Asylum Seekers' Perspectives on their Mental Health and Views on Health and Social Services: Contributions for Service Provision Using a Mixed-Methods Approach

The literature tends to use 'asylum seeker' and 'refugee' interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique position in British society which differentiates them from people with refugee status and which may have implications for their mental health. For example, 'asylum seekers' are supported and accommodated in dispersal areas under the National Asylum Support Service and they are not entitled to work. This mixed methods study investigated asylum seekers' symptoms of psychological distress, using mental health screening questionnaires (N = 29) and asylum seekers' subjective experiences of the asylum process, its potential impacts on their mental health, and participants' suggestions for tackling mental health needs, using in-depth interviews (N = 8). Asylum seekers, refugees and practitioners working with asylum seekers were consulted from the outset regarding the cultural sensitivity of the measures used. Given the potential limitations of using 'idioms of distress' across cultures, interview data provided rich descriptive accounts which helped locate the mental health needs that the asylum seekers experienced in the specificities of each participant's social context. Asylum seekers originated from 13 countries. The results revealed that psychological distress is common among asylum seekers (for example anxiety and post-traumatic stress), but so are post-migratory living difficulties (for example accommodation, discrimination, worry about family back home, not being allowed to work). They also report mixed experiences of health and social care services. These results suggest that asylum seekers' unique social position may affect their mental health. Implications for practice are presented and potential limitations highlighted.