Asylum Seeker Populations Research Articles

Impact of the increased asylum seeker population on a UK mental health crisis service

Impact of the increased asylum seeker population on a UK mental health crisis service

Beyond shelter: a scoping review of evidence on housing in resettlement countries and refugee mental health and wellbeing.

The number of displaced people globally has rapidly increased in the past decade. Housing is an important social determinant of health and a key contributor to poor health outcomes in refugee and asylum seeker populations. It is important to examine evidence for how housing impacts the mental health of refugees and asylum seekers. This review seeks to analyse the research describing how housing conditions and policies are associated with refugee mental health and wellbeing in high-income resettlement countries (such as the United States, Canada, and Australia). A scoping review identified forty-four relevant studies. These studies examined various aspects of housing and/or accommodation and their association with mental health and wellbeing in resettled refugee populations. We found evidence of a relationship between four domains of housing-policy, suitability, environment and time-and mental health. Furthermore, we found evidence that refugees settling in high income countries experienced significant housing issues. Overall, problems with housing quality, location, accessibility (i.e., the nature of systems that govern access to housing) and suitability were associated with poorer mental health outcomes. In high-income countries, the lack of choice and agency regarding housing contributed to poor mental health outcomes among refugees and asylum seekers. Policies and practices should prioritise the quality, suitability, and accessibility of refugee housing, look at ways to increase choice and agency in resettlement.

Does ad hoc language training improve the economic integration of refugees? Evidence from Germany’s response to the Syrian refugee crisis

Abstract Given the global displacement crisis, the integration of refugees has emerged as a critical policy issue for many host countries. A key challenge involves supporting refugees in learning the language of their host country. While several European nations have instituted publicly funded language training for asylum seekers and refugees soon after their arrival, evidence on the efficacy of these early language programmes in promoting economic integration remains limited. This study examines the impact of a pioneering, large-scale ad hoc programme introduced by German policymakers, which provided basic language training to over 230,000 refugees arriving in 2015–2016. Utilizing register data on the population of asylum seekers and exploiting a cut-off date in programme eligibility, we assess the programme’s effectiveness using a regression discontinuity design. Our findings reveal no discernible effect on refugee employment over the subsequent 2 years. To explore whether language programmes are generally ineffective during refugee crises, we contrast these results with the impacts of a more comprehensive, preexisting, yet smaller-scale programme. Using a variety of difference-in-differences estimators, we find that this programme considerably increased refugee employment. These contrasting findings offer important insights for policymakers on designing effective language training programmes for refugees.

Fostering sustainable livelihoods: Evaluating the skillsets of refugees and asylum seekers in Indonesia

This article is set in the broader context of the refugee and asylum seeker crisis with a specific focus on Indonesia. The research aimed to capture the skills, experiences and aspirations of refugees and asylum seekers in Indonesia. The research is based on surveys conducted with the assistance of volunteers from community organizations collaborating closely with refugees and asylum seekers in Jakarta, Bogor and Cisarua—areas known for their high concentration of these populations. The study uncovered a rich set of skills within the refugee and asylum seeker population in Indonesia and it probed refugees’ and asylum seekers’ willingness to participate in training and desire to work legally, emphasizing the importance of self-reliance and avoiding dependency on aid. Building on the findings of this research, future studies could investigate the potential economic and social impact of granting refugees and asylum seekers the right to work legally in Indonesia, considering its effects on both refugees and asylum seekers and the host society.

Outdoor health intervention for refugees, migrants, and asylum-seekers: A mixed-methods pilot study

Outdoor health intervention for refugees, migrants, and asylum-seekers: A mixed-methods pilot study

Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review

BackgroundAdequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups.MethodsWe conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections.ResultsTwenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10–0.60) to 0.96 (CI: 0.70–1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15–0.39) and 0.78 (CI: 0.47–1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies.ConclusionsThe studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all.

The impact of detention on the health of asylum seekers: An updated systematic review: A systematic review.

