Abstract
Background:Asylum seekers who are granted leave to remain in the United Kingdom are required to make a rapid transition to housing and welfare benefits. The challenges facing new refugees during this ‘transition period’ can affect their mental health, but this has not been quantified.Aims:To assess the impact of the transition period on new refugees’ mental health in the 12 months after being granted leave to remain in the United Kingdom.Method:A longitudinal survey design was used to measure the mental health of 30 newly recognised refugees at monthly intervals in the first 6 months and again at 1 year after receiving leave to remain in the United Kingdom. There were five outcome measures for symptoms of anxiety, depression, distress, post-traumatic stress disorder (PTSD), post-migration living difficulties (PMLD) and a life events calendar to record key changes in housing and welfare.Results:The results showed that the trajectory of scores across all measures fluctuates, but overall they all improve from baseline to Month 12. Scores for depression and PMLD showed significant improvement at Month 5, and scores for anxiety, depression, distress and PMLD showed significant improvement at Month 12. PTSD scores did not show significant improvement at any month. In months with a high number of stressful life events, participants had worse PMLD and PTSD scores.Conclusion:Overall improvement in mental health could partly be explained by the stability of being granted leave to remain in the United Kingdom, but may also be due to the high level of practical support these participants received. Recommendations are made for those working with clients during the transition period.
Highlights
Asylum seekers who are granted leave to remain in the United Kingdom are required to make a rapid transition to housing and welfare benefits
In 2018, 29,380 asylum applications were made in the United Kingdom, with 32.5% of the applicants granted a form of long-term leave to remain by the Home Office or independent tribunal (Refugee Council, 2019)
Asylum seekers who are granted leave to remain in the United Kingdom are issued with two identity documents: a Biometric Residence Permit (BRP) and a National Insurance
Summary
According to the 1951 United Nations Convention, a refugee is a person who has been forced to flee their country of origin and is not willing or able to return to it due to ‘a wellfounded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion’. A recent follow-up report by The No Accommodation Network (NACCOM, 2019) found that the percentage of newly recognised refugees accessing their night shelters within 6 months of being granted leave to remain rose from 21% in 2017/2018 to 36% in 2018/2019; some were still homeless a year after being granted leave to remain Organisations such as the Red Cross and NACCOM have highlighted the need for structural changes to services and for more advice and support for new refugees to avoid destitution and improve the success of the transition period. These symptoms have been shown to be exacerbated by isolation, a lack of social connections and purpose in the community due to not having a secure job or home, and experiences of hostility and racism in the host country (Burnett & Peel, 2001) Such experiences may trigger distressing memories of past traumatic experiences and may exacerbate pre-existing mental health difficulties, such as PTSD, anxiety, depression or other problems such as loss and bereavement. Other countries may learn that the design of this study and the nature of these difficulties may apply to their own populations, despite the global variation in immigration systems
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