Fears for mental health of asylum seekers
A year on from a triple suicide, Tristan Stewart-Robertson reports on a growing mental-health crisis
Campaigners have warned that an epidemic of mental health problems among asylum seekers and refugees in Scotland will lead to further suicides and self-harm unless more help is offered.
A year after three Russian asylum seekers leapt to their deaths from a tower block in Glasgow’s Red Road estate The Herald has learned that Glasgow City Council has logged a huge surge in individuals and families needing mental health support.
Meanwhile a lawyer who worked with the Russian Serykh family says the issue is being swept under the carpet, with lawyers left to act as social workers, breaking bad news to vulnerable clients.
Mental health referrals through Glasgow City Council’s Asylum Support Services rocketed last year, with singles and couples climbing from 10 cases in 2009 to 50 in 2010, and families with children under 18 from 11 to 34.
A spokesman for Glasgow City Council said mental health amongst the city’s 2,000 asylum seekers was something they took very seriously. He added: “We are working with partner agencies to ensure that individuals are being directed towards appropriate services should concerns arise about their well-being. All staff within our asylum support team have received training to help them to raise awareness of mental health issues and refer individuals if required.”
But Jamie Kerr, a solicitor with Drummond Miller who represented the Serykhs last year, says their deaths should have been a “catalyst” for changing the entire system. While theirs was an extreme case, there will be further tragedies without change, he said.
The Herald understands there have been at least two attempted suicides by asylum seekers in the past year, but incidents will generally go unreported and there are no central statistics. Mr Kerr estimates as many as 70% of the asylum seekers he sees have depression, half have post-traumatic stress disorder (PTSD) and 10% self-harm, and others in the field say this is representative. He says: “Red Road should have been a catalyst for review and reform. There will be more deaths before we decide to fix the system. It’s inevitable. Nobody will take responsibility and a problem which is everyone’s, becomes no-one’s.”
Preventing deaths would require a full-scale review of support services, immigration law and the tribunal system, he says.
Mr Kerr says he still wonders if he could have done more for the Serykh family, but argues the questions their case raised remain unanswered. “If you believed what they said was true, then they were in danger. If not, then you have to believe they were a danger to themselves. If they had serious mental health problems, why was nothing done?
“Mental health problems and how they are addressed was the real issue from that case. It’s definitely not being dealt with to the best of abilities in Scotland. It’s being swept under the carpet.”
He also believes the UK Border Agency (UKBA) is leaving solicitors to handle difficult conversations with clients it knows are vulnerable.
Mr Kerr says: “Lawyers are being put in a social work position by the Home Office. If UKBA are concerned about the person’s mental health, they are getting the lawyers to deliver the news.”
In one letter seen by The Herald from the UK Border Agency to a Glasgow lawyer, it asked the solicitor to pass on the government’s refusal of refugee status.
While the agency did not accept that mental health difficulties would prevent the client from being returned home, the letter states: “Mr X has previously self harmed and has mental health issues. […] It is probably not in the best interests of your client’s health, given his vulnerabilities, to receive my letter whilst alone.”
Mental health service charities say there are huge gaps in support. In the north of Glasgow, mental health charity Lifelink sees many asylum seekers through its crisis service who are having suicidal thoughts.
Carolyn Wood, senior practitioner with Lifelink, says their crisis team can see someone within a week of being referred for help, but are not specifically funded to work with asylum seekers and cannot offer support to anyone who moves to other parts of the city.
“There is a lack of immediately accessible mental health support services and any positive activities for asylum seekers to help them feel they have a meaning,” she said. “Suicidal thoughts are about escaping from the pain and this whole uncertainty. Even when there’s a positive outcome to their case, [they] can continue, because nothing really changes.”
Dr Anne Douglas is consultant clinical psychologist with Compass, the NHS liaison service for asylum seekers and refugees with moderate-to-severe mental health problems and a history of trauma.
“Asylum seekers could be feeling there’s no choice, with two intolerable outcomes: being detained in the UK or being returned,” she says. “There may be a sense of trying to take control of that situation through suicide.”
Clinicians and campaigners say there are three principle causes of mental health problems for asylum seekers and refugees: an initial trauma such as rape, torture or imprisonment in their originating country; any trauma which occurred during their journey to the UK, and the pressures of adjusting to a new life in the UK, including dealing with the immigration system.
Robina Qureshi is executive director of Positive Action in Housing (PAiH), which offers advice and support to asylum seekers and refugees. She says it was the system, not mental health problems, that caused the Red Road tragedy last year. “There are so many unreported cases of people trying to take their own lives. The asylum system is causing mental health problems.
“There has been no change in approach by UKBA to the most vulnerable. There are ways to process people without terrorising them mentally.”
One PAiH client, Anowar, has tears streaming down his face as he describes his life in Glasgow. The 42-year-old fled Bangladesh in 2007 after his business partner violently assaulted him and threatened to kill him. He still suffers from severe back pain from the injuries and takes daily medication, though he still can’t sleep at night. He is also destitute, having been refused in his asylum claim in October, relying on a friend for a place to sleep in Springburn and help from Positive Action in Housing. “Sometimes I want to die because my life is very difficult,” says Anowar, who has an eight-year-old daughter in Bangladesh and a 10-month-old daughter in England. “In my country, I have no life. I worry a lot about what will happen. Every day I’m thinking I have no life, no future, no anything,” he adds. “I want to stay in Glasgow. People are trying to help me here, but always all the pressure is coming in my head.”
The Scottish Refugee Council said the introduction of the Health Matters project in September, ensuring new asylum arrivals will have a full health assessment, will hopefully help care and the claims process. An interim mental health referral protocol from Glasgow City Council and UKBA looks set to be applied elsewhere in the UK. But Janine Hunt, director of operations, added: “We work with a high volume of vulnerable and often destitute people, some of whom will have been refused asylum because issues such as mental health were not recognised at the outset of the process.”
In response to questions to UKBA about the role of the immigration system in mental health, a spokesman said: “Every case is carefully considered on its individual merits, examining all relevant information.
“The UK Border Agency takes into account relevant mental health issues when considering asylum claims. In particular, it is aware of the need to safeguard and promote the welfare of children.
“Throughout their asylum application, all individuals receive the same free access to NHS services and additional support that is available to the general public.”