We often have service users with complex mental health issues come to us saying their counselling sessions have been ended early because they “talk about the Home Office too much”. This not only creates a deep mistrust of statutory mental health services, but it is indicative of one of the main barriers asylum seekers and refugees face in the UK – actually being able to access mental health support that is trauma-informed and understands the challenges asylum seekers and refugees face.

Accessing mental health services

When people are ready to ask for help with their mental health, they have already taken a massive step. Asking for help can be extremely difficult, especially if you are dealing with language barriers, which many of our service users are. First, they may have to speak to their GP about how they are feeling. However, many service users are disappointed that after disclosing how they are feeling, they are then told they will have to wait for a referral into a statutory mental health service.

During this wait time, some service users experience a re-traumatisation from having to speak about their trauma, and many have experienced panic attacks, flashbacks, and episodes of dissociation or psychosis will waiting for support. Once the initial assessment with a mental health service takes place, many services users have to wait upwards of 4-6 months to begin, and depending on the language you require for interpreting, this could be longer. That is a very long time to be experiencing panic attacks, flashbacks, or other symptoms of what could be complex PTSD.

Imagine waiting all of those months, finally accessing counselling, and then being told that you talk about the Home Office too much and aren’t ready for counselling. If you fear that your asylum claim is keeping you safe, and that being returned home could be dangerous, or potentially deadly, how could you not talk about the Home Office? 

Imagine being offered only five sessions, and then being told in the second session to disclose your trauma so it can be worked through in time. Who would feel comfortable opening up about such trauma, only to be told that a month later the sessions would be done?

Accessing mental health support is extremely difficult, even for those of us who speak English and who are familiar with the UK healthcare system. For our service users, language barriers, and misinformation on the part of the healthcare system about the entitlements of asylum seekers make it even more draining and complicated.

Mental health services that are untrained in the needs and experiences of the client group

Mental health services should reflect on the barriers their services are putting up that may impact the ability or desire for asylum seekers and refugees to seek and access mental health support. Where possible, staff training on what the barriers are that asylum seekers and refugees face in the UK would be helpful, as well as training on the asylum process itself, and how to provide trauma-informed mental health support.

Trauma-informed, holistic support should be at the centre of mental health support. What do we mean by trauma-informed? Mental health that is trauma-informed recognises that most people have experienced trauma and looks to find the presence of trauma and trauma symptoms in client’s lives. Essentially, it understands that trauma plays a huge role in an individual’s life and seeks to ensure that both the person providing support, and the client, are supported, as both probably have trauma they are recovering from. By holistic support, we mean that every person is different. Asylum seekers are not a homogenous group of people, nor are refugees. Each person has had unique experiences in life and will need different things from their mental health support. Support that doesn’t allow for differing experiences is not going to work for the many.

Mental health services should plan for how they can break these barriers down for this client group. We know that asylum seekers live on inadequate amounts of support. That means clients have to prioritise their money to make it go as long as possible – and travelling by bus or train or taxi is expensive. Is there anything mental health services can do to help clients get to appointments? If we are offering virtual sessions, can we offer phone top-up vouchers? These are all questions that should be looked at in order to provide support that is both trauma-informed and asylum seeker and refugee aware.

Impact on the mental health of asylum seekers and refugees

Statistics from The Mental Health Foundation on the mental health of asylum seekers and refugees show that 61% of asylum seekers in the UK will experience serious mental health issues, and that they are five times more likely to need mental health support than the general population, yet they are less likely to receive support.

Mental health services need to do better to provide the right kind of support to asylum seekers and refugees asking for help that will allow them to engage in mental health services feeling welcomed, safe, and in full agency over their long-term recovery from trauma and mental health issues.

Our services

We provide mental health support for our service users that is trauma informed. We recognise the impact of the asylum system on their daily lives and create a safe space for them to speak about their concerns. We do this through 1:1 support and group support, as well as working closely with our other colleagues to provide a holistic support system across the organisation.

We allow for flexibility and recognise that important things may come up at the last minute, and we provide bus passes for our service users so that they can travel to and from our support.

We work with interpreters so that service users can feel confident fully expressing themselves, and we provide support for our service users around accessing statutory health services.

During the pandemic, we also delivered essential items, such as clothing, food, toys, and cleaning supplies, because we recognise the hierarchy of needs, and understand that without basic necessities, it would be highly unlikely for anyone to be able to engage in mental health support.

We recognise that each of our service users have different stories, perspectives, hopes, and dreams, and we are guided by their feedback on how best to provide them support, as we also recognise that they are experts with lived experience that are best suited to advise on the needs and experiences of asylum seekers and refugees.

We hope that in the coming years, more services will commit to being trauma informed and aware of the needs of asylum seekers and refugees so that accessing these vital services will be one less barrier that they have to face on the road to safety and recovery.

We thank our service users for all they share with us, and we remain committed to providing relevant, trauma-informed, and holistic support across RWC.

October 2021

For more information about mental health support please visit:

Maternal Mental Health in the Asylum Seeker and Refugee Community Q&A