INnovative Supports Program for Refugee and Immigrant Empowerment (INSPIRE)

Program Description

Imagine being forced to leave your home, forced to flee with only the clothes you wear, a few small keepsakes and your children. You bring nothing beyond what you can carry, not knowing what lies ahead. For millions in the world today, they do not need to imagine, they have endured this firsthand including protracted stays in refugee camps with limited access to meaningful opportunities to work, attend school or participate in society at large. Forced to flee due to persecution, war and violence, these individuals seek what each of us strives for: safety, health and hope. In recent years, Nationalities Service Center (NSC) has concentrated the services we provide on our region’s most vulnerable newcomers. We have seen an increase in the number of individuals and families impacted by behavioral health needs due to extensive histories of hardship, trauma and loss. NSC’s INnovative Support Program for Refugee and Immigrant Empowerment (INSPIRE) addresses the complex needs of these clients and help participants build skills to lead productive and meaningful lives. INSPIRE utilizes an innovative occupational therapy framework to transform traditional case management services into actionable, targeted and impactful interventions to support vulnerable newcomers and their families.

Creativity

What does occupational therapy have to do with behavioral health? When most of us think of occupational therapy, we think of services for those recovering from surgery or stroke. Occupational therapy is so much more than re-learning tasks such as dressing or bathing. Occupations are defined as those everyday activities that people do to occupy time and bring meaning and purpose to life. For newcomers, this can be an ‘occupation’ as a mother parenting in a new country, being a worker working in a new language, or a community member in a new neighborhood or city. Occupational therapists’ long term goals are to improve occupational performance, whatever the role, as well as building motivation, promoting independence and enabling participation within society. This framework significantly enhances the traditional case management model often used in working with this population by providing targeted, tangible interventions that enhance the lives of newcomers.

Leadership

This program is lead jointly through an academic-social service partnership. Jessica Nambudiri, the INSPIRE Coordinator, holds an MSW from Rutgers University and has been working with immigrants and refugees for five years. Dr. Steven Kern is a board certified Occupational Therapists with extensive experience working with vulnerable populations including refugees and has experience working overseas including in Cuba. These two leaders have collaborated to design and implement the INSPIRE program within an OT framework. This has included developing training, guidelines, assessments and evaluation metrics for participants as well as continuously monitoring student progress and feedback. Project leaders have applied to present at national network meetings in both the refugee health and mainstream occupational therapy sectors. We truly believe that occupational therapy, when returned to the roots of the profession, can influence behavioral health, not only for refugees and immigrants, but for the population at large.

Sustainability

This program utilizes an academic student partnership with the Jefferson School of Occupational Therapy to provide supports to newcomers. The program emerged from a five year partnership between Jefferson and NSC, where students provided targeted in-home OT support through an introductory level class. After demonstrated success in this partnership, NSC and Jefferson OT expanded the partnership to include two full-time OT students co-located with NSC staff. By utilizing students, it allows the program to sustain at minimal cost while also offering learning opportunities to future OT professionals. Jefferson OT faculty provide supervision of students alongside NSC’s INSPIRE program coordinator. This program has allowed us to not only expand the breadth and depth of services offered to our clients, but also exposes the next generation of health care professionals to the unique needs of newcomers. Students develop expertise in working with low-income, limited English proficient, cross-cultural constituents enhancing their future practice.

Replicability

We believe that this program model has the capacity to transform work with vulnerable newcomers. The fresh, creative and solution oriented mentality of Occupational Therapy students (as demonstrated in some of their sample work attached) enhances the traditional strengths based case management model traditionally offered to these clients. Currently, only one other program nationwide utilizes this model, yet no publications or replication guides have been developed by that site. We aim to raise the banner of this innovative and low-cost model to other agencies through publication, presentations and technical assistance. Providing these supports, in a low cost manner, is particularly important as the new administration seeks to limit access and federal and state funding for the support of refugees and immigrants. Furthermore we believe that this project can demonstrate the true behavioral health roots of occupational therapy, potentially springing forth innovative partnerships for other sectors serving vulnerable individuals.

Results/Outcomes

Newcomers face many challenges as they adapt to their new roles and ‘occupations’ in a new country, city and community. This program impacts newcomer quality of life and overall self-sufficiency as measured by NSC’s Quality of Life and Self-Sufficiency indicator tools. Occupational therapy specific tools, such as the Canadian Occupation Performance Measure, may be used to measure a client’s progress towards goals for specific occupations. These metrics give us invaluable information on individual client and families’ progress toward goals such as independent access of health care, connection with community and community resources and increased coping mechanisms. In addition to these client level outcomes, this program also provides an opportunity for student to engage in hands-on learning around cultural competency.