Mind the Gap

Thanks to Dee for this follow-up article to the previous post on the practical challenges to integration. This article continues the discussion on mental health that was touched on previously. Through the research project mentioned in the article, this post identifies a number of mental health service issues that many refugees and asylum seekers can relate to.

Disjointed mental health service provision for refugees and asylum seekers

My previous blog looked at some of the practical challenges faced as asylum seekers transition to new refugee status such as ineffective multiagency working, resulting in gaps in service provision, and problems in obtaining ID documents and variations in the types of ID accepted by different organizations.

I now look at some of the challenges experienced by refugees and asylum seekers in accessing and using mental health services. A 2008 report published by the Faculty of Public Health, “The health needs of asylum seekers”, highlighted some of the issues faced by both asylum seekers accessing health services, and health service providers providing health services for asylum seekers. These include frontline staff with limited training in cultural and language differences, limited knowledge of the different service needs of asylum seekers, a lack of interpreting services, and ineffective multiagency working.

More recently Leeds NHS commissioned Positive Action for Refugees and Asylum Seekers (PAFRAS) and the Touchstone BME Community Development team to undertake a participatory research project: “Understanding how asylum seekers and refugees access and experience mental health support in Leeds". Nine focus groups (thirty-six participants) and fifteen one-to-one interviews with refugees and asylum seekers were used to better understand their experience of mental health services. Eight key themes were identified:

1. Inadequate/insufficient professional assistance (e.g. a more holistic approach to physical and mental health would be preferred).

2. Problems with appropriate referrals and a long waiting time.

3. Inadequate or confusing information for refugee and asylum seeker clients (e.g. the need for a “one-stop shop”).

4. Clients’ values and beliefs (e.g. the stigma of mental illness and confidentiality issues).

5. Clients’ needs and expectations (potential mismatch with what the mental health team can provide).

6. Engagement (e.g. lack of trust in mental health professionals and prioritizing housing and other needs over mental health issues).

7. Socio-cultural isolation (e.g. refugees and asylum seekers need to be given a greater voice in their mental health care).

8. The perceived effect of immigration status on the quality of care provided.

These barriers and disjuncture in easily accessing mental health services undermines the mental health and psychosocial wellbeing of refugees and asylum seekers, and delays their adjustment to a new life in the UK. As the researchers on this project said for mental health services and support in Leeds, “Our future lies in greater collaboration, and sharing what we have with one another.”