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Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. Arksey and O′Malley's scoping review framework. A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of ' leaving no one behind' in post-pandemic and future responses. [ABSTRACT FROM AUTHOR]

Purpose: This paper discusses an original theory of information exclusion and information inclusion, which explains how information interactions can be structured in ways that either exclude or include people seeking asylum. Design/methodology/approach: This theory was developed through an ethnographic study of the information experience of people seeking asylum in the United Kingdom. Fieldwork involved participant observations, participatory research workshops and semi-structured interviews, analysed using a constructivist grounded theory approach. Findings: People seeking asylum are confronted with two main information environments: the asylum system and the local third sector. Each environment frames contrasting information access, sharing and literacy practice modalities: the former produces information deprivation, information sharing agency denial and a fracturing information literacy practice; the latter facilitates multiple information affordances, information sharing agency promotion, and both local and heritage information literacy practice promotion. Our theory of information exclusion and information inclusion describes how through these modalities, an information environment can either promote or preclude inclusion. Originality/value: Previous information studies of migration tend to conceptualise social ex/inclusion as a linear journey. Our theory originally frames this as a non-straightforward and conflicting process, allowing to better understand the experience of people who are not simply either socially excluded or included, but may experience both states depending on context. It also shows that exclusion is not a matter of fact and is not fundamental to asylum systems: it is produced by specific policies and procedures and can therefore be changed. Thus, this theory provides conceptual tools for researchers to investigate the information experience of individuals moving between conflicting information practices, and for civil society actors and policymakers to document exclusionary information practices and design inclusive ones. [ABSTRACT FROM AUTHOR]

The 2022 UK diphtheria outbreak has wider contextual importance: it highlights that even in a country with good overall herd immunity against many infectious diseases from high vaccination coverage, strong surveillance mechanisms for infections that may re-emerge are essential. Factors before, during and after migration may increase the risk of asylum seekers contracting diphtheria and other vaccine preventable infections. Keywords: diphtheria; outbreak; asylum seekers; United Kingdom EN diphtheria outbreak asylum seekers United Kingdom 1 3 3 09/13/23 20230701 NES 230701 In 2022, in figures mirrored across Europe,[1] the UK saw a 7-fold increase in annual reported diphtheria cases[2],[3]; all among asylum seekers.[2],[3] Diphtheria has been rare in the UK since the introduction of the routine immunization programme in 1942, with most cases related to international travel.[4] In this paper, we give an overview of diphtheria infection, explore potential contributing factors to the unprecedented increase in cases among asylum seekers, examine the UK Health Security Agency (UKHSA) outbreak response and identify factors that may reduce the likelihood of resurgence of diseases of poverty and overcrowding. [Extracted from the article]

The contribution and role of psychologists, psychiatrists or mental health practitioners in working alongside forced migrants may take many forms. The guidance on which this paper is based, came about when several members of the British Psychological Society (including those with lived experience and insight and those who had set up services); became aware of the need for good practice guidance for clinicians working with refugees, asylum seekers including forced migrants across Britain. These guidelines cover a range of areas where clinicians work with individuals in clinical contexts, schools, nurseries, colleges and within community organisations. [ABSTRACT FROM AUTHOR]

The mental health benefits of physical activity and exercise are well‐documented and asylum seekers who may have poor mental health could benefit from undertaking recommended levels of physical activity or exercise. Digital mobile applications are increasingly seen as feasible to precipitate behaviour change and could be a means to encourage asylum seekers to increase their levels of physical activity and exercise. This paper reports on a study that aimed to assess the feasibility of asylum seekers using the digital animation as a tool to change behaviour and increase their physical activity and exercise levels. A feasibility study underpinned by the principles of the COM‐B behaviour change model was undertaken in West Yorkshire, UK, in 2019. Thirty participants were purposively recruited and interviewed. Peer interpreters were used as necessary. Deductive thematic analysis was undertaken to analyse the data. Overall, participants were positive about the feasibility of asylum seekers using the application as a behaviour change intervention. All expressed the view that it was easy to follow and would motivate them to increase their physical activity levels. Participants identified facilitators to this as the simplicity of the key messages, the cultural neutrality of the graphics and the availability of the mobile application in different languages. Identified barriers related to the dialect and accents in the translations and the over‐simplicity of the application. This study has identified that a targeted digital animation intervention could help asylum seekers change their behaviour and hence improve their health and well‐being. In designing such interventions, however, researchers must strongly consider co‐design from an early stage as this is an important way to ensure that the development of an intervention is fit for purpose for different groups. [ABSTRACT FROM AUTHOR]

