Search

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]

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]

Inclusive Cities, a university led knowledge exchange initiative works in collaboration with six UK city administrations facilitating the development of their strategic and practical approach to the inclusion of newcomers in the city. The paper places this case study into the context of the UK's centralized asylum reception and resettlement policy framework, contrasting it with the increasing recognition of the importance of the local level in integration and inclusion policy and the intersections between these differing modes of governance and competencies. The paper explores emerging learning from the programme in relation to the leadership role of local government, its ability to act as a place shaper in relation to inclusion and integration and it role in convening partners through horizontal, place-based, networks as well as the ways in which this case study can contribute to wider learning on the role of knowledge exchange in facilitating social change and policy framing at the city level and learning on the multi-level governance of reception and integration. The paper explores how mutual knowledge exchange may create space for a broadening out of the policy framing in relation to reception – in particular how a 'newcomer' frame may support increased innovation at the local level. [ABSTRACT FROM AUTHOR]

Socio-legal status determines the differential rights to residence, work and social welfare that accrue to migrants depending on their particular immigration status. This paper presents analysis of original empirical data generated in qualitative interviews with migrants who had both made a claim for asylum and experienced conditions of forced labour in the UK. Following an outline of the divergent socio-legal statuses assigned to individual migrants within the asylum system, early discussions in the paper offer a summary of key aspects and indicators of forced labour. Subsequent sections highlight the significance of socio-legal status in constructing such migrants as inherently vulnerable to severe exploitation. It is concluded that immigration policy and, more particularly, the differential socio-legal statuses that it structures at various stages of the asylum process, helps to create the conditions in which severe exploitation and forced labour are likely to flourish among asylum seekers and refugees in the UK. [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 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]

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]

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]

The 'refugee crisis' in Europe has drawn attention to the reasons why people risk desperate journeys to seek safety. However, less research has focussed on what happens to those on the move once they have reached their destination country. In recent years the UK government's 'hostile environment' policy for asylum seekers has taken precedence over attempts to integrate refugees, creating a system in which destitution, dispersal and detention have all become pervasive features. This paper takes a discursive psychological approach to the analysis of interviews with asylum seekers in Wales, UK. It argues that participants draw on economic repertoires of effortfulness to construct accounts in which belonging is dependent upon being able to contribute to the economic and civic life of the host society. It further highlights how participants construct accounts in which restriction from the asylum system is positioned as the reason for not belonging and that time spent as an asylum seeker is policy-imposed liminality. The findings suggest that allowing asylum seekers to work would be a key step forward in integration policy and contribute to generating a greater sense of belonging. [ABSTRACT FROM AUTHOR]

In recent years asylum seekers arriving in the United Kingdom have been subject to a 'hostile policy environment' (Zetter et al. 2005) initiated by the UK government consisting of dispersal, destitution and detention. At the same time, the UK government has also focussed on 'integrating' refugees. In this paper, Critical Discourse Analysis of seven policy documents is used to demonstrate how ambivalence is a feature of UK and devolved government refugee integration strategies. Analysis revealed that each strategy is predicated upon rhetorical devices which construct the governments as having a 'proud history' of offering protection to those fleeing persecution by drawing on long histories and traditions of welcoming refugees. Such rhetorical and commemorative devices may also function to dialogically repress (Billig 1997) the UK's history of not providing protection to refugees and of creating a 'hostile environment' for asylum seekers. It concludes that such devices construct refugee integration ambivalently, which is a result of an ideological dilemma (Billig et al. 1988) inherent in these strategies between the integration of refugees and deterrence of asylum seekers. [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]

Purpose: The purpose of this paper is to share research findings on the lived experiences of asylum seekers in Bristol (UK), with a particular focus on psychological needs and sources of resilience. Design/methodology/approach: The study was designed following the principles of action research and was carried out in three phases involving nine co-researchers. Thematic analysis was used to interpret the resulting data, collected through semi-structured interviews. Findings: The findings highlight challenges which are faced by asylum seekers after migrating to the UK and indicate how these do not allow for psychological needs to be met, undermining resilience. Co-researchers indicated that aspects of the asylum system were perceived as unfair, adding to existing losses and promoting fear. Strength was found through engaging with communities and religious practices. Practical implications: The research suggests that asylum seekers feel misrepresented and misunderstood within the public realm and raises serious questions around the current asylum legislation. It offers practitioners insight into key determinants for psychological well-being from the perspective of asylum seekers, providing suggestions for sensitive and appropriate interventions. Originality/value: The study offers original insights into asylum seekers' experiences, with a specific focus on Bristol. The use of action research and the involvement of asylum seekers as co-researchers are also noteworthy, as collaborative research is scarce in this field. [ABSTRACT FROM AUTHOR]

