1. What techniques do your team use to assist people in their healing?

 We 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.

 

2. Does providing mental health support work?

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.

 

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

 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.

 

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.