The barriers faced by asylum seekers and refugees in terms of access to social care support can be significant. Their voices are not heard and their needs misunderstood and overlooked.
The terms “refugee” and “asylum seeker” are often used interchangeably, suggesting that they refer to the same people. This is not the case. In law, a refugee is an individual to whom the government has offered protection in accordance with the Refugee Convention 1951 an asylum seeker is a person who has asked for protection but has not received a decision on their asylum claim.
Both groups of people may have experienced traumatic events such as torture or the death of loved ones and, once in the UK, they often face poverty and acute anxiety about their legal status. They can also experience racism, social exclusion and isolation, compounded by language barriers.
Several environmental factors shape the social care experiences of refugees and asylum seekers. First, within the context of UK policy and legislation, the provision of social and welfare support for asylum seekers has gradually been removed from the mainstream framework. Additionally, frequent and high-profile changes to legislation have caused confusion about entitlements, creating further barriers to accessing services.
Subsistence levels for asylum seekers are set below normal income support rates, and refugees and asylum seekers do not get the premiums normally paid to families with children, disabled people or older people. A study of organisations working with refugees and asylum seekers by Penrose found that 85% of the organisations interviewed reported that their users experienced hunger 95% reported that their service users could not afford shoes or clothes and 80% reported that their service users were unable to maintain good health.
Although there are no official statistics on the prevalence of disability in refugee and asylum-seeking communities, estimates range from 3% to 10% of the population. Unmet personal care needs, such as difficulties with washing and dressing, are common among disabled refugees and there is a lack of awareness that agencies, such as social services departments, can be approached for help. In other cases, although aware of services, the shame associated with disability acquired through torture prevented individuals seeking help.
Meeting the care needs of disabled asylum seekers is complicated by the fact that they are largely supported outside the mainstream framework and that their entitlements tend to be linked with their asylum status rather than their level of need.
One in six of the public is said to have mental health needs in the case of refugees and asylum seekers this is likely to be much greater. Barriers faced by refugees who need care include a fear that personal problems will be revealed to other members of their community and, in some cases, that it will affect their asylum status. Even if a service user is willing to engage with service providers, this is often hampered by language barriers.
With about one-third of refugees and asylum seekers arriving in the UK without any English language skills (the proportion is even higher for women), communication is a major barrier to accessing social care services.
The disapproving tone of public discourse about asylum contributes to an environment in which negative public attitudes to it exist, even among service providers. Finally, agencies’ lack of information about the numbers, characteristics and needs of local refugees and asylum seekers is a barrier to social care provision.
Against this policy and practice backdrop, social care providers have responded by treating refugees and asylum seekers as part of the larger generic “black and minority ethnic” category, without regard for their distinct experiences and needs. This is also apparent in service planning, where decisions are often made on the basis of data collected according to existing ethnic monitoring categories.
● Penrose, J (2002), Poverty and Asylum in the UK, London: Refugee Council and Oxfam
● Race equality discussion paper 02: The Social Care Needs of Refugees and Asylum Seekers
● The Refugee Council
● Immigration, Asylum and Nationality Bill 2005
● Department of Health (2006), Our Health, Our Care, Our Say: A New Direction for Community Services, social care white paper, London, Department of Health,
● Moving on from Destitution to Contribution, The Joseph Rowntree Charitable Trust
Good practice in service provision to refugees and asylum seekers includes effective partnerships between the statutory and voluntary sectors, and an holistic view of individual needs, which takes into account practical, legal and social issues.
Partnerships with refugee community organisations to plan, design and provide social care services are also beneficial, yet their potential remains untapped.
Here are some recommendations:
● Social care agencies should carry out local mapping and consultation exercises to collect data and information about asylum seekers – consider using flexible and innovative methods to secure their engagement.
● The social care needs of refugees and asylum seekers cannot and should not be met by local authority “asylum teams”.
● The refugee community and voluntary sectors should play a far bigger role in the planning, design and delivery of social care services.
This article appeared in the 23 August issue under the headline “Barriers to support”