Refugees, Mental Health and Stigma in Scotland

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Refugees, Mental Health and Stigma in Scotland Refugees, mental health and stigma in Scotland Introduction This briefing paper aims to provide policy makers and service providers with an overview of what we know about refugees’ experience of mental health stigma and discrimination, and sets out recommendations for how best to respond to the mental health needs of new communities. With the support of See Me, Scottish Refugee Council and the Mental Health Foundation are working in partnership to influence the national response to the mental health needs and stigma experienced by refugees and asylum seekers in Scotland, and to build capacity within refugee communities to challenge mental health stigma and discrimination. 1 POLICY BRIEFING AUGUST 2016 Who are refugees? Asylum Seeker Eritrea, Iran, Someone who has fled their Sudan, Syria, country but whose application 65 million for refugee status to a state Pakistan that has signed the 1951 UN Forcibly displaced Refugee Convention has not Top countries of origin of people in the world yet been decided. asylum applicants to the UK in 2015 Migrant Someone who moves from one region or country to another 86% Refugee 38,878 Someone who has been % of the world’s Number of asylum legally recognised as needing refugees sheltered by applicants to the UK protection under the 1951 UN developing countries in 2015 Refugee Convention Refugees are men, women and children Once in a country of sanctuary, life who have been uprooted from their as an asylum seeker or refugee can homes and communities around be characterised by insecurity and the world and forced to seek the uncertainty. protection of another country. They are in vulnerable circumstances. They Only a tiny proportion of the more than have faced persecution, perhaps due 65 million people forcibly displaced to conflict, to their political or religious from their homes around the world beliefs, their gender or sexuality. Many reach Scotland. However, it is essential have experienced trauma. Every stage that the right services and support are of their journey to safety can bring its in place for those who do. Scotland own challenges to physical and mental is welcoming refugees to parts of the wellbeing, which will differ for everyone. country new to providing sanctuary, as well as to those with existing refugee communities. 2 3 Refugees in Scotland The UK received applications for year.4 The UK Home Office currently international protection from 38,878 operates three refugee resettlement people in 2015. Around one third of programmes in partnership with the asylum applicants are women and girls, UNHCR: and two thirds men and boys.1 The UK Government relocates those who require Gateway Protection Programme support, while they await a decision on for refugees who have pressing their asylum application, to ‘dispersal humanitarian or security needs, are not areas’ across the UK. Over the last able to return to their countries of origin decade, the number of asylum seekers and cannot integrate locally (quota of in Scotland has equated to around 750 people per year) 10% of the UK asylum population, with the vast majority living in Home Office Mandate Refugee Scheme for refugees contracted accommodation in Glasgow.2 who have close ties to the UK If recognised as refugees and granted leave to remain, people may either Syrian Vulnerable Persons Relocation remain in Glasgow or relocate to another (VPR) scheme for Syrian nationals part of the UK.3 currently living in Turkey, Lebanon, Jordan, Egypt or Iraq with specific If granted leave to remain, a refugee can vulnerabilities (quota of 20,000 people apply for family members to join them. over five years 2015-2020) Currently in the UK, dependent children under 18 and spouses or partners can Scottish local authorities are playing apply for Refugee Family Reunion Visas a significant role in the Syrian VPR to join refugee family members. scheme, resettling around 40% of the first UK arrivals under the scheme The vast majority of the world’s refugees in late 2015. To date, one Scottish are unable to travel far beyond the local authority has participated in the borders of their home country. They Gateway Protection Programme and often live in refugee camps for years with others have participated in schemes many children living their entire lives in to resettle small numbers of Iraqi and such camps. One of the ways in which Afghan interpreters who worked for the the UN High Commission for Refugees British Armed Forces in those countries. (UNHCR) seeks to assist these refugees Scottish Refugee Council estimates is to offer resettlement to another third that in total, there are approximately country. Resettlement allows refugees 20,000 refugees and asylum seekers the opportunity to rebuild their lives in living in Scotland.5 safety and security. Around 80,000 refugees are resettled worldwide each 2 3 Policy context Asylum area