Join us for a Q&A to celebrate World Mental Health Awareness Day!

1. What techniques does Refugee Women Connect use to assist people in their healing?

The Mental Health Team are person-centred, so the techniques we use will depend solely on the needs of the service user and the goals that the service user wants to work towards. Generally, some techniques we use would be identifying cognitive distortions (negative or irrational thought patterns) and then working towards reframing these negative thought patterns to manage things such as anxiety or depression. Some service users like using tools such as thought records or worry trees to explore what issues or thoughts are causing the most distress, while others just want a safe space to talk about how stressful it is to be in the asylum process, and be able to better recognise the impact of this trauma on them, both mentally and physically. 

We also recognise that not everybody is ready or wanting this more complex 1:1 support, so we also run psychosocial group activities where we use creative methods to talk about self-esteem, engage in peer support, and learn more about mental health, coping strategies, and how to access support across Merseyside.

In the Early Action team, we often meet women about whom we know nothing and who come to us with a wide range of disparate needs; they come to our drop-in looking for help and when we sit down with them to complete the registration process they may be very reticent to share information or, conversely, desperate to talk.  We use a strengths-based approach in our work; we focus on individuals’ strengths and help them to prioritise their needs and identify personal and peer resources to help them tackle these.  This is an important part of empowering the women we work with, rather than creating a dependency on Refugee Women Connect or other support services.  We are a multi-disciplinary team and we recognise the importance and interconnectedness of issues such as mental health, housing, legal status etc so it is essential that we work with women in a holistic way to promote their wellbeing: providing information; developing skills; offering 1:1 support where needed; being realistic about the limitations of what is achievable so that we manage expectations and support women to focus on the areas where they can effect positive change.

2. Does providing mental health support work?

Mental Health Team - This is a really tough question to answer, because all of us have different experiences and issues when we enter mental health support, and no mental health professional can ever promise someone that by engaging in mental health support all of their problems or traumas or symptoms will go away. 

What we can say is that engaging in mental health support where you feel safe and the professional is someone you can trust, and who establishes an authentic helping relationship with you is a very important first step towards recovery. That is because feeling safe in this kind of environment allows people to have a voice, and to talk about things that maybe they’ve kept inside for a very long time. It also allows people to explore things about themselves and focus on individual strengths, slowly building self-esteem. It also allows people a space to learn – most of us are not taught symptoms of anxiety and depression, or trauma responses growing up because mental health is still so stigmatised, so it can be very healing to learn that the physical symptoms that manifest in our bodies come from somewhere – and learn how we can recognise them, monitor them, and ultimately manage them to make our daily lives easier.

From an Early Action Team perspective, I would say that the answer to the question “does mental health support work?” is a definite “yes”, assuming that, as outlined above, the support is safe and trusted.  That is because in Early Action we are also looking at the non-mental health impacts of that support. 

It can be incredibly difficult for someone who has experienced significant trauma or experiencing a mental health crisis to notice an improvement in their mental health and wellbeing.  However, once a person engages with mental health support and feels listened to and that their experiences are being recognised, they may well be better able to engage with other issues which are affecting their quality of life.  For instance, they may be able to talk to their GP about an unrelated issue, rather than feeling so overwhelmed by undisclosed and unaddressed mental health concerns that they are unable to discuss anything else.  They may be able to vocalise some of the impact of their mental health difficulties on their daily life, which can be very important for their legal case, for housing applications and for accessing additional support services.  Of course, the reverse is also true!   Supporting a person to address some of these non-mental health challenges may well have a positive impact on their ability to engage positively with mental health support.

So, while engaging in mental health support is unlikely to solve all of a person’s problems, we can say with confidence that it can work towards a person being better able to identify and address other challenges they are experiencing and this can have a huge impact on their wellbeing.

3. How do you address some of the barriers asylum seeking women face in accessing mental health support?

Mental Health Team - We offer flexible and trauma-informed support, based on the needs of each individual service user. Too often women are grouped together as having the same needs because they are asylum seekers and refugees, but within that large group, there are just so many vastly different experiences, cultures, languages, needs, beliefs, traumas, etc. One of the recurring issues our service users face is statutory services being too rigid with appointment times. Often, service users must attend last minute appointments with no pre-warning, resulting in cancelled appointments. If this happens within the statutory sector, support is usually withdrawn quite quickly, but we will always re-arrange an appointment to another time or day if we can. We also offer face-to-face and phone support, so service users can choose if they want to travel to see us or if it’s easier to speak via phone or video call. 

