Sanctuary - addressing mental health inequalities with asylum seekers and refugees in Scotland

This paper reports on a 4 year national action research initiative involving community-led focus group research with asylum seekers and refugees, exploring mental health problems, stigma and barriers to accessing services. Significant mental health problems were experienced by asylum seekers and refugees, arising from pre-migration trauma, the migration process, the impact of uncertainty, isolation and racism in the host country. There were a range of barriers in accessing services, including accessibility of services, community stigma, fear of being deported upon disclosing a mental health problem, lack of culturally sensitive services and language issues. The study revealed the lack of national initiatives to tackle mental health inequalities and outlined promising approaches for both services and communities. The paper also reviews a series of community led interventions to address these issues, involving practitioners, service users, communities and academics: community led workshops and a mental health practitioner awareness programme, involving the narratives of asylum seekers and practitioners. These programmes are designed and implemented by community activists in partnership with practitioners from health and social work services and voluntary organisations and delivered to 250 workshop participants. The paper will present findings on the impact of these interventions and consider implications for practice. The evaluation of the interventions that were implemented within communities resulted in increased willingness to seek and offer help and support, less fear and greater acceptance of recovery. Practitioners reported an increased knowledge of the mental health issues experienced by asylum seekers and refugees, emotional engagement and an increase in confidence and skills. The paper concludes by highlighting the importance of community led research in understanding and shaping interventions to address mental health inequalities experienced by asylum seekers and refugees. It also highlights the value of community led approaches where communities work in partnership with statutory and voluntary sector agencies