Copyright of Voluntas: International Journal of Voluntary & Nonprofit Organizations is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Upon arrival in the United Kingdom (UK), asylum claimants undergo a complex application process with no guarantee of being granted leave to remain. Throughout this process, applicants live in 'limbo' with no certainty regarding their future. They are forced into poverty, are at risk of destitution and often live in substandard accommodation, all of which causes further harm, compounding the circumstances from which they have fled. This paper explores the stress and vulnerability faced by male asylum seekers during the application process and how they cope or resist vulnerability during this time. Based on narrative interviews, this research finds that the most stressful experiences for participants include living in 'limbo' throughout the asylum application process and beyond. As such, many coped by using distraction techniques, seeking support and through cognitive restructuring. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Purpose -- The purpose of this paper is to highlight the key issues of concern for asylum seekers in the UK by focusing on their in depth talk about their experiences, a so far neglected element in the current debate about asylum seeking. Design/methodology/approach -- The study involved thematic analysis of asylum seekers' accounts of their lives in their country of origin, their journeys to the UK and experiences following arrival. Nine participants took part in semi-structured interviews. Findings -- Analysis resulted in seven themes; the importance of safety, negative experiences of the Home Office, support, emotional effects, significance of family, hopes for the future and the positive experiences of living in the UK. Research limitations/implications -- Asylum seekers largely left their countries of origin to escape conflict, persecution, violence, arranged marriages and rape. They reported safety as a key concern and for this reason they were scared to return home. Practical implications -- The research found Asylum seekers have fled traumatic situations and then have a difficult time in the UK. A more compassionate and supportive approach is needed. Policy recommendations are made with the aim of improving service responses. Social implications -- The research demonstrates that the public understanding of asylum seeking does not match asylum seekers' experiences and increased knowledge may help to improve this (mis) understanding. Originality/value -- There is currently a lack of literature and empirical investigation of this subject area, so this research makes a contribution to the field of understanding asylum seekers' experiences. The paper's focus is original and important combining asylum seekers' accounts of their experiences following arrival in the UK. This subject is strategically important due to the pressing need to develop holistic and culturally sensitive research, which bridges and informs academia, more sensitive service responses and civil society. [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]

Background: Healthcare and support workers play a pivotal role in delivering quality services and support to people seeking sanctuary who have experienced poor physical and mental health linked to previous trauma, relocation and loss of freedoms. However, they often encounter various challenges in their daily work, ranging from communication barriers to resource constraints. This qualitative study seeks to delve into the perspectives of healthcare and support workers' experience of workarounds, employed to overcome barriers to providing care. Aim: This study aims to describe healthcare providers', practitioners' and health and third sector support workers' views on barriers and workarounds to providing care for people seeking sanctuary, to inform policy and practice. Design: A qualitative study was carried out using semi‐structured telephone interviews. Setting: This study focused on primary, secondary, community and specialist National Health Service (NHS) support services for people seeking sanctuary in Wales, United Kingdom (2018). Method: We interviewed 32 healthcare providers, practitioners and support workers employed by primary care and third sector organisations. Our approach involved obtaining verbal informed consent before digitally recording and transcribing all interviews. To analyse the data, we used the Four Levels of Change for Improving Quality model as a guiding framework for interpretation. Results: Our study findings reveal that certain respondents expressed challenges in meeting the needs of people seeking sanctuary; notably, their experience of delivering care differed by care settings. Specifically, those involved in providing specialist NHS care believed that there was room for improvement. Mainstream primary, secondary and community health practitioners faced limitations due to resource constraints and lacked tailored information to address the unique circumstances and needs of sanctuary seekers. To address these gaps, workarounds emerged at both individual and local levels (team/departmental and organisational level). These included establishing informal communication channels between providers, fostering cross service collaboration to fill gaps and adapting existing services to enhance accessibility. Conclusion: Understanding healthcare providers', practitioners' and support workers' perspectives offers invaluable insights into ways to enhance healthcare delivery to sanctuary seekers. Acknowledging challenges and harnessing innovative workarounds can foster a more effective and compassionate service for this vulnerable population. Patient or Public Contribution: The HEAR study actively involved public contributors in the design, delivery and dissemination of the research. Two public contributors (S. M. and G. R.) who had personal experience of seeking asylum served as study co‐applicants. They played pivotal roles in shaping the research by participating in its development and securing funding. Alongside other co‐applicants, S. M. and G. R. formed the Research Management Group, overseeing study delivery. Their contributions extended to strategic decision‐making and specific feedback at critical junctures, including participant recruitment, data collection, analysis and reporting. Additionally, S. M. and G. R. were instrumental in recruiting and supporting a team of peer researchers, enhancing respondent participation among people seeking sanctuary. To facilitate effective public involvement, we provided named contacts for support (A. K. and R. F.), research training, honoraria, reimbursement of expenses and accessible information in line with best practice. [ABSTRACT FROM AUTHOR]

