- A Needs assessment in a refugee mental health project in north-east London: extending the counselling model to community support
- Harris, K; Maxwell, C.
- Larkswood Centre; Thorpe Coombe Hospital
This article describes the model devised by a refugee support psychologist to set up a mental health project in the London borough of Waltham Forest. A needs assessment was undertaken; one of the aims of this was to examine how mental health problems are viewed in various countries of origin, and the strategies for dealing with these problems.
A needs assessment was carried out by the refugee support psychologist in partnership with a variety of local refugee community groups, individuals and support organisations [71 participants in total]. All groups were asked how they felt being in exile affected members of their community, and to suggest solutions to these problems.
Findings are divided into three main sections. The first considers the difficulties of exile, which included: isolation and loneliness which is compounded by language difficulties, the loss of a familiar culture and self-identity, and anxiety regarding immigration status and having to prove the legitimacy of their asylum claim. It is argued that these reactions should be considered by mental health professionals as normal reactions to traumatic experiences rather than as symptoms of psychiatric disorder. Changing family roles were also highlighted, including an increase in domestic violence, children abandoning the traditional values of their parents and the increasing independence of women causing friction within relationships. Reactions to traumatic events in the past were mentioned by respondents, but less than expected. Potential reactions to this were lack of concentration and social withdrawal. These however are as likely to be as a result of experiences in exile as they are of trauma in the country of origin.
The second section considers community suggestions for interventions. These included: counselling, which was mentioned by many, however this may reflect the length many of the informants had resided in the UK; for many refugees, counselling is an alien concept. Another suggestion was awareness raising, to help inform communities about mental health problems, and deal with the stigma associated with it. One solution was to produce a leaflet in several languages about common reactions to life in exile. Work, hobbies and socialising were seen as coping strategies and have the potential to solve issues arising from loneliness. Reference was also made to traditional healers as a way of treating illness.
The third section considers the model for action, which should include the following four elements: contact with family members; social support [links to integrated community groups]; strong religious or political ideology; and having a proactive problem solving style. The latter must involve other agencies that can help with legal, housing, employment and training issues. Refugees should be linked to wider networks and groups; and psychologists should actively support these groups, and help build bridges between refugees and the host society.
• The refugee support psychologist should mobilise community organisations, and help them to link in as much as possible with the host society;
• they should become involved in applying for funding for community projects in the area of mental health;
• they should encourage awareness raising of mental health issues with refugees and with health workers;
• they must be sensitive to demands by refugees for counsellors/psychologists of a similar racial or cultural background to their own;
• they must integrate social and political concerns into the therapeutic relationship.
A broader range of interventions for refugee clients with mental health problems should take place than just counselling. Eventually, there should not be a need for a refugee support psychologist, when better links are established with mainstream services and the capacity for addressing psychological needs within community organisations develops [including the knowledge of where to refer people for medical and non-medical concerns].
- Resource Type
- Journal article
- Medicine, Conflict and Survival 16 (2)