Reference no: EM133281252
Mina arrived in Australia when she was 6 years old. Her family originated from South Sudan, which they fled due to ongoing conflict. Her parents and older brothers had joined other refugees on a long walk to Kenya. Many people died along the way due to illness and attacks, and food and water were scarce. The family had to rely on rations provided by the United Nations. Eventually the family were settled in the Kakuma refugee camp, where Mina was born.
When Mina arrived in Australia no one in her family could speak English, and although over time everyone learnt to speak English, it was not the language used at home. When Mina started at school, she understood few words that were spoken to her. She was very shy, especially as when she did try to participate in games and activities, she often did not follow instructions properly and some of the other children made fun of her, calling her "stupid", and sometimes more hurtful names. There were a few other Sudanese families in the neighbourhood, but none of the children in those families were similar ages to Mina, and she felt very alone.
Mina's father Jacob worked as an Uber driver, often working long hours to make sure the family could pay the rent and keep food on the table. When Mina did see her father he was often tired; however, he would try to spend his free time with her and her siblings. Her second oldest brother Martin was a great athlete and played football for the local team. One of Mina's favourite memories was of the whole family going together to watch Martin play and cheer him on. Even Mina's mother, Sara, would join in the outing. Sara didn't leave the house very often, and never alone. Mina knew something bad had happened to her mother in the refugee camp, but it was never spoken about. Sara didn't like Mina leaving the house either, except for school and occasionally when one of her brothers or her father would accompany her somewhere. Some of the girls at Mina's school spoke about attending dance classes and other clubs, but Sara was worried about Mina attending these types of groups, and money was tight, so she never got to go.
Mina struggled at school and was placed in remedial classes at primary school to help her reach an acceptable academic level. When she got to secondary school she met Roxy, who became her closest friend. Roxy introduced Mina to a whole new world of music, fashion and crushes on TV stars. Roxy laughed at everything and everyone and didn't seem to care about not being good at school or getting into trouble from the teachers. Mina and Roxy would skip classes from time to time to go hang out at Roxy's place to watch Netflix or dance. When Mina invited Roxy over to her house, Roxy would say that she wouldn't be allowed to go because her parents would think that Mina's brothers were in a gang, because Sudanese gangs were always being talked about on the news. However, they would be okay with Mina coming over to visit her whenever she liked. Over time Sara and Jacob noticed that Mina seemed happier and more confident since having Roxy as her friend and allowed Mina to visit after school and sometimes on the weekend. Eventually this extended to overnight stays as well.
Through Roxy, Mina expanded her group of friends, especially once they started going to parties when Mina was having an overnight stay at Roxy's place. Roxy taught Mina how to smoke cigarettes, saying that if you smoked you could always find people to hang out with. This was particularly useful advice once Roxy got a boyfriend who she would often disappear with when they were at parties, leaving Mina alone for hours at a time. Mina's new friends understood that it was difficult for her to get alcohol and cigarettes, and generously shared what they had with her. Mina was grateful for this but began to resent her family being different to everyone else's. When they were 16 Roxy began to worry that they were putting on too much weight and thought it would be good to switch their party alcohol with the drug ice (methamphetamine) instead. She warned Mina that she would have to get a job or find some other way to pay for her own supply, as everyone couldn't keep helping her out.
Sara and Jacob became worried about Mina, when they noticed she was losing weight, was sometimes happy and co-operative and at other times angry and aggressive at home. She appeared to be getting into trouble at school more and they were contacted several times about her missing classes or being disruptive in class. They tried talking to with her, giving her extra responsibilities at home and grounding her. Often Mina would simply leave the house angry or even climb out her window when they tried to keep her in her room as punishment. In desperation they went to discuss their concerns with the Minister at their church, who suggested that Mina might need professional counselling. He assisted Sara and Jacob with contacting Headspace, the local youth mental health service which offered free counselling. They were told that they would be happy to see Mina for an appointment in 6-8 weeks, but Mina had to make the appointment for herself - her parents couldn't make it for her.
When Sara and Jacob tried to talk with Mina about seeing a counsellor at Headspace she became very angry with them, saying it wasn't her that needed counselling, but them. Not knowing how to manage the situation Mina's parents decided not to push the issue any further at the time. Two weeks later Mina had an argument with Roxy ending their friendship. Later that night, Mina's brother Martin found her with self-inflicted deep cuts to her wrists in the family bathroom. An ambulance was called, and Mina was hospitalised for several days. She was assessed and later diagnosed as having bipolar disorder. Mina was prescribed medications that her parents are struggling to pay for. After the initial regular visits with psychiatric services, Mina is now managed by her GP, as she will provide the medications at the Medicare rebate rate. Mina can also access 10 free psychologist visits per year organised by the GP, with the potential for a six-month extension (to 18 months). Sara and Jacob are unable to afford private psychology sessions for Mina.
Analyse the client scenario provided and examine the relevant social determinants of health and their influence on the client.
Consider potential enablers or barriers to health equity.
Describe the plan for a health promotion activity that you develop to mitigate (reduce the impact of) or address one the social determinants that you have identified as having a negative influence on the health of a character or characters in the case study.