Mental health services for refugees and asylum seekers - a messy picture

Posted: Friday 6 November 2009

For many years, Mind has stood up for (and with) people who are marginalised in our society.

We stood up for people in institutional care in the asylums, we stood up for people who faced a loss of liberty because of their mental health, and we continue to tackle the stigma faced by 90 per cent of people who experience a mental health problem.

But it is the plight of people who are seeking refuge in our country which has been highlighted by two new Mind reports (A civilised society: mental health provision for refugees and asylum seekers in England and Wales and Improving mental health support for refugee communities) which were launched yesterday. The product of two years of research seeking to understand the experiences of refugees and asylum seekers who experience mental health problems, the results make for interesting reading.

And it's a pretty messy picture. There's a lack of joined up policy between the Home Office and the Department of Health. Refugees and asylum seekers are entitled to access very limited services, and evidence shows that even these are being provided in a patchy way. There are cultural and linguistic barriers, and in many cases there is a lack of expertise and understanding.

Perhaps this quote from an Afghan refugee best summarises what we found:

The relationship with mental health services is one of extremes - from nothing being available on one hand, to overreaction and sectioning on the other. It is often difficult to find the appropriate middle ground.

Many people arrive in this country fleeing war and persecution because of their beliefs - they may well arrive without having had a chance to seek help for their mental health, because at home they feared for their lives. And so they may well arrive with an existing mental health need.

However it is also possible that the asylum process can add to this distress, and exacerbate poor mental health, as this Iraqi mental health advocate explains:

Family and other support systems may have been left behind...people can become very isolated.

Yet, our reports suggest it doesn't have to be like this. A Somali Advocacy Project, run by Mind in Harrow, works with the local community to ensure that people get the help they need, that interpreters (both linguistic and cultural) are on hand. Funded and evaluated by the King's Fund it offers hope of a long-term sustainable model.

Abdi, who runs this project, describes passionately the help he offers:

This sort of self sustaining model is what we have been looking for and it's giving people their life back.

So where next? Our own funding for this work, from the Lloyds TSB Foundation and Department of Health has enabled us to map available help, develop a training course for refugee community organisations, and recommend ways forward. It's a great start, and a unique piece of work but there's much more that needs to be done.

The issues around immigration are often politically sensitive, and it's not always a popular cause, but Mind is committed to helping refugees and asylum seekers find the help and support they need. We need to stimulate debate and discussion, through this blog and beyond.

Paul Farmer, Chief Executive, Mind