The challenges of mental health care provision for traumatised asylum seekers and refugees

Part A
Part A is a literature review of qualitative research exploring the perceived barriers to accessing and engaging with mental health services for asylum-seekers and refugees. A thematic synthesis of the findings from nineteen studies was carried out. Findings indicate two primary analytic themes describing barriers to mental health service utilisation: the perceived misfit of Western mental health services and the fear of opening up. These two analytic themes were composed of seven descriptive themes. The synthesis of findings is discussed in relation to the wider literature. The clinical implications are considered, and future research is proposed.

Part B
Part B is a qualitative research study employing interpretative phenomenological analysis in order to understand the experiences of six asylum-seekers who underwent a clinical assessment in order to have a medico-legal report prepared for use as evidence in their claims for asylum in the UK. Three superordinate themes were identified: tension between negative and positive expectations, therapeutic impact, the pain of having to share and remember. The findings have important clinical implications for clinicians carrying out assessments with asylum seekers and highlight the need for implementing trauma-informed approaches to care within the UK asylum system.