around the UK, where they will Asylum is a complex policy area where attend an asylum interview and await a devolved and reserved competencies decision from the Home Office on their overlap.6 Decision making on asylum and application. immigration - who is entitled to enter and remain in the UK - is reserved to the If recognised as needing protection, they UK Parliament. However, the provision will be granted leave to remain, their of many support services to refugees asylum support will be stopped and they and asylum seekers that live in Scotland are required to move into mainstream is devolved to the Scottish Parliament. housing and welfare provision within These include health, education, criminal 28 days. If refused protection, there is justice, housing, children’s services and normally a right of appeal to a judge in preventing violence against women. the Immigration and Asylum Tribunal, The provision of financial support and but asylum support will be stopped accommodation to asylum seekers after 21 days. If specific criteria can be is a statutory obligation of the UK met, such as ongoing legal proceedings, Government. dependent children, or severe health needs, an applicant may be eligible to The asylum process itself is very apply for £35 per week preloaded onto a complex.i An applicant must lodge an cashless payment card (called the Azure application and undergo a ‘screening’ Card) valid in designated shops, and interview either on arrival at a port (usually shared) accommodation, until or airport, or, if already in the UK, in appeal rights are exhausted or they leave Croydon. If destitute and eligible for the UK. Further changes are being made support, applicants will be relocated to the asylum support system for refused on a no choice basis to a dispersal asylum seekers under the Immigration Act 2016. i See Appendix I for a diagram of the UK asylum process. 4 5 Refugee integration Key aspects of refugee integration Health policy are devolved to the Scottish Health policy in this area is also Parliament. The Scottish Government complex and differs across the devolved promotes an ‘integration from day administrations of the UK. In Scotland, one’ approach, which means that the law exempts refugees and anyone asylum seekers can access support and who has made a claim for asylum from services under the competence of the any charging for NHS services.8 The Scottish Parliament from the day they Scottish Health Directorate is clear that arrive in Scotland. This differs from the all asylum seekers are entitled to register approach in England, where integration with a GP in Scotland and states in its begins upon recognition of refugee policy on ‘overseas visitors’: status, which can be months or years after arrival in the country. Scotland’s Anyone who has made a formal approach is embedded in its New Scots application for asylum, whether pending refugee integration strategy, which or unsuccessful, is entitled to treatment was developed in partnership with on the same basis as a UK national who key stakeholders and is implemented is ordinarily resident in Scotland while through a series of thematic working they remain in the country.9 groups.7 This differs from other parts of the UK. In September 2015, the Scottish For example, in England, those who Government established a Refugee have been refused asylum and do not Response Taskforce, which brought receive Home Office support are liable together statutory, voluntary sector and to be charged for access to secondary refugee community representatives healthcare services.iii The Department to oversee Scotland’s response to the of Health also recently consulted on the ‘refugee crisis’ and the resettlement introduction of charging for primary of Syrian refugees to Scotland. Going healthcare services in England, including forward, this group will be incorporated accident and emergency and some GP into the work of New Scots. services.iv iii Emergency care, family planning, infectious diseases, and treatment due to domestic or sexual violence or female genital mutilation, are exempt from charging. As are victims of trafficking, immigration detainees and looked after children. iv Consultation included proposals to extend charging into A&E, ambulances, prescriptions, dental care, eye care and some GP services: www.gov.uk/government/uploads/system/uploads/attachment_data/ file/483870/NHS_charging_acc.pdf 4 5 Amani’s story: Part one Amani came to the UK when she was 13 years old. This is her story… “I came to the UK with my family from East Africa due to political unrest. My mother decided it was unsafe for us to live in our homeland and so we had to leave. This was a difficult and painful decision where everything we knew had to be left behind: our culture, our heritage, our family and friends. “Starting our new life was not easy. There was a language barrier, the feeling of not belonging and the fear of not being accepted in society was always on your mind.
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