Many migrant groups, particularly those that are politically and economically marginalised, such as asylum seekers and refugees (ASRs), face inequities in access to health care as well as poorer physical and mental health outcomes. The role of post-arrival experiences in contributing to these inequities is increasingly being explored, and it is suggested that being a migrant is itself a determinant of health outcomes. Drawing on the theoretical concept of structural vulnerability, this paper explores ASRs' experiences of health, wellbeing, and health practices in the context of their lived realities in Scotland. 24 semi-structured interviews were conducted with ASRs from Sub-Saharan Africa between January and December 2015. Data were explored using thematic analysis. Experience of the UK asylum system, both alone and in conjunction with other sources of vulnerability including racism, poverty, and language barriers had a negative and ongoing impact on the physical and mental health of ASRs. These impacts continued, even once refugee status was obtained. Efforts to engage ASRs in preventive health programmes and practices must take into account the ways in which the asylum system acts as a determinant of health, affecting both what it means to be healthy and what capacity individuals have to engage with their health. Political choices in how the asylum process is enacted have far-reaching implications for individual and population health. [ABSTRACT FROM AUTHOR]

Purpose: Refugee and asylum-seeking women are particularly vulnerable to experiencing mental health difficulties during the perinatal period, with social factors compounding these experiences. Research is limited into the mental health needs of perinatal women who are refugees or seeking asylum. The purpose of this paper is to examine the best available international evidence on this topic and to discuss the findings with relevance to the UK context. Design/methodology/approach: A modified population, intervention, comparison, outcome was used to formulate the research question and search strategy. Databases searched were: cumulative index of nursing and allied health literature, Medline, PsychINFO, Web of Science and Scopus. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis framework, results were screened against an inclusion and exclusion criteria. Each study underwent a quality assessment in which they were appraised using the mixed methods appraisal tool. Findings: Eight papers were retrieved, and a thematic analysis was conducted. Two major themes were identified: mental health needs and social influences. Refugees and asylum seekers are likely to have experienced trauma as reasons for migration. Post-migration stressors, including hostility and dispersal from social networks, lead to cumulative trauma. These each add to the mental health needs of perinatal refugee and asylum-seeking women that cannot be ignored by policymakers, health and social care services or professionals. Originality/value: Refugee and asylum-seeking women are particularly vulnerable to mental health difficulties in the perinatal period. Stressors accumulated pre-, during and post-migration to the host country exacerbate mental distress. In the UK, the treatment of this population may be detrimental to their mental health, prompting the need for greater critical awareness of the socioecological environment that refugee or asylum-seeking women experience. [ABSTRACT FROM AUTHOR]

This paper questions whether asylum seeker integration is promoted through inter-organisational relationships between non-profit and voluntary organisations (NPVOs) and government agencies. It focuses particularly on the role of NPVOs in service delivery (co-management) and in the delivery and planning of public services (co-governance). It presents a research study on the public services provided to asylum seekers in Glasgow and asks the following questions: What role do NPVOs play in the planning and delivery of public services? When planning and delivering public services, to what extent do NPVOs work across organisational boundaries and what kind of relationships exist? And in practice, what makes inter-organisational relationships work? This paper offers new empirical evidence and also contributes to the theoretical debate around the integration of asylum seekers. [ABSTRACT FROM AUTHOR]

Drawing on data from in-depth interviews with refused asylum seekers from Zimbabwe and Kurds from Turkey, who have stayed in Britain as irregular migrants, this paper examines everyday lives, strategies and fears. The paper focuses on four main areas: individual experiences of the asylum system leading to irregularity; living as an irregular migrant with the constraints on economic participation and limited housing options; social lives, relationships and community activities alongside the ways in which decisions about social interactions intersect with irregularity and subsistence support; the fears and everyday struggles faced by irregular migrant's living in England, and the ways in which this translates into relationships with place and space. The paper draws out both the commonalities and the diversity of experiences among refused asylum seekers living in England. [ABSTRACT FROM AUTHOR]