We also understand the impact of the asylum process on our service user’s lives. Many of our service users have their support ended by statutory mental health services because they “talk about the Home Office too much”, which is considered a sign that they are not ready for mental health support. We understand that talking about the Home Office is essential to being able to discuss mental health, because of the impact on mental health that the Home Office has, and we offer a safe space where our service users are in full control of the issues they talk about and will always guide it back to their mental health, recognising symptoms, and learning to manage these in their daily lives.

Early Action Team - We also recognise that practical support can be required to enable asylum-seeking and refugee women to access mental health support; if being supported by Refugee Women Connect, we can assist with the cost of travel to appointments or of data for their phone appointments.  We ensure high quality interpreting support so that women can speak in their first language, and can arrange appointments to take place in a quiet place within our drop-in services if women wish to also access ESOL, social and hot food support the same day.

If women require support from statutory services, we support them to understand their rights and the appropriate referral pathways to access that care, and advocate for them if they are not supported appropriately.  This might be linked to a failure to provide an interpreter for appointments or to accommodate a request for female staff, refusal of service due to staff not understanding the rights of asylum seekers with regard to health care or doctors having insufficient time within the typical appointment to get a full picture of the person’s needs (a particular issue when interpreters are needed), or problems caused by disruption of care when service users are moved out of area at very short notice by the Home Office.

4. What is trauma-informed support?

Trauma-informed support recognises the impact trauma has on an individual’s life. It recognises this impact and responds to it by encouraging individual’s to develop their personal strengths to re-establish personal agency and build resilience. Trauma-informed support also centres the need for an individual to feel safe in order to build resilience, and seeks to always avoid re-traumatisation of the individual. Trauma-informed support is also person-centred, collaborative, and empathetic.

Being trauma-informed means also recognising that all of the above are true not just of service users, but for staff and volunteers as well. The mental health team is made up of staff and volunteers, many of whom have lived experience of anxiety, depression, and trauma, and we engage in reflective peer supervision monthly to ensure we are monitoring our work for signs of vicarious trauma, and the ways in which our personal traumas may present challenges and opportunities for growth within our professional work.

5. What does a typical 1:1 session look like?

A typical 1:1 session begins with looking back at the last week and sharing big events that might have occurred. It would also typically involve discussing what symptoms were most present in the past week and how hard or easy they were to manage. There is usually quite a lot to discuss in terms of events from the week and what that brought up for them, and what symptoms they may have experienced as a result. Then we might discuss a past event or relationship with another person that these present issues are bringing up (if applicable) and we might spend time exploring those feelings and how we can acknowledge them and move on towards recovery. We might also explore coping strategies and discuss personal strengths, recognising the work of the service user in managing their mental health. If goals have been set, we’d also look at the steps the service user is taking to achieve those goals, and discuss anything that might be getting in the way of achieving them. If there are practical needs relating to the asylum process, we may also ask additional questions so that we can refer or signpost the service user to get the support they need, as collaboration is key in trauma-informed care, and we work closely with our colleagues and partner organisations to make sure our service users are able to access the support they need. We try to always end sessions on a positive note, by looking at what progress has already been made, and what tools could be useful in the following week that we can discuss in the next session.

6. How long do you support clients for?

We support our service users for as long as they want our support. We work with some service users for shorter periods of time, maybe because they no longer need support, or because they need more intensive statutory mental health support, or because they are in crisis and need to focus on practical issues before they can focus on mental health. Other service users may need long-term support over several years. Being person-centred and trauma-informed means being very flexible with how long we support people, as all clients have different needs.

Service users can continue to access support from the Early Action team for as long as they wish.  It is not uncommon for people to stop attending our drop-ins for a while, and then come back when their circumstances change.  Women often get in touch because they have received a decision in their asylum case and need information on what to do next, or because they are pregnant and would like to engage with our perinatal services.  Last year, we saw a large number of longstanding service users come back to our drop-ins asking for help due to the Cost of Living crisis and the particular difficulties accessing support with utility bills for those on prepaid meters.  Although a difficult time for the individuals, it was also wonderful to see how much more resilient and able to cope with the challenges these women were than they had been early in their asylum journeys; they knew where to access information and support and were taking action to address the situation they faced.

It is a cause for celebration when women are able to continue with their lives independently and no longer need our regular support, and the most positive outcomes are when service users get back in touch with us to refer someone they have met in their community, or to let us know that they would like to come back as a volunteer.  For us, it is good when we are no longer needed!

Help us to continue supporting the mental health of refugee women in our community, every donation, no matter the size, makes a difference and sends a powerful message of solidarity and compassion. All donations are crucial to support Refugee Women Connect and its valuable work. 

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