Since the events of 9/11 in the US in 2001 and, four years later, the 7/7 London bombings in the UK, warnings of terrorist attacks are high on the public agenda in many western countries. Politicians and tabloid press in the UK have continued to make direct and indirect connections between asylum seekers, terrorism and crime. This has increasingly resulted in harsh policy responses to restrict the movement of 'third-world' nationals, criminalisation of immigration and asylum policy, and making the violation of immigration laws punishable through criminal courts. This paper largely highlights the narratives of five asylum seekers who committed 'crime' by breaching immigration laws and were consequently treated as 'dangerous criminals' by the state authorities. More importantly it shows how these individuals experienced this treatment. The aim of this paper is to give voice to the victims of state abuse, claim space for victim agency, gather victim testimonies, challenge official explanations and in the process confront criminal and racist state practices. [ABSTRACT FROM AUTHOR]

Abolishing 'modern slavery' has now achieved international policy consensus. The most recent UK initiative – the 2015 Modern Slavery Act (MSA) – includes amongst other aspects tougher prison sentencing for perpetrators and the creation of an independent anti-slavery commissioner to oversee its implementation. However, drawing on research into forced labour among people seeking asylum in England, this article argues that when considered alongside the UK government's deliberate creation of a 'hostile environment' towards migrants, not least in the Immigration Acts of 2014 and 2016, state action to outlaw modern slavery is flawed, counter-productive and disingenuous. We show how the MSA focuses only on the immediate act of coercion between 'victim' and 'criminal', ignoring how the hostile state vulnerabilises migrants in ways that compel their entry into and continued entrapment within severe labour exploitation. [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 article explores externalization schemes regarding asylum claims that have been proposed by Denmark and the United Kingdom in relation to Rwanda. Some of the details, issues and impediments that exist regarding implementing such schemes are examined here. It shall be seen that despite the fact that the countries in question are two independent states, their relationships to certain supranational and international structures means that there may potentially be complications and obstacles in their attempts to implement policies relating to border security and asylum which they believe are in their national interest. [ABSTRACT FROM AUTHOR]

This paper presents and analyses the poem 'Tea and Bread'. It is about content and process, about a struggle for survival as an asylum seeker in a UK city and about exploring poetic transcription, as pioneered by sociologist Laurel Richardson, as representational practice in public health. The asylum seeker, known by the pseudonym of Peter, was interviewed as part of a project to compare the destitution of the past with that of today. [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]

Background: Refugees and asylum seekers present with high levels of post-traumatic stress disorder (PTSD), whilst little research has been conducted to assess the effectiveness or acceptability of psychological interventions for this group. Imagery rescripting is effective in reducing distressing intrusive memories within a range of conditions. The current study evaluates this approach for the treatment of PTSD in refugees and asylum seekers within a UK NHS service. Aims: To evaluate the clinical outcomes of using imagery rescripting for the treatment of PTSD in UK-based refugees and asylum seekers. Method: Ten adult service-users from an NHS specialist service with a primary diagnosis of PTSD were recruited as part of routine service delivery. A multiple baseline design was used with participants randomly allocated to a baseline varying from 5 to 9 weeks. A baseline wait-period was followed by up to five sessions of psychoeducation and treatment preparation, in turn followed by up to 10 sessions of imagery rescripting. The Post-traumatic Symptom Scale (PSS) and Physical Health Questionnaire-9 (PHQ-9) were collected every week during baseline, at end of treatment and weekly for 5 weeks after treatment, and again at 12-week follow-up. Data were analysed with mixed regression. Results: Results indicate a significant improvement both in PTSD symptoms and mood, and that this was attributable to the imagery rescripting phase of the intervention, and not the passage of time or non-specific therapy factors. Conclusions: Evidence indicates imagery rescripting to be a safe and effective treatment choice for PTSD in refugees and asylum seekers. [ABSTRACT FROM AUTHOR]