Refugees and asylum seekers have become increasingly demonised as part of anti-migrant sentiment leading to social exclusion. Sport has been utilised as a tool for social cohesion though evidence as to its efficacy in such a task is limited. Based on a three-year research programme exploring the role of football in the lives of refugees and asylum seekers in the U.K., this paper examines the concept of belonging, provides evidence for the role of community-based sport in social development and concludes with a call for practitioners to maximise their belief in concrete utopian ideals without losing the inherent critical approach needed to positively develop the industry in which they work. [ABSTRACT FROM AUTHOR]

Numerous studies have linked the high rates of traumatic events experienced by refugees to the elevated rate of mental health problems in these populations. A growing body of evidence has also highlighted the importance of considering postmigratory stressors when making sense of displaced person distress. This study explored the relationship between mental health and postmigratory stress for asylum seekers and refused asylum seekers in Britain. The study further examined if those refused asylum experienced elevated distress and postmigratory stress compared to those awaiting the outcome of asylum applications. Results indicated that participants (N = 97) had endured a range of pre- and postmigratory stressors and had high scores on measures of anxiety, depression, and PTSD. A postmigratory factor comprising items associated with isolation, restrictive policies, and stressors associated with having an insecure immigration status, was significantly associated with PTSD scores. This relationship remained when controlling for the variance accounted for by premigratory trauma predictors. Being refused asylum was the strongest predictor of depression and anxiety. Those refused asylum scored higher on a factor associated with barriers to accessing services. Social materialist theories of distress are drawn upon to contextualise the heightened vulnerability of those refused asylum. The paper concludes by emphasising the problems associated with taking an exclusively trauma-focussed approach when working with asylum seekers and argues for community orientated interventions to support displaced people to cope with the various stressors endured in exile. [ABSTRACT FROM AUTHOR]

This paper reflects on the concept of insecurity defined as ‘the capacity to hurt’. It begins by considering asylum seekers and refugees as hyper-precarious groups that have experienced bodily, material and psychological ‘hurt’ in the UK. At the same time, the paper considers how these hyper-precarious groups are perceived to have the capacity to hurt (bodily, materially, psychologically and spatially) the majority population. Having drawn out two understandings of the capacity to hurt—both the ability to be or feel hurt and the act of hurting others, we argue that a shared recognition of what it means to feel hurt (co-suffering or suffering together)—albeit to very different extremes and with very different consequences—and an understanding of the processes which drive this might be mobilised politically to challenge the act of hurting others. In doing so, we argue for a group politics of compassion to respond to increasingly insecure times. [ABSTRACT FROM AUTHOR]

This paper examines the spatial consequences for activism of viewing the state through either a statist or post-structural lens. It is argued that understanding the state in different ways produces very different spatial strategies among activists. Drawing upon detailed case studies of two asylum-seeking activist organisations in the UK, the connections between imaginations of the state, spatial strategies towards institutionalised authority, and the pros and cons of these strategies for activism itself are examined. Through these cases, the paper emphasises the importance of everyday theories about the state not only for understanding what the state is, but also for understanding how relationships with the state are formed and points towards the constructive power of imaginations of the state in their own right. [ABSTRACT FROM AUTHOR]

This paper investigates the issue of trust, or mistrust, specifically in relation to single adult asylum seekers and asylum seeker families compulsorily dispersed across England. It draws upon doctoral research on the social exclusion of asylum seekers as a result of dispersal and their separation from mainstream welfare provision due to the creation of the National Asylum Support Service (NASS) following the Immigration and Asylum Act 1999. Trust is an ambiguous term and four forms of trust are delineated to assist conceptualizing the experience of forced migration: social, political, institutional and restorative trust. This paper provides an overview of the aims and each phase of the implementation of dispersal. It is argued that the dispersal system leaves little room for political or institutional trust to be restored and hinders the restoration of social trust. It is suggested that this lack of space for the restoration of trust has negative implications for the longer term resettlement process of asylum seekers who obtain refugee status. It is also suggested that trust is an essential component of UK government policies promoting social or community cohesion, community engagement and initiatives to combat trafficking, forced marriage and `honour' based violence and that mistrust of asylum seekers as a group directly contradicts such policies and initiatives. [ABSTRACT FROM AUTHOR]

