refugee Health Hub in Melbourne, and has experienced the issues faced by the people of the Legacy Caseload firsthand. She shares these experiences with newsGP.
 
What is the SRSS?
The SRSS program provides needs-based financial and casework support for people seeking asylum while they are awaiting the outcome of their claim for refugee protection in Australia. It was provided in place of Centrelink and enabled individuals and families to meet their basic healthcare and living needs if they are unable to work, or do not have work rights.  
 
The most typical financial support available is 89% of the New Start allowance, around $250 per week. In February 2018, more than 13,000 people nationally were receiving this support.
Since the recent eligibility changes, the Federal Government projects that less than 5000 will be able to access the program. The majority of individuals and families cut from the program live in Melbourne and Sydney.  
 
What impacts from the SRSS cuts have you seen in the course of your own work?
The impacts have been significant; due to many having fled conflict zones or persecution, our clients are some of the most vulnerable people seeking asylum with very complex and chronic health issues.
 
For those who arrived by boat, there is no eligibility for permanent protection in Australia. A successful application results in them receiving a temporary protection visa (TPV) or safe haven enterprise visa (SHEV) which prevent family reunion and allow only three or five years of residency in Australia prior to them having to apply again if they remain in fear of returning to their home country.  For most, this provides no relief and equates to prolonged uncertainty, lack of safety, and is associated with adverse mental health issues. 
 
The mental health effects of leaving your home country because of fear of persecution, living with uncertainty, any combination of torture and trauma, prolonged separation from family members – often coupled with concerns about the safety of family members who remain in their country of origin – and financial insecurity, are substantial.   
 
Almost 80% have been waiting more than five years for their protection claim to be processed, and around 20% have been waiting more than eight years. For many, this means they haven’t seen their closest family, including wives and children, parents and siblings, during this time.  
 
More than half of our clients have no access to Medicare and more than 90% have no regular income, rendering them reliant on our service for their primary and mental health care needs and access to essential pharmaceuticals. Many have experienced previous torture and trauma and been held in immigration detention since arriving in Australia, and 50% have a mental health diagnosis.
 
We have had more referrals in recent months for people who have been made homeless or are experiencing unstable housing and food insecurity, in that they are reliant on charitable food banks or their local community to access food; this group includes families with young children.  

status-resolution-support-service-article.jpgDr Gillian Singleton would like to see ‘a more humane approach’ to the plight of asylum seekers in Australia.
 
What would you like to see happen now?
A more humane solution is needed. The Australian context is minuscule compared to the global context of 70.8 million displaced people, 25.9 million refugees and 3.5 million people seeking asylum. And we know that the majority of people who arrive by boat in Australia seeking asylum are either found to be refugees, or cannot be returned home voluntarily because they fear persecution in their country of origin.
 
Prolonged processing times and restricted access to basic income support, healthcare, pharmaceuticals and torture and trauma counselling compound the risk of significant mental and physical health issues. This causes further injury to already vulnerable individuals and families, with lifelong impacts.
 
Providing a supportive environment and resources that facilitate access to the help they need to begin to heal will result in much better outcomes that will benefit our society as a whole. Currently, state and territory funded and charitable services are carrying the load for this cohort impacted by these federal legislative changes.  
 
How can GPs help asylum seekers in their communities?
GPs are well-placed to recognise these vulnerable individuals and families, and advocate for them to access support and to refer them to appropriate local services, if they exist.  
 
Recognition of previous and ongoing trauma and provision of trauma paired with informed, compassionate and respectful care, using interpreters if appropriate, is so important for these groups.
 
Interested GPs can also volunteer with their local refugee service – for example, the Cabrini Asylum Seeker and Refugee Health Hub have a few core paid staff, but most of the care is provided by an inspiring group of pro-bono GPs, psychiatrists and allied health staff.    
 



Refugee and asylum seeker health refugee healthcare SRSS Status Resolution Support Service



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Bruce Watts   19/07/2019 8:22:34 AM

Interested in helping in Coffs harbour.
Is there any contact in Coffs to offer pro bono GP services?


NewsGP   19/07/2019 9:58:33 AM

Hello Bruce, thank you for your inquiry.
Probably the best option would be to contact the RACGP Specific Interests Refugee Health network, they should be able to point you in the right direction. You can contact the network by calling 1800 090 588 or you can email them on gpsi@racgp.org.au


Jim Pollitt   19/07/2019 5:28:43 PM

What is the equivalent service in Sydney?


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