The mental health of young asylum seekers and refugees is in crisis, and we need to talk about it

The mental health of young asylum seekers and refugees is in crisis, and we need to talk about it

As part of my previous role working at Off the Record, a youth counselling service based in Croydon, I delivered well-being workshops to young asylum seekers and refugees who were mostly in their late teens. I worked in educational and community settings, generally delivering sessions that focused on how they could take small steps in improving the quality of their sleep and better manage their stress. It was not uncommon for students to be curious about my heritage and ask me “Miss, where are you from?” “Do you speak Arabic/Tigrinya/Amharic?” “Are you Muslim?” “How come you speak Italian?” Who I was outside the classroom mattered to them, as I looked culturally familiar to most as a Black woman of East African heritage.

What became quickly apparent after delivering multiple sessions and interacting with hundreds of young people is that in most cases the students were generally aware of what helpful and unhelpful practices for their well-being looked like. However, when the root of so much of their stress, and consequently, of the poor quality of their sleep was founded on causes outside of their control, what good was it to ‘talk about your problems’ or ‘exercise’? “Miss, I worry about my family in Afghanistan. I worry all the time!” “Teacher, I am waiting for my family to come here. I am worried for them!” “Teacher, I am waiting for the Home Office [response]. There is nothing I can do. Just wait.” “Teacher, if you want to help me with my stress, why don’t you bring my family from Albania. That will help with my stress!” These were uncomfortable conversations to have, but they were absolutely? right. As they navigate a hostile (read: discriminatory) asylum system that leaves most in a constant state of limbo, not knowing whether they are able to remain in the UK or not, whilst at the same time experiencing other disadvantages such as structural racism and economic inequality, how can they even try to look after their physical and mental health?

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According to a recent briefing by the Centre for Mental Health (2022), evidence suggests that “rates of depression, serious mental health illness and suicide […] worsen with increased poverty and deprivation in a very clear dose-response relationship – the more the exposure, the worse the outcomes”. Since the outbreak of the Covid-19 pandemic, referrals to children’s mental health services increased by 134% within a year and cases in emergency crisis care are up by 80% (Royal College of Psychiatry, 2021).

So what does that mean for unaccompanied children seeking asylum ?

An interdisciplinary research project titled ‘Lives on Hold. Our stories told.’ explored the impact of Covid-19 on delays in the asylum process relating to the provision of legal advice, support and the representation for young people (aged 16-25). Initial findings suggested that “Covid lockdown periods coincided with a significant increase in the proportion of unaccompanied asylum seekers being subject to age assessment: by the end of 2021, two-thirds (66%) of unaccompanied asylum seekers were age-disputed compared with 31 per cent in 2020 and 21 per cent in 2019.” In 2021, 69% of those whose age was disputed were assessed as adults, a significant increase from 31% 2019. Fast track age assessments put in place by the Home Office have resulted in more young asylum seekers being processed as adults, and effectively being denied the appropriate support and care needed by those vulnerable children and young people.

The introduction of the new Nationality and Border Act in April 2022, puts young asylum seekers and refugees at further risk of being exploited and trafficked, both within the UK and abroad (Coram CLC, 2022). The recent scandal of over 200 young asylum seekers going missing from hotels run by the Home Office is yet another example of how little care there is for the welfare of asylum seekers and refugees, even when they are minors (The Guardian, 2022). The introduction of a two-tier system, effectively further delaying the process and limiting the support they can access simply because of the irregular means through which they have reached the UK (which in most cases is the only way that people are able to make the journey in search of safety), creates further uncertainty and insecurity for individuals who have already gone through a lot of trauma and hardships (Freedom for Torture, 2022; Coram CLC, 2022).

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So, how can we best support the mental health and general wellbeing of young asylum seekers and refugees, whilst acknowledging the increasingly complex and hostile system of asylum they have to navigate, and at the same time, the shortage and limited capacity of frontline workers?

Well, it is clear that the issue at hand is deeply political, and it is paramount that the government and policy makers are held accountable for the harmful policies they have put into place.

That being said, there are ways in which professionals who work with young asylum seekers and refugees can make their interactions more welcoming for the young people. In a training session on trauma informed practice offered by Nicola Lester, I learned about the SENSE model, which comprises five key interventions:

1. Stabilisation: meet the immediate practical and emotional needs

2. Education: provide education about the impact of trauma

3. Normalisation: use education to normalise responses and offer reassurance

4. Social Support: Facilitate connections with family, friends and the wider community

5. Engagement: Promote engagement with specialist support services if they need it.

At the core of the SENSE model lies the importance of acknowledging the existing resilience and coping mechanisms of people who experienced trauma, and empowering them to strengthen and diversify their coping mechanisms. It is important to really highlight the importance of empathy and active listening, and to engage in a non judgmental way. In my work there have been many instances where all I could do was hold space and bear witness to these young people’s pain, and sometimes, that was enough. There are times where young people do want to open up, they just need to feel emotionally and physically safe to do so.

What seemed to be effective in my work with young asylum seekers and refugees, which was also emphasised and informed by the training, was the importance of (1) offering a safe space, physically and emotionally, (2) restoring choice and control however and whenever possible, (3) responding to identity and context, (4) building strength and (5) support coping. Charities such as Da’aro Youth Project or CARAS just to name a couple, do an incredible job in offering a safe space for young people and truly incorporate a trauma informed approach in their practice, and it shows in the relationships they were able to develop with the young people. At the core of their practice is also the understanding that identity and cultural norms are important means through which professionals can engage. For example, during the weekly Injera Club sessions, young people are free to speak their own language, play their own music and most of the staff and volunteers speak one additional language. The diversity of the staff and the volunteers means that young people see themselves reflected in them, and more importantly, they feel seen. Up until the early 2000s, Refugee community organisations in the UK played a fundamental role in supporting newly arrived migrants in their settlement experiences. Diaspora organisations were therefore able to support new migrants whilst speaking the same language and understanding culturally-specific needs. As immigration policies became increasingly hostile, funding for those vital actors were cut, really impacting the local authorities and frontline workers negatively.

As the cost of living crisis along other crises at national and supranational level continue to impact everyone, but particularly those living on the margins, let us not forget about the asylum seekers and refugees that arrived to the UK in search of safety. In the words of the talented British-Somali poet Warsan Shire “No one puts their children on a boat unless the water is safer than the land”.

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