The number of people fleeing persecution and regional conflicts is rising. Western countries have applied increasingly stringent measures to discourage those seeking asylum from entering their country, amongst them, to confine asylum seekers in detention facilities. Clinicians have expressed concerns over the mental health impact of detention on asylum seekers, a population already burdened with trauma, advocating against such practices. The main objective of this review is to assess evidence about the effects of detention on the mental and physical health and social functioning of asylum seekers. Relevant literature was identified through electronic searches of bibliographic databases, internet search engines, hand searching of core journals and citation tracking of included studies and relevant reviews. Searches were performed up to November 2023. Studies comparing detained asylum-seekers with non-detained asylum seekers were included. Qualitative approaches were excluded. Of 22,226 potential studies, 14 met the inclusion criteria. These studies, from 4 countries, involving a total of 13 asylum-seeker populations. Six studies were used in the data synthesis, all of which reported only mental health outcomes. Eight studies had a critical risk of bias. Meta-analyses, inverse variance weighted using random effects statistical models, were conducted on post-traumatic stress disorder (PTSD), depression, and anxiety. A total of 27,797 asylum seekers were analysed. Four studies provided data while the detained asylum seekers were still detained, and two studies after release. All outcomes are reported such that a positive effect size favours better outcomes for the non-detained asylum seekers. The weighted average SMD while detained is 0.45 [95% CI 0.19, 0.71] for PTSD and after release 0.91 [95% CI 0.24, 1.57]; for anxiety 0.42 [95% CI 0.18, 0.66] and for depression 0.68 [95% CI 0.10, 1.26] both while detained. Based on single-study data, the SMD was 0.60 [95% CI 0.02, 1.17] for depression and 0.76 [95% CI 0.17, 1.34] for anxiety, both after release. Three studies (one study each) reported outcomes related to psychological distress, self-harm and social well being. Psychological distress favoured the detained but was not significant; whereas both effect sizes on self-harm and social wellbeing indicated highly negative impacts of detention; in particular, the impact on self-harm was extremely high. The OR of self-harm was reported separately for asylum seekers detained in three types of detention: Manus Island, Nauru and onshore detention. The ORs were in the range 12.18 to 74.44; all were significant. Despite similar post-migration adversities amongst comparison groups, findings suggest an independent adverse impact of detention on asylum seekers' mental health, with the magnitude of the effect sizes lying in an important clinical range. These effects persisted beyond release into the community. While based on limited evidence, this review supports concerns regarding the detrimental impact of detention on the mental health of already traumatised asylum seekers. Further research is warranted to comprehensively explore these effects. Detention of asylum seekers, already grappling with significant trauma, appears to exacerbate mental health challenges. Policymakers and practitioners should consider these findings in shaping immigration and asylum policies, with a focus on minimising harm to vulnerable populations.

Caring and building friendships in the UK’s asylum system

To care and feel cared for are considered fundamental to what makes us human, and what enables us to live and thrive in this world. Yet for the UK’s asylum-seeking population who is living with uncertainties for the future, care appears absent. In such contexts, it is imperative to understand how care is enacted, experienced, and valued amongst spaces and people often considered to be care-less. Drawing on data collected in four collaborative photographic workshops and photo elicitation interviews with asylum seekers and refugees (ASRs) (N: 7), this study aims to gain insight into how ASRs in the UK care and feel cared for and their relative ability to forge friendships during their migration journey. We show how their relationship to caregiving and care-receiving changes over time and is deeply influenced by asylum policies and the refugee experience more generally. Responding to feminist scholars’ calls to disrupt the normative assumptions about how and between whom care is exchanged, this article highlights the diversity of friendships forged while on the move and seeking asylum as well as the caring practices emerging in situations of precarity, the pervasive impacts of the hostile environment on disrupting and distorting such caring relationships, and cautious but agentic and caring ways that ASRs seek to navigate the ambiguities of friendships in hostility. In doing so, the article provides an important counter-narrative to the dominant portrayal of ASRs as passive recipients of care, by highlighting how their way to approach care and friendship varies across time and circumstances.

Psychological adaptation among health care workers who work with trauma-exposed refugees in Greece.

Greek health care workers (HCWs) working with refugee and asylum-seeker populations may be at risk of trauma exposure and related distress. The current study sought to further understand the factors that may promote or hinder psychological adaptation among HCWs working with trauma-exposed refugee populations in Greece. Participants were HCWs (N = 20) who completed semistructured interviews. Thematic analysis procedures identified three main themes: vicarious traumatization, (b) mismatch of expectations, and (c) difficulty coping. Our study findings highlight the need to provide adequate training, supervision, and mental health support for HCWs to prevent mental health issues in this population. Additional studies are necessary to understand the long-term consequences of working with refugee populations and explore ways to assist HCWs with self-care.

HIV screening of migrants in the autonomous Province of Trento (North-Eastern Italy).

Migrants have accounted for more than 40% of new HIV diagnoses in Europe in 2022. Among the population of asylum seekers currently present in the Trento Province, screening for HIV infection is poorly carried out for various reasons. Here we report our experience about screening for HIV infection in asylum seekers present in that area using rapid self HIV-testing.

Infectious risk profile and strategies for prevention and control of outbreaks in refugee, asylum seekers and migrant populations in EU/EEA countries: a systematic narrative review of evidence.

