Asylum Seekers

Rights and Entitlements

African Christian Faith and Health ConferenceSaturday 9th July 2011

“Many refugees and asylum seekers have experienced physical and psychological trauma as a result of human rights abuses and protracted conflict. Their experiences , combined with anxiety, uncertainty and lengthy resettlement process can have long lasting detrimental effects on their physical , emotional and mental health” (Thomas et al 2010)

Asylum seekers and refugees

Risk factors include; migration traumatic events poverty education unemployment low self esteem poor physical health and gender based persecution

Asylum seekers and refugees (cont.)

“any person who-owing to a well founded fear of being persecuted for reason of race, religion, nationality, membership of a particular social group or political opinion is outside the country of his nationality and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country”

Refugee Convention 1951

Research carried out by the Gender Violence Unit of the London School of Hygiene and Tropical Medicine and Scottish Refugee Council

46 asylum seeking women interviewed face to face

Just over half of the women reported that their health was worse in Scotland than in their home country

Research-Asylum-Seeking Women, Violence and Health, 2009

More than half showed symptoms associated with Post Traumatic Stress Disorder

20% of women indicated they had suicidal thoughts in the past seven days

93% of women in Scotland said they had received adequate health care

33% had received STI testing and 54% had been tested for HIV

Research (cont.)

National Asylum Support Service created in 2000-accommodation and subsistence

Asylum seekers have to prove that there are destitute before any support is issued to them-Policy Bulletin 4

Social Work services offers support to asylum seekers with needs ‘above and beyond destitution’-Policy Bulletin 82- Asylum Seekers with care needs

UKBA Asylum Support

Policy Bulletin 83 – Duty to offer support, family unity, vulnerable persons, withdrawing support

Policy Bulletin 85-Dispersing asylum seekers with care needs - Implications for disclosure and medical report requests

Policy Bulletin 70-Domestic Violence(Physical, emotional, financial and sexual)-Cultural and empowerment issues

Asylum Support (cont.)

Scottish Government (CEL 09(2010) “Anyone who has made a formal application

for asylum, whether pending or unsuccessful, is entitled to treatment on the same basis as a UK national who is ordinarily resident in Scotland while they remain in the country. If their application to remain in the UK is successful, they will be granted refugee status and will continue to be exempt from NHS charges on the same basis as a person ordinarily resident in Scotland”

Scottish Government Guidance 2010)

In Scotland the statutory regulations and government guidance do not permit charging for NHS primary care other than certain dental and optical services to asylum seekers and refugees

It is for GP practices to exercise their discretion as to whether to register an overseas visitor or to treat them privately but they should not be refusing refused asylum seekers by the fact that their asylum claim is refused

Scottish Government Guidance 2010 (cont.)

Anecdotal evidence from service providers and asylum seekers suggests that the statutory regulations on asylum seekers’ rights to access health care following a negative decision are not being consistently implemented in practice in accordance with Scottish Government guidance

In practice refused asylum seekers are not allocated GPs by the Glasgow Asylum Health Coordinator

Experience

New Asylum Model Access to good quality legal representation Accommodation issues Refused asylum seekers Health matters-Health service for newly

arrived asylum seekers housed at Y people

Experience (cont.)

General practitioners’ surgeries present a point of reference at a time when they are few others

Presentation reflect culturally ordained help seeking behaviour

GP allocation through Health Coordinator in Glasgow City Council

Midwife for asylum seekers Medical Foundation for the Victims of

Torture

Services

Royston Stress Centre and Lifelink Compass team provides specific service for

mental heath needs Archway provides services for men and

women raped or sexually assaulted in the past 7 days

Health matters recently introduced Homeless GP

Services (cont.)

Comorbidity issues Evidence that abuse is rife in migrant

communities including refugee communities including gender based violence, child sexual abuse and domestic violence

SRC and LSHTM study found out that 70% of the women experienced physical and/or sexual violence in their lifetime

Migration and Health

People who arrive in host countries face the same problems as those faced by local people

Asylum seekers and refugees have added pressure because of the uncertainty of their immigration status

SRC and LSHTM study found out that 54% of the women said that the asylum process had made their health worse

Detention

Migration and Health (cont.)

Destitution and homelessness Labelling/stigma issues Xenophobia and racism

Migration and health (cont.)

Engagement with communities Empowerment Cultural awareness for both hosts and

visitors Training interpreters on how to work best in

therapeutic settings and health settings How to handle disclosure and implications

What can help practice