Refugee women in the UK: factors affecting engagement with mental health services

Section A. This paper opens with a broad overview of theoretical and empirical literature on refugee mental health. It highlights a relative weakness in the understandings of post-migration mental health, particularly in the context of female refugees. The paper then focuses on three areas of refugee women's mental health, critically evaluating theoretical and empirical literature: 1) risk factors and prevalence of mental health difficulties 2) coping strategies, 3) mental health service utilisation. Gaps in the extant literature are highlighted and suggestions are made for future research. Section B. This paper describes a qualitative study which aimed to explore refugee women's experiences of distress and their encounters with mental health services in the UK. Refugee women do not utilise UK mental health services as frequently as might be expected owing to their vulnerability to mental health problems. The study investigated the mental health experiences of refugee women who have encountered mental health services in the UK in order to contribute to understandings about factors affecting service utilisation. A grounded theory qualitative methodology was employed. Ten refugee women were recruited from a local non-governmental organisation and participated in semi-structured interviews about their experiences of distress, coping strategies and encounters with UK mental health services. A two-staged model emerged from the data. The first model depicted women’s experiences of distress predominantly in the context of post-migration experiences and how they coped, drawing notably from spiritual and social resources. The second stage of the model indicated how mental health service encounters were varied and a process of engagement involved evaluation and re-evaluation at particular stages. The study concluded that understanding refugee women’s utilisation of mental health services demands a multi-factorial, dynamic appraisal. Section C. This paper offers a critical appraisal of the study reported in Section B. The paper reflects on the research skills and abilities developed by the principal researcher and considers areas for development in terms of future clinical and research work in this field