Availability Lebanon Centres work on various levels, e.g. community-based refugee programmes, programmes with specialised international agencies, such as UNHCR, and in places of detention USA Australia Thirty-four centres, across 15 states and Washington, D.C., provide rehabilitation as part of the National Consortium of Torture Treatment Programs (NCTTP) Historical and cultural expectations that the state must take responsibility for the provision of services Of these, 24 centres have a comprehensive torture treatment programme; five centres offer legal or other support Funds available through the Torture Victim Relief Act, distributed by the Office of Refugee Resettlement. Also limited federal funding, funding from UNVFVT, state grants, foundations, corporations and individual donations Universal availability of good basic health and social services Support to survivors of torture or trauma provided by the FASTT network of rehabilitation centres, funded by the Department of Health and Ageing Centres aim to provide long-term counselling and other support to high-need torture and trauma survivors and assist them to access mainstream services Appropriateness Focus on psychological and social rehabilitation as part of the resettlement process. Less work on legal redress or reparations Treatment tailored according to individual’s needs, e.g. family therapy used for many refugees Refugees often see resettlement as the only solution, which can affect their response to certain kinds of therapy Refugees face additional pressures, which can hamper rehabilitation, e.g. feelings of injustice, hopelessness, guilt, separation from family National data is systematically collected across centres in the NCTTP More research planned to study effectiveness of treatment methods for best practice development Centres provide case management with ASTT using a strength-based model that aims to empower the victim to realise his/ her own needs Holistic services, including psychosocial counselling, advocacy, empowerment and recovery, psychiatric/GP clinics, child and youth programmes, complementary therapies, training of other service providers and capacity building in communities. Most victims are not in first country of asylum (in contrast to Lebanon) meaning trauma is often not at the acute stage Accessibility Open-ended services recognise that symptoms of torture may reappear and full rehabilitation can be a lengthy process Challenge of accessing unregistered refugees who need urgent treatment A growing number of refugees places pressure on the ability of services to provide support to all who need it There is a severe difference between availability of social services (food, housing, medical care) for asylum-seekers compared to refugees Torture treatment services are limited All centres experience long waiting lists Few asylum-seekers in detention have access to legal support and even less have access or support from rehabilitation centres Medical care in detention is lacking Safe environment for victims and staff Challenges associated with treating refugees or asylum-seekers, e.g. loss of identity, separation from family, cultural and linguistic barriers Distinction between conditions faced by refugees and asylum-seekers, many of whom are detained. Safety issues around working with detained asylumseekers and challenges with working in a non-therapeutic environment Increased demand means long waiting lists to access services Right to Rehabilitation for Torture Victims, Beirut, Lebanon – 27/28 June 2013 13