Seeking Asylum and Mental Health: A Practical Guide for Professionals

335 Pages·2022·4.248 MB·English

by  Chris Maloney, Julia Nelki, Alison Summers

Seeking Asylum and Mental
Health
Published online by Cambridge University Press
Published online by Cambridge University Press
Seeking Asylum
and Mental Health
A Practical Guide for Professionals
Edited by
Chris Maloney
Julia Nelki
Alison Summers
Published online by Cambridge University Press
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Information on this title: www.cambridge.org/9781009292184
DOI: 10.1017/9781911623977
© Royal College of Psychiatrists 2022
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First published 2022
A catalogue record for this publication is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Names: Maloney, Chris, 1959- author. | Nelki, Julia, author. | Summers,
Alison, author.
Title: Seeking asylum and mental health : a practical guide for
professionals / edited by Chris Maloney, Julia Nelki, Alison Summers.
Description: Cambridge, United Kingdom ; New York, NY : Cambridge
University Press, 2022. | Includes bibliographical references and index.
Identifiers: LCCN 2022002199 (print) | LCCN 2022002200 (ebook) | ISBN
9781009292184 (paperback) | ISBN 9781911623977 (ebook)
Subjects: MESH: Mental Health Services | Refugees–psychology | Needs
Assessment | Health Services Accessibility
Classification: LCC RC451.4.R43 (print) | LCC RC451.4.R43 (ebook) | NLM
WA 305.1 | DDC 362.2086/914–dc23/eng/20220511
LC record available at https://lccn.loc.gov/2022002199
LC ebook record available at https://lccn.loc.gov/2022002200
ISBN 978-1-009-29218-4 Paperback
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Every effort has been made in preparing this book to provide accurate and up-to-date information that
is in accord with accepted standards and practice at the time of publication. Although case histories
are drawn from actual cases, every effort has been made to disguise the identities of the individuals
involved. Nevertheless, the authors, editors, and publishers can make no warranties that the information
contained herein is totally free from error, not least because clinical standards are constantly changing
through research and regulation. The authors, editors, and publishers therefore disclaim all liability for
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Published online by Cambridge University Press
Contents
The Authors vii
Foreword xi
Acknowledgements xiii
Glossary xiv
Introduction xvi
1 Why do people seek asylum? 9 Intervention: the essentials 166
The global context 4 Alison Summers and Chris Maloney
Rukyya Hassan
10 Specific interventions 184
2 Seeking asylum in the United Piyal Sen, Grace Crowley, Chris
Kingdom 29 Maloney, and Alison Summers
Jude Boyles, Robin Ewart-Biggs,
11 Children, families, and young
Jonathan Kazembe, Jo Miller,
people 207
and Karin Oliver
Veronika Dobler and Julia Nelki
3 Seeking asylum and mental
12 Records and reports 230
health 51
Janine Bonnet and Beate Dasarathy
Norma McKinnon and Chris Maloney
13 Improving mental health
4 Access to mental health care 71
services 253
Alison Summers, Norma McKinnon,
Alison Summers, Philomène Uwamaliya,
and Jo Miller
Jude Boyles, and Helen Pears
5 Assessing mental health needs 90
14 Therapeutic complexity 275
Julia Nelki and Piyal Sen
Renos K. Papadopoulos
6 Interpreting assessment
15 Working with people seeking
findings 116
asylum 288
Chris Maloney and Cornelius Katona
Chris Maloney, Julia Nelki,
7 Formulation and diagnosis 132 and Alison Summers
Alison Summers
8 Common diagnoses 150
Piyal Sen, Alison Summers, and Chris
Some resources 306
Maloney
Index 309
Published online by Cambridge University Press
Published online by Cambridge University Press
The Authors
Janine Bonnet is the lead doctor for the survivors of torture and human trafficking)
Manchester office of Freedom from Torture and is an active member of the Royal
(a charity supporting survivors of torture College of Psychiatrists’ Working Group on
seeking protection in the United Kingdom), the Health of Refugees and Asylum Seekers.
and a part-time general practitioner in
Beate Dasarathy is the Legal Officer in
North Wales. She also has oversight of the
Freedom from Torture’s medicolegal
Manchester Health Assessment Service, in
report service in Manchester. Prior to
which experienced GPs carry out extended
this, she was the Director of the Greater
health consultations with Freedom from
Manchester Immigration Aid Unit, and a
Torture clients. She has also trained in general
supervising solicitor with a human rights
adult psychiatry, spent two years working
legal practice in Liverpool. She started
as a medical officer on Greenpeace ships,
her legal career within a Citizen’s Advice
and worked for Médecins sans Frontières
Bureau after completing a Masters in
in Assam and Darfur, and spent eighteen
comparative immigration and asylum law at
months training in general adult psychiatry.
the School of Oriental and African Studies.