The process of seeking asylum is complex and often leads to extended periods of uncertainty and liminality for people awaiting decisions on their status. Occupational engagement—defined as meaningful activities and roles that bring purpose and agency to one's life—may be a key driver for mental health recovery for marginalized populations, including asylum seekers with traumatic experiences pre- and post-migration. This study aimed to clarify how occupational engagement impacts on mental health and wellbeing and how asylum seekers maintain engagement in occupation in the context of socio-political constraints of the asylum process. We explored the occupational experiences of 12 clients of one human-rights charity, utilizing community-based participatory research methods. Participants completed group mapping sessions where they depicted routine journeys taken to perform occupations in London, which included discussion around the significance of their journeys. Four participants also completed additional "walking maps"—semi-structured interviews which occurred along a selected "occupational journey" they identified as meaningful to their wellbeing. All data were analyzed using thematic network analysis. Findings revealed that engagement in routine occupations within safe, social spaces positively affects the mental wellbeing of asylum seekers by promoting competence, agency, and feelings of belonging. The liminal space of the asylum process meant that participants' occupational engagement was limited to 'leisure' activities but was still critical to establishing forms of agency associated with their wellbeing. Implications for programs and interventions responding to the needs of asylum seekers are discussed. [ABSTRACT FROM AUTHOR]

Background/Aims For refugee women, pregnancy and early motherhood can exacerbate poor underlying health, poverty, and deprivation. Despite the wealth of research exploring the experiences of pregnant refugee women, maternity care providers remain unprepared for their unique needs. The aim of this study was to ask what refugee women require from maternity care, reduce adverse risks, and improve maternity care experiences Methods Secondary analysis of focus group data from refugee women as part of the 'What women want' White Ribbon Alliance campaign. Results Three key themes emerged: feeling safe in the maternity system and in their communities; fair and equal access and treatment in maternity care and the asylum system: building a future in the UK. Conclusions Midwives need additional training and education to understand the wider issues of the negative discourse around migration and being an asylum seeker and use this knowledge in practice when caring for women to help them feel safe. [ABSTRACT FROM AUTHOR]

Background: Asylum seekers and refugees (AS&Rs) experience impaired mental health and wellbeing, related to stresses in their country of origin, experiences in transit and reception on arrival, including significant barriers to accessing mainstream services. Their contact with health care is often crisis-driven and mediated through non-governmental organisations (NGOs). Problem Management Plus (PM+) is a psychosocial intervention recommended by the World Health Organisation to address distress experienced by adults affected by humanitarian crises. We are investigating its application for the first time in a high-income country.Methods: In a pilot randomised controlled trial (RCT), PM+ will be delivered to AS&Rs in contact with NGOs in Liverpool City Region, UK by lay therapists who have lived experience of forced migration. Following systematic review and stakeholder engagement, PM+ has been adapted to the local context, and lay therapists have been trained in its delivery. We will assess the feasibility of conducting a three-arm RCT of five 90-min sessions of PM+, delivered individually or in groups by lay therapists to AS&Rs experiencing emotional distress and functional impairment, compared with each other and with usual support offered by local NGOs. Distress and impairment at baseline will be measured by the Hospital Anxiety and Depression Scale (HADS) and the WHO Disability Assessment Schedule (WHO-DAS). We aim to recruit 105 participants, 35 per arm. Primary health outcomes are anxiety and depressive symptoms at 3 months, measured by HADS. Secondary outcomes include subjective wellbeing, functional status, progress on identified problems, presence of post-traumatic stress disorder and depressive disorder and service usage. Longer-term impact will be assessed at 6 months post baseline, on the same parameters. We will assess the feasibility of conducting a full RCT in relation to the following elements: recruitment and retention of lay therapists and study participants; fidelity of delivery of PM+; and suitability of the study measures, including any linguistic or cultural barriers.Discussion: We will use these findings to specify the parameters for a full RCT to test the effectiveness and cost-effectiveness of PM+ in reducing emotional distress and health inequalities, and improving functional ability and wellbeing, amongst asylum seekers and refugees.Trial Registration: ISRCTN, ID: ISRCTN15214107. Registered on 10 September 2019. [ABSTRACT FROM AUTHOR]

