The mental health needs of adult asylum seekers in Newcastle upon Tyne
| Published date | 01 March 2005 |
| DOI | https://doi.org/10.1108/17465729200500006 |
| Pages | 17-23 |
| Date | 01 March 2005 |
| Author | Philip Crowley |
| Subject Matter | Health & social care |
Dealing with the needs of asylum seekers and refugees presents a challenge to local health services,
and mental health has been identified as the main health issue for this group.This paper reports the
findings of a quantitative and qualitative study of the mental health care needs of asylum seekers and
refugees in Newcastle upon Tyne.Primar y and mental health services were found not to be meeting
the needs of this group. In some practices,attitudes to asylum seekers among both GPs and other
patients were reported as stigmatising. But there is evidence that many of the mental health problems
of asylum seekersare related to post-migration stress arising from pr actical and economic difficulties
and experience of racism and other discrimination, highlighting the need to build support and social
connections and include the needs of asylum seekers in local mental health promotion strategies.
The mental health needs
of adult asylum seekers in
Newcastle upon Tyne
Dr Philip Crowley
Specialist in public health
medicine
Institute of Public Health
in Ireland
philip.crowley@icpg.ie
RESEARCH
17
Itis important to consider the mental health care
needs of asylum seekers in the broader context of
the needs of all ethnic minorities. Asylum seekers
are ethnic minorities but have additional needs
arising from the asylum experience (The Health
of Londoners Project, 1998; Aspinall, 2004). These
include factors in the country of origin such as
imprisonment, violence, rape and torture (Refugee
Council, 1996), and factors that confront the asylum
seeker on arrival in this country, such as legal
uncertainty,economic and social marginalisation, racial
harassment (Silove & Franz, 1999; Gorst-Unsworth &
Goldenberg, 1998; Jahal & Julian, 2002; Carey Wood
et al,1995; Karmi, 1992; Gupta, 1999) and ‘cultural
bereavement’ (Keyes, 2000). Post-migration stressors
have been shown to be as significant a determinant of
mental distress as pre-migration stressors (Watters,
2001; Sinnerbrink et al, 1997).
There have been few estimates of mental health
need among asylum seekers in the UK. A study in the
Northern region (Wilson, 2002) explored the general
health needs of asylum seekers and identified mental
health as the most frequently encountered health issue.
However, estimates of need based on diagnosis may be
inappropriate or problematic. There are problems with
applying western psychiatric thinking to asylum seekers
and other ethnic minorities from very different cultures,
and this may affect diagnostic accuracy (Silove & Franz,
1999; Burnett & Fassil, 2002). Applying a diagnosis has
also been questioned. Symptoms of mental distress are
common, but interpreting these as mental illness has
been challenged (Burnett & Fassil, 2002). For example,
it has been argued that applying the label of post-
traumatic stress disorder to asylum seekers pathologises
anormal psychological process (Friedman & Jaranson,
1994). The relevance of the diagnostic criteria for PTSD
to largely non-western, war-affected populations has also
been questioned (Summerfield, 2001).
Deficiencies and inequities in mental health service
delivery for ethnic minorities in general have been
highlighted in national policy initiatives (Department
of Health, 2003). Data problems arise from persistent
weaknesses in ethnic monitoring in hospitals and
further guidance has been issued in an effort to improve
it (Department of Health, 2001; National Institute for
Mental Health in England , 2003). A Department of
Health study highlighted differential access to services
and differential delivery of services for ethnic minority
groups in the UK (Department of Health, 2000).
Studies have shown that Asians and other ethnic
journal of public mental health
vol 4 • issue 1
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