This paper explores the ways in which mobility can have governmental effects in the context of the management of asylum seekers awaiting deportation from the UK. Drawing upon the case of Campsfield House Immigration Removal Centre, a facility for the incarceration of immigration deportees near Oxford, the paper makes the case that the way asylum seekers are moved between detention centres within the UK has implications for the way they are represented to both asylum activists and asylum sector employees, causing them to choose to use their influence differently by with-holding the support that they might otherwise provide. The constant moving and repositioning of asylum seekers means that they are depicted as transitory, fleeting and depersonalised to those actors with the greatest degree of influence over them. The subjection not only of asylum seekers through forceful, blunt forms of power, but also of more powerful asylum sector actors through subtler, governmental techniques, has significant material implications for the incarcerated asylum seeking community that populates Britain's detention estate. [Copyright &y& Elsevier]

Group therapy is a useful form of intervention for individuals with histories of extreme trauma. This paper will discuss the relevance of group interventions with refugees and asylum seekers who have suffered persecution and trauma in their home countries. Using case examples, this paper will illustrate how groups can provide an environment in which members can begin to work through past traumatic experiences and begin the process of finding a home in the UK, within a context of continued uncertainty and threat. The central principles of group analytic psychotherapy and how these can be applied and adapted to meet the needs of this specific group will be explored. Key issues, including working with an interpreter, cultural factors and dealing with high levels of vulnerability and dependency, will be discussed. The complex boundary issues arising from needing to intervene with practical issues outside the group therapy process will be considered. The paper will also explore the impact of this work on the group facilitators and ways in which this can be managed. [ABSTRACT FROM AUTHOR]

Asylum seekers living in the UK have been shown to have fled danger in their countries of origin, only to face hardship and the threat of deportation once there. This paper draws on the discursive psychological approach to address the way in which asylum seekers in the UK manage questions about returning to their country of origin. Interviews were conducted with nine asylum seekers in a refugee support centre in the Midlands. The interviews were transcribed and analysed using discourse analysis. The analysis showed that participants drew on the notion of safety to counter suggestions that they should return to their country of origin and to manage their identity as legitimate asylum seekers in need of support. The use of this strategy and the use of interviews for discursive analysis are discussed. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper explores how middle aged and older asylum applicants in the UK speak about health in relation to migratory experiences. It proposes biocredibility as a novel theoretical concept, through which the narratives of those migrating to the UK to seek asylum can be analysed. The UK government's hostile environments policies, which aim to make life uncomfortable for irregular migrants in the UK in order to drive down migration, have been criticised on legal, material and moral grounds. This paper adds to this critique. Narrative analysis of semi-structured interviews shows that the majority of the asylum applicants interviewed felt their health was poor and told of the difficulties of life in the UK. Stories of homelessness, poverty and exclusion dominated, underpinned by the erosion of their perceived trustworthiness and credibility through encounters with the Home Office. Particular personal experiences of social, political and economic strife in exile were narrated closely against stories of illness. The concept of biocredibility refers to, and provides a way of understanding, participants' propensity for creating narrative enclaves for pathographies as a discursive mechanism to add credibility to narratives of lived experience. In this way, visceral descriptions of biological suffering can function as a narrative resource. It does this firstly by providing material and social context for adverse health, thus allowing participants to attribute a socio-political cause for their illness. Secondly it interjects experiences of illness into life narratives, thus effectively communicating the significance of such experiences. Finally, it provides narrative evidence of individuals' autobiographical testimony. For discredited and marginalised asylum applicants, biocredibility can be understood to represent a strategy used to re-negotiate credibility and urges a critical consideration of the hostile and austere socio-political context in which it is observed. • In the UK hostile environment policies aim to decrease net migration. • Narrative analysis shows how this impacts asylum seekers' health. • Asylum seekers associate life in the UK with biological dysfunction. • This paper conceptualises this through a novel paradigm: Biocredibility. • Biocredibility describes the narrative biologisation of lived experience. [ABSTRACT FROM AUTHOR]

