Mental health support for asylum seekers Sarah Wilshaw – Specialist Mental Health Nurse NHS Stoke On Trent Who we are How lone we’ve been going.

Objectives of the Asylum Health Team Facilitate access to a GP Help improve access to all Health and Social Care Health Screening Point of contact Provide Health Advice. Educating around using The NHS Liaison between services Advise Resource to others / Model of best practice. Teaching and disseminating knowledge Referral to and utilising mainstream services. Direct care pathway to secondary Mental Health Services / Chest Clinic/ Sexual Health Team. Engagement with Faith Groups / Social Inclusion

Who is an Asylum Seeker? The Immigration and Asylum Act 1999 defines an asylum seeker as: “Asylum Seeker means a person who is not under 18 and has made a claim for asylum which has been recorded by the Secretary of State but which has not yet been determined” (IAA 1999 s94 (1))

Refugee/Asylum seeker, What is the difference? An Asylum Seeker is awaiting a positive decision from the Home Office A Refugee has been granted a positive decision from the Home Office

Definition of a failed asylum seeker “ A person who’s application for asylum has been refused and has exhausted all appeals therefore is fully determined ’’ (people may be entitled to claim section 4 Support)

Mental Health 1 in 6 Refugees have severe life affecting physical health problems. In contrast two thirds of the refugee and Asylum Seeker population have significant Anxiety and Depression ( Carey Wood et al 1995 ) Le Feuvre ( 2002) Suggests that Mental Health is affected by poor access to health services and where integration in society is poor

Mental Health : Case Study Amina is from Pakistan and worked for an International company. She had a fiancé and family who loved her. Ali is from Iraq and was an Investigative Judge

A Solution Focussed Approach Assessment Religion / Culture Violence / Aggression – History of. Exploitation / Harm from others Thought Disorder. “Crazy” Support Systems. “What works. What can you do more of?” “Tell me the things you’re good at?” Past Employment / Current Hobbies Physical Health – Allergies etc Strengths Based! They are the expert about them Asylum Claim – Resources Agencies Involved Arrival in UK Medication / Benefits of Mood / Anxiety / Sleep – Scaling / Exceptions questions Suicidal Thoughts – “Do you ever feel life isn’t worth living? Who would miss you?”

A Solution Focussed Approach Assessment - continued Three parts of the Refugee Experience: “Tell me a little bit about your life before you came here. Only tell me what you want me to know”. Pre -Flight Flight Exile (Arrival in The UK) Survival. “You went through so much and yet…You’re here today. How have you done that?” The Miracle Question Goal Setting – Small, achievable. “What would you like now?” “Has today been useful?” Summary of Risk Plan of Action Signpost to Sanctus Groups and Burslem Jubilee group

Resilience! “What does not kill me. Will make me stronger.”