The recent surge in migration to and within the European Union and European Economic Area has brought the development of migration policy, including health policy, to the forefront of regional priorities. While migrants, in general, do not pose a health threat to the host population, specific subgroups of migrants, including refugees, asylum seekers, and irregular migrants, are particularly vulnerable to infectious diseases. To support public health policies in this area, the Emergency Preparedness and Management' working group of the Italian Society of Hygiene, Preventive Medicine and Public Health has conducted a systematic narrative review with the aim to comprehensively analyze the infectious disease risk within the refugee and asylum seeker populations in EU, EEA, and EU-applicant countries. Forty-two studies were systematically selected from scientific articles in the MEDLINE/PubMed database from January 1, 2008, to June 1, 2023. The infectious risk associated with each infectious disease among refugees and asylum seekers, as well as the strategies to prevent and control outbreaks, was collected from all available studies. The congregate living conditions in refugee camps, transit centers, and temporary housing facilities make this population particularly vulnerable to infectious diseases. As such, implementing stringent hygiene and preventive measures is critical to safeguarding the health of refugees and reducing the risk of outbreaks that may affect both the refugee population and the host communities. Effective vaccination and preventive strategies for migrants, refugees, and asylum seekers are vital for public health and the well-being of these populations. They should be delivered as part of universal health care. By addressing barriers and implementing tailored programs, we can ensure equitable access to vaccines and protect the health of these vulnerable individuals.

From policy to practice: What factors influence GP's provision of health assessments to Ukrainian refugees in Denmark?

Abstract Denmark has received over 30,000 displaced people from Ukraine since February 2022 and has implemented certain accommodations specific for this population. Not bound by the EU Temporary Protection Directive, a special Act has been introduced, whereby Ukrainians have been offered streamlined access to temporary resident permits with faster access to health services than what is granted in the asylum-seeking population, for whom parallel systems often exist to provide care. While other refugee groups receive health screenings in the asylum centers during the asylum process, Ukrainian have received quick access to general practitioners (GP's) in the public system. Danish health authorities have recommended that GPs provide a detailed examination of chronic diseases, vaccination status, infectious diseases, and mental health for Ukrainian refugees. Provision of this recommendation is necessary to meet the health needs of Ukrainian refugees. However, how these recommendations have been received and implemented remains unknown. We will present results from a survey sent to 3000 general practitioners in Denmark (expected response rate 30%) investigating how GPs implement the health assessment recommendations and what factors influenced the provision (or not) of health assessment to newly arrived Ukrainian refugees. The survey, which has been developed after conducting a review of the guidelines and conducting interviews with GPs and refugees (n = 11), examines knowledge of the health recommendations; implementation of guidelines; structural (i.e. time, interpretation) and individual factors (i.e. experience with war exposed patients) affecting health assessments and care; and cooperation among different parts of the health system. This presentation will shed light on how, in the context of large numbers of refugees entering EU countries, health policies are translated to practice and what factors affect the provision of adequate care for Ukrainian refugees in Denmark.

Screening for Neglected Tropical Diseases and other infections in African refugees and asylum seekers in Rome and Lazio region, Italy

Screening for Neglected Tropical Diseases and other infections in African refugees and asylum seekers in Rome and Lazio region, Italy

Communicating effectively with inclusion health populations: 2022 ICCH symposium

Communicating effectively with inclusion health populations: 2022 ICCH symposium

Design of a service project that provides a model for interprofessional collaboration and layered learning within the refugee and asylum seeker community

Background: Development of an interprofessional service outreach within the refugee and asylum-seeker population gives pharmacy trainees the opportunity to develop healthcare skills and gain cultural awareness. Programme description: The interprofessional team prepared for the medical service trip through meetings, gathering supplies, and engaging in fundraising events. The team partnered with Siguiendo los Pasos de Jesús (SPJ) and Annunciation House while observing and partaking in service. A retrospective review of medical records was completed to develop the research project. Evaluation: A team of nine participated in a service project providing medical care and support for asylum-seekers. Layered learning and the importance of interdisciplinary communication were demonstrated within the team. The most common medical ailments for patients were respiratory, gastrointestinal diagnoses and headache/pain. Future plans: Service outreach offers the experience of caring for underserved populations and increases awareness of cross-cultural development, which is transferable in any clinical setting.