Copyright of Kriminologisches Journal is the property of Julius Beltz GmbH & Co. KG Beltz Juventa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The past five decades have witnessed a dramatic growth in immigration controls. The external controls have expanded, but at the same time, there has been a proliferation of internal control measures. The British state has increasingly resorted to using penal machinery to punish people who violate immigration laws. Individuals can now be prosecuted under the criminal law and receive custodial sentences for immigration crimes. This article draws upon narratives, interviews and experiences of asylum seekers who were imprisoned for such crimes, in order to understand how their trauma is exacerbated and ways in which injuries are strategically and deliberately inflicted by the state and built within legal and policy frameworks. It draws attention to the racist nature of the crimmigration system and production of violence. [ABSTRACT FROM AUTHOR]

"How could she ever put the terrible pictures in her head into words?" (Naidoo, Truth 51). This question is at the heart of Beverley Naidoo's The Other Side of Truth (2000), which narrates the trauma of Nigerian asylum seeker children Sade and Femi as they flee to Britain. Speech and silence are ambivalent within the text, fluctuating in meaning dependant on the social context in which they are enacted. Showing this text to be primarily a narrative of activism, I explore how Naidoo's representations of trauma inform her critique of the British immigration system. This text invites a reading that draws on recent postcolonial theories of trauma. Using both textual and paratextual analysis of the novel and Naidoo's archive, held by Seven Stories: The National Centre for Children's Books in Britain, I draw on Greg Forter's model of psychosocial trauma to demonstrate that the trauma the protagonists face is a result of their encounter with a racist society and bureaucracy. Reflecting Adrienne Kertzer's claim that social justice should be central in trauma narratives for children, Naidoo shows healing from trauma to be the locus of political awakening for both characters and implied reader. The aim of this article is to integrate contemporary models of postcolonial trauma with an understanding of the activist nature of Naidoo's work, showing that in this sort of children's trauma narrative, the site of healing from trauma is simultaneously the site of social change. Since the trauma that the child protagonists face is a social phenomenon, the speech that allows the children to begin to heal is similarly socially situated, and their healing is synonymous with social justice. [ABSTRACT FROM AUTHOR]

Children experiencing persecution, torture, ill-treatment, exploitation and violence are compelled to flee across international borders to seek protection in another state. When a child seeks international protection, the framework of rights under the Convention on the Rights of the Child and the Convention Relating to the Status of Refugees should guide a state to determine the child's status and protection needs. However, a child's best interests and right to protection may clash with a state's interest in immigration control. Increasingly, states are implementing strict laws to discourage irregular migration and to encourage those without leave to remain to return to their countries of origin. Such laws or policies have an impact on people seeking international protection, including children. The UK government's 'hostile environment' policy is an example of this and applies to all adults and children who enter the UK irregularly and have no right to remain. I argue that the UK's approach violates its international obligations under the Convention on the Rights of the Child. This article analyses how the children's rights framework, in particular the 'best interests' principle, is able to challenge the UK's 'hostile environment' policy. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether the mental health of unaccompanied asylum-seeking children (UASC) was negatively affected by having their ages disputed and being detained. Method: Participants within this cross-sectional study were 35 UASC, aged between 13 and 17 when they were detained. Some years later, a team of child mental health professionals interviewed them to assess their current mental health and to determine, as far as possible, the impact that having their age disputed and being detained may have had on their mental health. The Structured Clinical Interview for DSM-IV (SCID-IV), Reactions of Adolescents to Traumatic Stress (RATS), Stressful Life Events (SLE) and Detention Experiences Checklist–UK version (DEC-UK) were administered. Results: The vast majority of UASC reported being negatively affected. Based on diagnostic interviews using the SCID-IV, self-report measures and contemporaneous records, the professionals reported a diagnosis of post-traumatic stress disorder (PTSD) developing in 29% (n = 10), PTSD exacerbated in 51% (n = 18), major depressive disorder (MDD) developing in 23% (n = 8) and MDD exacerbated in 40% (n = 14). A total of 3 years post-detention, 89% (n = 31) met diagnostic criteria for psychiatric disorders and reported high PTSD symptoms. Conclusion: There was a high prevalence of psychiatric disorder. The additional stress of age dispute procedures and detention was judged to have been harmful. [ABSTRACT FROM AUTHOR]

