2 Refugees and resettlement – Lebanon, USA, Australia Eliane Arida (Restart Center, Lebanon) introduced the work of Restart in Lebanon. They currently face major challenges in helping the increasing numbers of refugees in Lebanon. The organisation at present has three projects relating to refugees. The first, a psychological rehabilitation programme, treats 1,400 victims of torture, which includes holistic services for non-Palestinian refugees. In addition, they run a community-based programme that has assisted more than 100 victims between December 2012 and May 2013. The programme reaches out mostly to Syrian refugees, who are torture victims and in detention. The third project provides mental health services, in collaboration with UNHCR, to refugees and asylumseekers from Syria. Providing services to refugees can create particular challenges as many refugees are not registered, thus making referrals difficult and hampering treatment. Sana Hamzeh (Restart Center, Lebanon) introduced family therapy as one of the many forms of therapy used by Restart and, as such, an example of how they have adapted forms of therapy to meet the specific needs of the patient, i.e. taking a patient-centred approach. Family therapy, Ms Hamzeh explained, is often used with refugees and families of torture victims as regular therapy has been found to have a limited impact on these groups. The aim of the therapy is to allow the family to restart its life together and to support each other under the new and unfamiliar conditions faced by refugees. There are challenges in using this therapy, such as high costs, duration, the lack of trained therapists and gaining trust with the family. Dr Karen Hanscom (Advocates for Survivors of Torture and Trauma, USA) reflected on the different structures in the USA for treating asylum-seekers and refugees who are torture victims. Refugees resettled in the USA have access to benefits – education, settlement services, financial assistance and access to employment. They are able to become a permanent resident after one year and a US citizen after five years. However, few receive specialised torture treatment. On the other hand, asylum-seekers have no rights and many who arrive without a visa are placed in detention, where they have no access to legal support, medical assistance, etc. The 24 rehabilitation centres in the USA work with asylum-seekers or refugees and have a capacity to serve up to 6,000, although it is estimated that there are around 400,000 torture victims in the USA. The centres are united through membership in the National Consortium of Torture Treatment 12 International Rehabilitation Council for Torture Victims Programs (NCTTP). Bernadette McGrath (Survivors of Torture and Trauma Assistance and Rehabilitation Service Inc., Australia) highlighted the stark contrast in the Australian approach to rehabilitation from the USA, in terms of the elements in the General Comment. She pointed out that as Australia is geographically isolated from the rest of the world, it developed a service model with unique features. The Forum of Australian Services for Survivors of Torture and Trauma (FASTT) is a network of agencies that respond to the needs of survivors of torture and trauma. There are eight agencies located in each capital city. The network builds and shares expertise and resources, provides input to government policy and programmes, collects, collates and analyses national data, strengthens and develops fundraising, negotiation and project management of the centres. As such, it provides a coherent voice in the field of torture rehabilitation and the development of National Minimum Standards for the Provision of Services to Survivors of Torture and Trauma. At present, FASTT funding is set at 4.6 million AUD (3.1 million EUR) and is divided between the eight agencies proportionally. Larger agencies voluntarily subsidise the smaller agencies. There is a concern that the recent change in government could lead to a potential loss of funding, alongside the increasing numbers of asylum-seekers. General discussion The general discussion outlined some of the common challenges faced by the three case studies in the work they carry out with refugees and asylum-seekers. It was agreed that refugees often focus on the issue of resettlement, and it may take some time for them to see the positive aspects of rehabilitation. In all three countries, the issue of lengthy detention for asylum-seekers is a concern, particularly as this often hinders their access to rehabilitation services. In Australia, FASTT agencies have access to detention centres, but in the USA it is harder to gain access. In Australia, the ability of centres to work independently when they are funded mainly by the state was raised. To overcome this, Australia recently passed legislation that prevents funds from being withdrawn in the event that an organisation speaks out against the government. It was suggested that improving communication and sharing experiences between countries dealing with refugees seeking resettlement and those working with resettled refugees would be beneficial to understanding the various challenges in providing rehabilitation services.

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