Interest in the integration of refugees has grown with the increase in numbers of asylum seekers dispersed across the UK. The ability to communicate effectively in English is seen as the key priority in facilitating integration, while a lack of English language is seen as one of the major barriers to refugee employment. Some £267 million was spent on English for Speakers of Other Languages (ESOL) classes in 2004/05. However, commentators have observed that asylum seekers and refugees continue to struggle to speak English. This paper examines data from interviews with refugees and ESOL tutors, and statutory data recording retention and achievement of asylum seekers and refugees, to explore the extent to which they are achieving in ESOL, and the effectiveness of the existing monitoring system in assessing whether ESOL meets the needs of asylum seekers and refugee learners. It finds that there are major inconsistencies between the retention and success rates observed in the monitoring data and those reported by tutors and refugees. A range of problems are identified that indicate that monitoring is neither robust nor reliable and that refugees and asylum seekers are struggling to learn sufficient English to enable integration. [ABSTRACT FROM AUTHOR]

Canada and the United Kingdom have pedigrees in offering asylum; however, research in both countries has demonstrated widespread poverty amongst asylum seekers and a high risk of homelessness. Focusing on case examples drawn from 60 in-depth interviews with refugees in Toronto and London, this paper shows how national and local structures shape pathways to homelessness, and how refugees interpret their homlessness in the context of their flight from persecution, reception, and settlement. [ABSTRACT FROM AUTHOR]

Objectives: The study described in this paper sought to identify the social, cultural, and political factors that effect African unaccompanied asylum-seeking minors’ (UASM) vulnerability to sexual maltreatment in England. It aimed to illuminate how child protection measures could be strengthened for this highly marginalized group. Methods: A mixed method approach was used. Former UASM from Ethiopia, Eritrea and Somalia who had been sexually maltreated in the UK were interviewed in-depth. Prior to the interviews they all completed a questionnaire which captured their biographical details as well as sensitive but factual information. Results: Of the 53 (N =53) former UASM who participated in the study only 2 were males. Most arrived in the UK aged 15–17. A range of sexual maltreatment, from sexual harassment to rape was reported. Three quarters experienced more than 1 incident. Most initial incidents happened in the first 12 months of their arrival in the UK. Two perpetrators were female carers. Many participants reported being groomed and sexually maltreated by people from their own country. Many described being seriously sexually maltreated, particularly by groups of young males living in the same accommodation or nearby, some reportedly also asylum seekers. Participants that had been warned of the dangers of sexual maltreatment were more likely to both disclose and to seek professional help. Conclusions: Professionals should assume that UASM will suffer sexual maltreatment in their host country if not protected adequately, which they are unlikely to disclose. They are likely to need more protection from outside sources and help to develop their personal resources than many have received in the past. Practice implications: Preventative measures include provision of safer environments, ideally single sex housing; more monitoring and supervision; more opportunities to develop trustworthy relationships and have emotional needs met; greater opportunities to develop language skills/access to interpretation; early information regarding the social system, culture, and sexual maltreatment; and improved professional awareness and competence in dealing with minors from other cultures. [Copyright &y& Elsevier]

In this paper we seek to highlight the interconnectedness between work and migration and the maintenance of the new social order in the United Kingdom. The content of this article is based upon a number of qualitative research projects that the authors have been involved with over recent years. These research projects have shown the way in which work is interwoven into the migration and settlement experiences of various new migrants, and how this relates to mobility within UK society. Under this common theme we explore the role of immigrants within the United Kingdom's division of labour, and how in turn economic mobility and mobility in terms of work is described, experienced and managed by migrants themselves. We analyse how issues of governance relate to issues of mobility for citizens and migrants. We explore how the official framework for the regulation of labour migration is reflected and refracted in the accounts given by a range of migrants in the United Kingdom, including foreign recruits, irregular workers, asylum seekers and work 'visa' holders. [ABSTRACT FROM AUTHOR]

A series of decisions made by successive UK governments with the aim of reducing the flow of immigration has impacted in countless ways on those seeking asylum. The recently published 5-year strategy for asylum and immigration ( Home Office, 2005 ) has potentially very serious implications for unaccompanied asylum seeking children with the government making plans to commence routine detention and deportation of these children if their asylum claim is not accepted. This paper aims to lay out recent legislation in relation to the treatment of unaccompanied 16- and 17-year old young people seeking asylum and to outline the complex asylum process negotiated by these young people. [ABSTRACT FROM AUTHOR]