27th July 2021

As part of Refugee Week 2021, we collaborated with the Maternal Mental Health Alliance for a Twitter Q&A session to draw attention to the needs of asylum seeking and refugee women. 

The needs of asylum seeking and refugee women are particularly complex due to factors occurring before and during their journey including but not limited to sexual violence, domestic abuse, female genital mutilation and forced abortions. In addition, navigating a hostile asylum system results in this group of women requiring specialised care and support. 

MMHA: What are the unique needs of asylum-seeking and refugee women when it comes to maternal mental health? 

RWC: Refugees and asylum-seeking women face practical and cultural barriers which can prevent them from accessing support, including, but not limited to,:

• Limited English 
• Navigating a hostile asylum system
• The stigma around seeking mental health support
• Lack of social support
• Poverty/economic hardship.

In addition, refugee and asylum-seeking women can face discrimination and structural racism within the healthcare system, such as:

• Lack of mental health assessments for BAME women.
• Insensitive and/or racist, ethnocentric comments from healthcare professionals.
• The assignment of men interpreters.

Navigating statutory services and knowing who to ask for help can be really challenging. Counselling waitlists are long, the needs of these women aren’t understood and there is a lack of specialist services for women who have suffered female genital mutilation (FGM) or sexual violence.

There are inappropriate tools for this group of women for gauging mental health such as the Edinburgh Scale, used to screen for postnatal depression (PND). UK scales may not necessarily be culturally relevant and women may have a challenging time relating to or identifying that they are experiencing symptoms, or that these symptoms indicate PND.

Services may homogenise this group, even though asylum-seeking and refugee women are an incredibly diverse group of people with completely unique needs, experiences, languages, and cultures.

MMHA: What effects will the New Immigration Plan have on the maternal mental health of refugee and asylum-seeking women?

RWC: The full impact has yet to be seen, but it’s likely to penalise women who haven’t entered through “safe and legal” routes and reduce their ability to get refugee status. The Temporary Protection Status (TPS) will also increase stress and vulnerability, and make it difficult to plan for the future.

The no recourse to public funds attached to the TPS means already isolated mothers will have no safety net if they are unable to work or support themselves and their children. This also increases the risk of exploitation, domestic abuse and deprivation.

Women’s immigration status is a huge stress for them during pregnancy. If fewer women are able to claim asylum, many won’t have access to the National Asylum Support Service (NASS) and may be too afraid to come forward for maternity care.

There will be added pressure for women to disclose trauma and gender-based violence early in their asylum claims. Survivors of trauma need time and support to make these disclosures to avoid re-traumatising. The impact on pregnant women will be particularly acute.

MMHA: What reforms do you think are necessary to ensure equal access to mental health care during pregnancy for asylum-seeking and refugee women?

RWC: Refugee Women Connect recommends removing all NHS charges for maternity care, so women aren’t scared to come forward and we can ensure medical professionals and other staff understand what asylum is. We also recommend offering all pregnant asylum seekers and refugees Continuity of Care with specialist teams trained to respond to the particular challenges faced by displaced pregnant women.

A faster and fairer asylum decision will mean not being stuck in immigration limbo. The effective use of interpreters and health care professionals committing to providing longer appointments and explaining the maternity care process in greater depth will help.

MMHA: Why do you think organisations like Refugee Women Connect, and others, are important to provide refugee and asylum-seeking women with maternal mental health support?

RWC: Refugee Women Connect is committed to working in a trauma-informed, holistic way, so individual needs are understood before offering support. It’s imperative to understand the trauma of the UK asylum system to effectively support individuals and appreciate the impact it has on the mental health of refugees.

We can provide the support that considers the barriers that we know asylum-seeking and refugee women face and try to break those barriers down so that women have the agency to advocate for themselves. This is essential for improving mental health.

We recognise the diversity within asylum-seeking and refugee communities and understand there are many different experiences, hopes, dreams and personalities that shouldn’t be conflated into a homogenous voice.

MMHA: Women who are seeking sanctuary in the UK are much more than just their immigration status. How can organisations work with women to support them as a whole person?

RWC: It’s important to view women as a whole person not just as asylum seekers and refugees. If you don’t understand where someone has come from, or how they currently feel, you won’t be able to help them reach a safer, more relaxed sense of self and belonging.

It’s also important to understand the “hierarchy of needs”, someone can be offered a free college course, but if their housing situation is unsafe, or if their basic needs aren’t being met, it’s unlikely they’ll be able to focus on the course.

We’ve repeatedly heard women mention their counselling sessions were discontinued because they “talked about the Home Office too much”. If you live in fear of being returned to a dangerous situation, how can you be expected not to talk about this aspect of your life?

It is the job of the health service, not the person, to adapt in a way that is helpful.

If you are an asylum seeker or refugee within the Liverpool area and you’re struggling with maternal mental health, please contact us.

Alternatively, if you are outside Liverpool, we have complied a list of organisations you can contact below.

 

Asylum seeking and refugee women

• Happy Baby Community (Leeds)

https://www.happybabycommunity.org.uk/research-and-reports

• Refugee Council

https://www.refugeecouncil.org.uk/our-work/mental-health-support-for-refugees-and-asylum-seekers/mental-health-support-for-refugee-women/

 

Supports for Mums and Families

• Netmums

Netmums offer peer support via their Maternal Mental Health Drop-In Clinic.

 

• Action on Postpartum Psychosis

Moderated Forum, click here to find out more.

One-to-one messaging available through the site, just register here

Email: [email protected]

• Association for Post Natal Illness 

https://apni.org

Helpline: 10am – 2pm – 0207 386 0868

Email: [email protected]

 

• Best Beginnings 

https://www.bestbeginnings.org.uk

Free NHS-accredited Baby Buddy app offering evidence-based information and self-care tools to help parents during pregnancy and early stages of parenting.

App users also have access to a confidential, text-based Crisis Messenger which provides 24/7 support for new and expectant parents who are feeling extremely anxious or overwhelmed.

• Welcome to Maternal OCD 

https://maternalocd.org

Peer support available, email [email protected] to arrange

 

• PANDAS 

https://pandasfoundation.org.uk

Helpline open from 9am-8pm every day – 0843 2898 401

Email support available – [email protected]

 

• Petals 

https://petalscharity.org

Petals offers free-of-charge specialist counselling to anyone who has experienced pregnancy or baby loss.

Web: petalscharity.org/counsellingcontact/

Email: [email protected]

Tel: 0300 688 0068

 

• Samaritans 

https://www.samaritans.org

Tel: 116 123 (this is a free telephone number and will not appear on the phone bill)

Web: www.samaritans.org

Email: [email protected]

 

• Tommy’s 

https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbeing/mental-health-during-and-after-pregnancy

Tommy’s has a team of in-house midwives who offer free support and information for women and their families at any stage of pregnancy and after the birth.

Web: www.tommys.org

Helpline: Tommy’s helpline has been closed temporarily but their midwives are answering questions via email, Facebook, Instagram and Twitter.

Email: [email protected]