Jude Boyles manages a psychological She has 30 years of experience advising
therapy service for resettled refugees for and representing asylum seekers and has
the Refugee Council, a charity providing worked for Freedom from Torture since
support for people seeking asylum and 2010.
other refugees. Prior to this, she established
Veronika Dobler is a consultant child and
Freedom from Torture North West and
adolescent psychiatrist in Cambridgeshire,
managed it for fourteen years. She is a
where she supports local authority mental
psychological therapist specialising in crisis
health provision for unaccompanied
and trauma work, and also a human rights
asylum-seeking minors. She has extensive
activist, drawing public attention to the
experience in Germany and Austria,
impact of the asylum process on mental
developing innovative services and
health. Jude has published widely including
psychological interventions for traumatised
a book on psychological therapy with
unaccompanied minors in clinics, schools
survivors of torture, a volume on working
and children’s homes. She has trained in a
with interpreters in therapy, and chapters
broad range of psychological interventions,
and articles in other books and journals.
completed a PhD in neurosciences, and
Grace Crowley is a psychiatrist and studied the impact of early life adversity
academic clinical fellow in South London. on adolescent mental health. Veronika
She has a Masters in Global Mental Health, feels humbled by the incredible strengths,
and her research interests include suicide, resources, and resilience of displaced
self-harm and mental health among children, young people, and families and
migrants and ethnic minority groups. She believes that exploring and understanding
has volunteered with the Helen Bamber these should be at the heart of most
Foundation (an organisation that supports interventions.
Published online by Cambridge University Press
viii The Authors
Robin Ewart-Biggs is a UKCP-registered experience were heard whilst policy was
family therapist in Cumbria, offering developed. In 2017, he co-ordinated the
psychosocial support to staff at the British NHS Welcome project, helping GP surgeries
Red Cross and running a charity for young across Greater Manchester improve access
people living with cancer. He had roles in the to healthcare for asylum seekers in the
voluntary sector and NHS for twenty-eight Northwest. He was previously a teacher in
years. He worked with survivors of torture the Democratic Republic of Congo, where
at Freedom from Torture for eighteen years, he campaigned against the use of child
as a group and family therapist and then as a soldiers.
clinical services manager.
Norma McKinnon Fathi is the co-founder
Rukyya Hassan is a consultant general adult and director of a social enterprise that
psychiatrist working in Greater Manchester, provides counselling services to people
and a volunteer medicolegal report writer seeking asylum and other refugees, and
for Freedom from Torture. She has an a range of organisational development
interest in the mental health of minority and consultancy services. She is a UKCP
and marginalised groups generally and has registered psychotherapist, and qualified
experience of working with refugees and community worker. Norma lives and works
people seeking asylum in a range of primary in Scotland, and has more than twenty
and secondary care and custodial settings. years’ experience working with refugees and
She is a member of the Royal College of people seeking asylum in both community
Psychiatrists’ Working Group on the Health and clinical settings, and has managed
of Refugees and Asylum Seekers. clinical services for torture survivors at a
national charity.
Cornelius Katona is Medical Director of the
Helen Bamber Foundation, a human rights Chris Maloney is a consultant psychiatrist
charity working with refugees and people and GP. He was consultant medical
seeking asylum. He is Honorary Professor psychotherapist in East Berkshire, and then
in the Division of Psychiatry at University a GP partner in Hackney, East London, for
College London, and the Royal College of twelve years, with many people and families
Psychiatrists’ lead on Refugee and Asylum seeking asylum as patients. From 2003 he had
Mental Health. He has published more than an expert witness practice, writing psychiatric
300 papers, written/edited sixteen books, and physical injury reports for people’s asylum
and had an active role in updating NICE claims and related matters. He is a co-author
guidelines on PTSD in 2018. In 2019, he was (with John Ballatt and Penelope Campling) of
awarded the Royal College of Psychiatrists’ Intelligent Kindness: Rehabilitating the Welfare
Honorary Fellowship, the college’s highest State, published by Cambridge University
honour, for his ‘outstanding service to Press in February 2020.
psychiatry’.
