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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]

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]

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]

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]

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 discusses the four-year (2003-2007) research process towards my exhibition and publication "Border Country", which focuses on the experience of immigration detainees (appellant or "failed" asylum seekers) in the UK's "immigration removal centres". I discuss my earlier exhibition "Homes and Gardens: Documenting the Invisible" which focused on the repression in Kosovo under the Miloševic regime, and the difficulties of representing the "hidden violence" which led to the adoption of a particular sound/image structure for the exhibition. I discuss how I then chose to work with a similar sound/image framework for "Border Country" and the aesthetic and conceptual considerations involved. I discuss the decision to expand the focus of the exhibition from one individual detainee to eleven, and to omit the photographic portraits of detainees from the exhibition for ethical and conceptual reasons. I finally produced a juxtaposition of photographs of immigration removal centre landscapes and interiors (devoid of people) with a soundtrack of oral testimonies. The voices of individual detainees could be heard at listening stations within the gallery spaces or on the publication's audio CD. Within this research process I also discuss my interview methodology and questions of power imbalance between photographer/artist and incarcerated asylum seekers. [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]

"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]

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]

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]