Introduction: Seeking asylum creates circumstances that impact significantly on occupational opportunities, leading to negative outcomes for individuals, families and the host community. Understanding the specific meaning of occupation during this major life transition provides valuable insights regarding occupation cross-cuIturaIly, during transition or under socio-legal restrictions. Method: This study employed a phenomenological approach, using a series of in-depth interviews to illuminate the role of occupation in the everyday lives of 10 participants. Findings: All participants spoke of the challenges of the asylum process, and the powerful drive to keep busy. They each identified the special role of occupations done for the benefit of others - family, network or community - linking these with cultural ideals and their own desired outcomes of value and purpose. Conclusion: Occupation has enormous potential for enhancing post-migratory experiences, but the choice of occupation is also important. People strive to move beyond simply 'keeping busy' to find occupations of real meaning that foster connections and purpose, and in particular feed their need to feel valued. Occupations undertaken for the benefit of others connect with culturally appropriate collectivist ideals, and seem to do more to promote 'doing, being, belonging' and 'becoming'. [ABSTRACT FROM AUTHOR]

Background: Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities.Methods: For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status.Results: The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation.Discussions: Macro- and micro-level intersections of accustomed societal beliefs, practices and norms, broad-level legislation and policy decisions, and health care and social services delivery methods have affected the health and health care experiences of forced migrants that reside in the UK. Research highlights how 'minoritization processes,' influencing the intersections between social identities, can hinder access to and delivery of health and social services to vulnerable groups. Similar findings were reported here; and the most influential mechanism directly impacting health and access to health and social services was legal status.Conclusions: Equitable health care provision requires systemic change that incorporate understandings of marginalization, 'othering' processes and the intersections between the past histories and everyday realities of asylum seekers, refugees and persons without legal status. [ABSTRACT FROM AUTHOR]

This is the first study undertaken in the UK that investigates the notion of professional identity among practitioners who work with asylum seekers and refugees. Drawing on a social constructionist epistemology and a Foucauldian theoretical and methodological framework of power and discourse, I analysed extracts from semi-structured interviews that were conducted with eight specialist professionals who have worked with this population. The findings of this study suggest that the notion of professional identity among these practitioners envelops a social and political activist stance and a deep sense of commitment towards promoting social change within the wider community. Likewise, clinical work with refugees combines professional knowledge and values with a politicised involvement that fosters a psychosocial perspective on clients' distress and difficulties. [ABSTRACT FROM PUBLISHER]

Background: Many asylum seekers have complex mental health needs which can be exacerbated by the challenging circumstances in which they live and difficulties accessing health services. Regular moderate physical activity can improve mental health and would be a useful strategy to achieve this. Evidence suggests there are barriers to engaging black and minority ethnic groups in physical activity, but there is little research around asylum seekers to address the key barriers and facilitators in this group.Methods: A two stage qualitative study used semi-structured interviews underpinned by the Theoretical Domains Framework. The interviews were conducted in voluntary sector groups in four towns/ cities in Northern England. Purposive sampling recruited 36 asylum seekers from 18 different countries. Interviews were audio recorded, transcribed verbatim and subject to framework analysis. Stage two involved a nominal group technique with five key stakeholders including asylum seekers and those that work with them. They followed a four stage process to rank and reach consensus on the key barrier to undertaking physical activity/ exercise that could be addressed locally through a future intervention.Results: A number of barriers and facilitators were identified including a lack of understanding of the term physical activity and recommended levels but knowledge of the health benefits of physical activity/ exercise and the motivation to increase levels having engaged with activities back home. Living as an asylum seeker was considered a barrier due to the stress, poverty and temporary nature of living in an unfamiliar place. The outcome of the nominal group technique was that a lack of knowledge of facilities in the local area was the prevailing barrier that could be addressed.Conclusions: Public health practitioners could develop interventions which capitalise on the motivation and knowledge of asylum seekers to encourage an increase in physical activity which may in turn reduce the breadth and depth of mental health needs of this group. [ABSTRACT FROM AUTHOR]