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This literature review highlights materials on why asylum seekers and refugees come to the UK. The factors that affects the vulnerability of asylum seekers to human [rights, mental health, health, violence, and access to services.
Asylum seekers and refugees have been subject of many recent media and political attention, but they are often misrepresented and stigmatised (Burnett et al 2001). Since 1951, any country that has signed the UN Convention on Refugees is obligated to consider the application of anyone who claims refugee status and grants the person refuge on basis of the evidence provided (Giner 2007). Each individual case is decided on its merits and failed applicants are deported, however; the UK has signed the European Convention on Human Rights, which forbids torture, inhuman or degrading treatment or punishment (Mann et al 2006). According to (Freedman 2008) other forms of persecution are persistent and long-term: political repression, deprivation of human rights, and harassment. In camps, refugees may have experienced prolonged squalor, malnutrition, lack of personal protection, and deprivation of education (Silove et al).
Asylum seekers and refugees have been forced to flee their country, family, friends, community, job and culture which leads to mental health problems but to a greater extent (Silove et al 2000). Anxiety, depression, stress and post-traumatic stress disorder were found to be the most types of psychological problems in asylum seekers and refugees (Silove et al 2000). However, this could be normal reactions to stress rather than diagnoses of mental illness (Sales 2002). Although systematic research into the mental health of asylum seekers is in its infancy, and methods are limited by sampling difficulties, there is growing evidence that salient post-migration stress facing asylum seekers adds to the effects of previous trauma in creating a risk of ongoing posttraumatic stress disorder and other psychiatric symptoms (Solive et al 2000). According to
Gerritsen et al (2004) examining the prevalence of specific psychological disorder in refugees living in Western country and found that the prevalence of depression, anxiety and PTSD is often high. They find that those affected with depression was 36%, anxiety 28%, and post-traumatic stress disorder was 43% (Mann et al 2006). However; asylum seekers and refugees are not a homogeneous group of people and have different experiences and expectations of health and health care, symptoms of psychological distress are common, but do not necessarily signify mental illness Burnett et al (2001).
The health of refugee children and young people suggests that health needs are complex and that generally, their needs will be similar to adult refugees (Coker et al, 2001). There are a number of factors which affect the health of refugee children and young people; poverty (including poor housing), lack of access to health care pre-exile, difficulty in accessing health services in the UK, lack of interpreters, lack of understanding or recognition of the needs of refugees with disabilities, bullying and racism (Coker et al, 2001). There is also a strong link made between the areas of physical and emotional health (Burnett, et al 2001). Studies of all refugees have found that one in six refugees have significant physical health problems and over two-thirds have suffered from anxiety or depression (Carey-Wood et al, 1995). This figure is likely to include some children and young people. Health is culture dependent (Burnett et al 2001), and both what a young person is able to talk about in relation to their health, and the symptoms they present with may be influenced by their cultural background and current circumstances.
Asylum seekers flee from their countries in fear of persecution and violence (Mann 2006). The experiences which people may have endured include massacres and threats of massacres, detention, beatings and torture, rape and sexual assaults, and witnessing death squads and torture of others; being held under siege, destruction of homes and property and forcible eviction, disappearances of family members or friends; being held as hostages or human shields, and landmines injuries (Fazil 2006). In 2000 it was reported that approximately 1% of the world population were fleeing around 40 violent conflicts (Summerfield 2001). Adults and children have been conscripted into army, and women and girls may have been forced to become sexual slaves (Sales 2002). Organised violence is defined as violence which has a political motive, survivors of torture or organised violence have often been ill treated by government agents such as the army, police, or security forces or other groups perpetrating organised violence, including rebel groups (Barnett et al (2001). States have a duty to prevent, investigate, and prosecute cases of torture, but if those who are supposed to do this are themselves the torturers, then there is no official protection (Phillimore et al (2005). Systematic torture is designed to break the spirit of an individual, but in many countries, the intention is also to intimidate a minority or dissident group or even an entire population (Jara et al (2006).
Asylum seekers and refugees, unlike other overseas visitors, are entitled to all NHS services without payment, yet many say they have difficulty obtaining health care (Burnett 2001). However according to (Fazil 2006) the Department of Health appealed a High Court ruling, which found that, in certain circumstances, asylum seekers can pass the ordinary residence test that confers an automatic right to free NHS hospital treatment or, alternatively, be exempt from charges for hospital treatment after having spent one year in the UK. There is a lack of data on patterns of utilisation of health services by asylum seekers and refugees including mental health, general practitioner’s surgeries represent a point of reference at a time when they have few others, and some GPs see them as frequent attenders (Summerfield 2001).
- Burnett, A. et al (2001) What brings asylum seekers to the United Kingdom Education and Debate.
- Mann C M et al. (2006) Mental illness in asylum seekers and refugees Development and policy.
- Freedman J, (2008) Women’s Right to Asylum: Protecting the Rights of Female Asylum Seekers in Europe Human Rights Review
- Sales R, (2002) The deserving and the underserving? Refugees, asylum seekers and welfare in Britain Critical Social Policy
- Solve D, et al (2000) Policies of Deterrence and the Mental Health of Asylum Seekers Special Communication
- Summerfields D, (2001) Asylum seekers, refugees and mental health services in the UK Cambridge Core.
- Jara G, Female asylum seekers with musculoskeletal pain: the importance of diagnosis and treatment of hypovitaminosis D
- Phillimore et al, (2005) Problem or Opportunity? Asylum Seeker, Refugees, Employment and Social Exclusion in Deprived Urban Areas
- Burnett et al (2001) Health needs of asylum seekers and refugees The BMJ
- Giner R (2007) Estimating the numbers of refugees in London Public Health
- Gerristen et al (2004) Primary care for refugees and asylum seekers The BMJ
- Coker et al (2004) The comfort of strangers: social work practice with unaccompanied asylum seeking children and young people in the UK Child and Family Social Work
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