A narrative review of refugee & asylum seekers’ transitions into & experiences of working in the United Kingdom National Health Service

BackgroundThe United Kingdom (UK) has a significant and rising population of refugees and asylum seekers, including many who have previously worked as healthcare professionals. Evidence shows they have struggled to join and successfully work in the UK National Health Service (NHS) despite initiatives designed to improve their inclusion. This paper presents a narrative review based on research surrounding this population to describe the barriers that have impeded their integration and possible ways to overcome them.MethodsWe conducted a literature review to obtain peer-reviewed primary research from key databases (PubMed, Web of Science, Medline, EMBASE). The collected sources were individually reviewed against predetermined questions to construct a cohesive narrative.Results46 studies were retrieved, of which 13 satisfied the inclusion criteria. The vast majority of literature focussed on doctors with minimal research on other healthcare workers. Study review identified numerous barriers impeding the integration of refugee and asylum seeker healthcare professionals (RASHPs) into the workforce that are unique from other international medical graduates seeking employment in the UK. These include experiences of trauma, additional legal hurdles and restrictions on their right to work, significant gaps in work experience, and financial difficulties. Several work experience and/or training programs have been created to help RASHPs obtain substantive employment, the most successful of which have involved a multifaceted approach and an income for participants.ConclusionsContinual work towards improving the integration of RASHPs into the UK NHS is mutually beneficial. Existing research is significantly limited in quantity, but it provides a direction for future programs and support systems.

The prevalence of major depressive disorder and anxiety disorders among asylum seekers in South Florida

The prevalence of major depressive disorder and anxiety disorders among asylum seekers in South Florida

Immigration Protocols and Extralegal Demands: A Comparison Between the U.S.-Mexican Borderlands and South Africa

This paper presents a comparative case analysis arguing that undocumented immigrants in the U.S.-Mexican borderlands and in South Africa become criminalised by navigating host and recipient country legal protocols and norms. The immigrants (often bonafide asylum seekers and refugees) live in host countries without the necessary legal immigrant papers and therefore lack legal status. Illegality attaches to this status and creates economic demands satisfied by those who produce unauthorised (or authorised) immigrant papers. At times, government functionaries participate in these extralegal economies, adding to the robustness of the illicit economies and further harming this vulnerable population of immigrants, refugees, asylum seekers, and undocumented migrants. (For this paper, the term immigrants is an umbrella term for all the migrants.) The criminalisation of immigrants is rooted in the actions or inactions of government actors in the Global North and Global South who deny immigrants legal standing in the host country or in transit. These government functionaries and their smuggler counterparts, in turn, create an extralegal demand for papers and profit from restrictive immigration protocols.

Attitudes and experiences of asylum seekers and refugees to the COVID-19 vaccination: a qualitative study.

COVID-19 disproportionately affected asylum seeker and refugee (ASR) populations owing to language and cultural barriers, lower health literacy, polytraumas and mental health needs, and increased exposure. Despite this, there was vaccine hesitancy and low vaccination rates in ASR populations. To explore the attitudes to and experiences of the COVID-19 vaccination among ASRs. Qualitative study of 12 diverse purposively recruited ASRs in Bristol. Semi-structured interviews were conducted, transcribed verbatim, and analysed thematically to identify emergent themes. Eight refugees and four asylum seekers were recruited, five of whom were female and seven male, aged between 23 years and 48 years; together representing seven countries. Six were part of a UK Home Office (UKHO) resettlement programme, and six had arrived in the UK by independent means. Analysis showed delayed uptake rather than vaccine refusal owing to the following three main themes: systemic asylum issues (repeated relocation, uncertainty, and dependency on the charity sector); fear (secondary to social isolation, misinformation, and mental illness); and trust (surrounding access to care and community relationships). Fear, trauma, and isolation propagated by systemic issues are primary factors impacting healthcare decision making, and standard approaches to increasing vaccination uptake must be reconsidered in light of these issues. General practice must appreciate and invest in providing security in healthcare access for ASR populations. Barriers to practice registration must be overcome to enable ASRs to access care both around vaccination and afterwards. Communication must be clear and accessible to aid individuals in making informed decisions, balancing the benefits and potential risks of vaccinations.

Lampedusa, football and COVID-19: transitions at the border and the role of sport

ABSTRACT Lampedusa is a remote Italian island, known as a border zone and European point of entry for many asylum-seekers coming by boat from North Africa. This research seeks to understand the value of sport in Lampedusa for its local and migrant population, in the context of the global COVID-19 pandemic. Data were collected through semi-structured interviews with experts from the local community. Results show that sport in Lampedusa is often synonymous with football. Football has always been informally practiced in the island but has proved to be of practical social value to both asylum-seekers and the local population. The pandemic has however interrupted the playful interactions occurring between asylum-seekers and the local youth. Findings show that the interactions and connections enabled through football can be fundamental for asylum-seekers to find direction in their journey but since the start of the pandemic, these interactions have become limited, and serve exclusively as temporary moments of relief. These changes have also impacted the local population, anxious about the transition occurring within the COVID-19 pandemic, resulting in worries about the condition of the asylum-seeking population who are proceeding in their European journey without the assistance of the locals.