Jo Miller is a GP working with people
Jonathan Kazembe is an asylum and seeking asylum and other refugees at a
refugees’ rights advocate. He is Expert by specialist general practice in Huddersfield.
Experience Manager for the charity Refugee She is a founder member of TortureID,
Action in Manchester, and oversees its a group of clinicians and lawyers in
public engagement work. He previously Yorkshire and the North West developing
coordinated the experts by experience innovative ways of increasing the medical
programme for Freedom from Torture, documentation of human rights abuses
ensuring that the voices of people with lived for newly-arrived people seeking asylum.
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The Authors ix
For ten years she was the lead doctor professional life training and supervising
for Freedom from Torture North West’s specialists in these three spheres. As
medicolegal report service. consultant to numerous organisations, he
has worked with refugees, tortured persons,
Julia Nelki is a consultant child and
and other survivors of political violence and
adolescent psychiatrist and a UKCP-
disasters in many countries. His writings
registered family therapist and systemic
have appeared in eighteen languages.
supervisor. She was a volunteer doctor
in Freedom from Torture’s medicolegal Helen Pears is a consultant general adult
report service for twenty-five years, and psychiatrist in Liverpool, and a clinical sub
currently volunteers for the Refugee dean at the Universities of Liverpool and
Resilience Collective, supporting volunteers Edge Hill. She also has an MSc in the Ethics
working with people seeking asylum in of Healthcare. Helen developed a special
Calais, Greece, and Serbia. Julia set up interest in the mental health of people
the Haven Service offering drama and art seeking asylum and other refugees whilst
therapy to refugee children, and also the working with this group in her inner-city
Family Refugee Support Project, which community mental health role, learning
uses horticulture as a medium for therapy there about the struggles they face, and the
(www.frsp.org.uk). She has published many difficulties of providing services for them.
articles in peer-reviewed journals, and has Her interest in issues of race, discrimination,
written a book about her Jewish family and and equality arose out of encounters with
experience as a child of refugees; Villa Russo: racist violence in her teens.
A Jewish Story was published by Offizin-
Piyal Sen is a consultant forensic
Verlag in Hannover in 2022.
psychiatrist and Medical Director for
Karin Oliver is the Director of Fisher Elysium Healthcare, a private provider of
Stone Solicitors in Halifax, specialising in specialist mental health services, based
asylum and human rights law. She qualified at Chadwick Lodge in Milton Keynes. He
as a solicitor at the Greater Manchester has visiting academic links with Brunel
Immigration Aid Unit (GMIAU) in 2010 University and King’s College, London, and
and worked there before setting up a new is the Chair of Royal College of Psychiatrists’
service in Huddersfield offering advice and Special Committee on Human Rights. He is
support to asylum seekers and refugees, in also a member of their Working Group on
collaboration with Citizens Advice and a the Health of Refugees and Asylum Seekers.
law centre. Karin was a founding member of Piyal does medico‐legal work for people
TortureID. seeking asylum and other refugees, and
research into the mental health conditions
Renos K. Papadopoulos is Professor
affecting people in immigration detention,
in the Department of Psychosocial and
and foreign national prisoners. He grew up
Psychoanalytic Studies; Director of the
in Kolkata, India, encountering refugees
Centre for Trauma, Asylum and Refugees
from an early age: victims of the Partition of
and of the postgraduate programmes in
India and the Bangladesh liberation war.
Refugee Care, at the University of Essex;
as well as Honorary Clinical Psychologist Alison Summers is a consultant psychiatrist
and Systemic Family Psychotherapist at the and UKCP-registered psychodynamic
Tavistock Clinic. He is a practising clinical psychotherapist and supervisor. She writes
psychologist, family therapist, and Jungian medicolegal reports for TortureID clients,
psychoanalyst who has spent most of his works on social initiatives alongside people
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