People seeking asylum face unique challenges and frequently experience mental health problems. Effective support requires an understanding of their mental health needs in the broader context of their lives, cultures and extreme experiences. This book provides practical guidance for professionals and services working with people seeking asylum in mental health, social care, legal, government. managerial and commissioning roles. With authors from a wide range of professional backgrounds, the book is enriched by accounts from people with first hand experience of the asylum system itself. It considers the challenges and dilemmas faced by all involved, including clients, clinicians and service planners, with a wealth of practical information about how to assess and understand strengths and needs, avoid inappropriate conclusions and discrimination, consider treatment options, and write records and reports. The authors emphasise that effective support depends on reflection, humanity and compassion. The book is a must-have resource for professionals working with those who have to seek asylum.
Reviews & endorsements
‘A timely book, full of wisdom and practical advice for all those working with those who are seeking asylum. With contributions from those with lived experience and illuminating vignettes, the book takes the reader through the events and challenges faced …The book is a compendium of all you need to know to understand, assess, help, care for and work alongside and learn from displaced people. A humbling read, horrifying in places but always full of hope. Issues are addressed from the standpoint of the individual, and handled with sensitivity, dignity and respect. And a helpful reminder of the strength of the human spirit, the similarities amongst those who seek asylum but their very real differences. Most will not develop mental illness and normal responses to extreme challenges must not be pathologised. I thoroughly recommend to all who work in healthcare, and essential for those working closely with those who seek asylum.’ Dr Adrian James, President, Royal College of Psychiatrists, UK
‘This guide is a fantastic resource for anyone, including lawyers, judges and social workers, wanting to get to grips with the complex issues around asylum seeker mental health. Clearly written and very well explained, it offers expert insight into how and why asylum seekers are assessed and diagnosed with mental health conditions. There is also a lot lawyers could learn from this guide about how to sensitively obtain best evidence from vulnerable witnesses.’ Colin Yeo, barrister, Garden Court Chambers, and editor of Free Movement website
‘Given the context of Brexit and current political debates about refugees and migration this is a timely, topical and useful book which gives a clear overview of the issues experienced by people seeking asylum in the UK. It is written by a range of experienced practitioners who present a number of different perspectives, but all of whom focus on providing the best service to the asylum seekers they are working with. It is a practical book which draws upon research, clinical and legal expertise. Most books do not focus on asylum seekers but on a wider group, so this provides a range of extremely helpful and detailed information.’ Rachel Tribe, School of Psychology, University of East London and Centre for Psychiatry and Mental Health, Queen Mary, University of London, UK
‘With clarity and precision, but also with compassion, the book provides facts, data and stories about asylum seekers in the United Kingdom. Covering different angles and perspectives, it refreshingly avoids stereotyping and judgemental generalisations. Overall, it contains most helpful information for all those who want to understand the challenge and options for helping those asylum seekers who suffer from mental disorders.’ Stefan Priebe, Professor of Social and Community Psychiatry, Queen Mary, University of London, UK
‘The numbers of refugees and asylum seekers seeking safety are on the increase. It is well- recognised that often these groups are looking for safety, fleeing persecution because of their religious, political beliefs or factors such as sexual orientation. Disasters-be they manmade or natural, wars and conflicts, climate change and other geo-political factors contribute to these movements. There is a considerable research evidence that these groups are not only vulnerable but consequently have high rates of various psychiatric disorders. Due to cultural variability often their mental health needs get ignored thereby leading to delays in help-seeking and poor outcomes. This book is a very welcome addition to the field of managing these vulnerable groups as it provides practical advice on assessing and managing refugees and asylum seekers.’ Dinesh Bhugra CBE, Professor Emeritus of Mental Health and Cultural Diversity, Institute of Psychiatry, Psychology & Neuroscience, Kings College, London, UK
‘This is a rare book indeed- it is unique in combining scientific expertise with informed practical guidance and invaluable insight into the critical role mental health professionals play in the profoundly challenging experience of those seeking asylum in a hostile environment. This is achieved by putting the lived reality as its central reference point and the human experience at its heart. It is an essential text not just for medical practitioners but for all those involved in the asylum process whether decision makers, judges, lawyers, advisors or providers of support services and indeed for anyone with an interest in better understanding the importance of mental health provision for the protection of the fundamental rights and human dignity of asylum seekers.’ Stephanie Harrison QC, a leading human rights barrister, editor of Macdonald’s Immigration Law and Practice, Head of Garden Court Chambers leading specialists in asylum law
Table of Contents
1. Why do people seek asylum? The global context
2. Seeking Asylum in the UK
Jude Boyles, Robin Ewart-Biggs, Jonathan Kazembe, Jo Miller and Karin Oliver
3. Seeking asylum and mental health Norma McKinnon and Chris Maloney
4. Access to mental health care Alison Summers, Norma McKinnon and Jo Miller
5. Assessing mental health needs Julia Nelki and Piyal Sen
6. Interpreting assessment findings Chris Maloney and Cornelius Katona
7. Formulation and diagnosis Alison Summers
8. Common diagnoses
Piyal Sen, Alison Summers and Chris Maloney
9. Intervention – the essentials Alison Summers and Chris Maloney
10. Specific interventions Piyal Sen, Grace Crowley, Chris Maloney and Alison Summers
11. Children families and young people Veronika Dobler and Julia Nelki
12. Records and reports Janine Bonnet and Beate Dasarathy
13. Improving mental health services Alison Summers, Philomène Uwamaliya, Jude Boyles and Helen Pears
14. Therapeutic complexity Renos Papadopoulos
15. Working with people seeking asylum Chris Maloney, Julia Nelki and Alison Summer.
Chris Maloney is a psychiatrist, psychotherapist and General Practitioner. He worked as a GP with people seeking asylum for many years, and has been an expert witness in asylum cases since 2003. He is a co-author of Intelligent Kindness: Rehabilitating the Welfare State (2nd edition), together with John Ballatt and Penny Campling (Cambridge University Press, 2020).
Julia Nelki is a child psychiatrist and family therapist. She has set up services for families and unaccompanied children seeking asylum in Liverpool, is a trustee of a Refugee charity, and wrote medicolegal reports in asylum cases for twenty-five years. She now works with the Refugee Resilience Collective offering support to volunteers working with refugees. She has authored many peer reviewed publications and Villa Russo: A Jewish Story (Offizin Verlag 2022).
Alison Summers is a general psychiatrist and psychodynamic psychotherapist. She has worked with people seeking asylum since 2008 as a psychotherapist and more recently a medico-legal report writer. She is a board member and medical report writer for Torture ID, and works with people seeking asylum that live in her local community.
Rukyya Hassan, Jude Boyles, Robin Ewart-Biggs, Jonathan Kazembe, Jo Miller, Karin Oliver, Norma McKinnon, Chris Maloney, Alison Summers, Julia Nelki, Piyal Sen, Cornelius Katona, Grace Crowley, Veronika Dobler, Janine Bonnet, Beate Dasarathy, Philomène Uwamaliya, Helen Pears, Renos Papadopoulos