Refugee children deserve to get the mental health support they need
The deaths of 27 migrants in the Channel have focussed the national consciousness on the issue of migrant rights and the perilous journeys they take.
But long before refugees embark on dangerous Channel crossings in fragile boats, many of them will have already spent months or even years journeying across continents, compounding the suffering they endured in fleeing their families, homes and communities. Some will have also been victims of ill treatment by smugglers’, or worse, they will have “earnt” their way to Europe through slavery, prostitution or enforced labour at the hands of people traffickers.
Which means that even after their physical journeys end, for many refugees their journeys do not end there.
This is especially true for unaccompanied asylum-seeking children (UASC) for whom the upheaval of leaving loved ones and witnessing tragedy and horror cannot be overstated.
Even arrival can be a traumatic experience for unaccompanied children who may be separated from the people who travelled with them. They find themselves in an unknown country, with people whose language and culture they don’t understand and without the supportive relationships they had at home. In many cases, years of education will have been missed. Sleep and eating patterns may take years to regulate. The process of settling and mending takes time and the symptoms of mental health distress can, in some cases, only manifest later. Some will need specialist help.
Support for these extremely vulnerable children is 'inconsistent' and 'inadequate'
However, according to the findings of a small new study into what mental health support is available to refugee children arriving in the UK – Mental Health Support for Child Refugees - these children “enter a complex and often bewildering system”. What emerges from the report is that, while there is a great deal of expertise around the country and dedicated professionals play a vital and often transformative role in supporting these children, waiting lists for mental health services are long, services are not always easy to access and they are often over-stretched and under-resourced.
Consequently, support for these extremely vulnerable children is “inconsistent” and “inadequate” with “some local authorities lacking the support, resources and specialist skills”. This leaves some refugee children without the therapy and support services they desperately need.
The report highlights a serious shortage of language and trauma specialists with expertise in working with children. It found that some services, including NHS services, can’t engage a child in therapy because of a lack of interpreters, who, when available, are often sourced from agencies and have no background in mental health. In addition, more mental health training is needed for social workers and all professionals involved in a child’s care.
The report specifically highlights two parts of a typical UASC’s journey through care as especially difficult and needing additional support. On arrival asylum interviews “can be re-traumatising” and initial health assessments are not always adequate for identifying mental health difficulties or those at risk of developing mental health problems. Again at 18, when there is usually a reduction in support from children’s services and asylum applications may still be ongoing, additional support may be needed. There is also a need to monitor mental health on an ongoing basis as some issues may not manifest until later.
In April 2019, major charities, including UNICEF, the Children’s Society and the NSPCC, wrote to the UK government about their concerns that gaps in mental health provision were causing some refugee children to self-harm and in some cases to take their own lives. They cited the suicides of at least two unaccompanied refugee children who had arrived in the UK from Africa after fleeing conflict. This new report suggests those gaps still persist.
I am reminded of a young refugee boy whom I met in a camp in Calais. He had fled Aleppo after witnessing his father being killed by a bomb just a few yards from where he stood. His trauma was visible.
Following the Taliban take-over, it is inevitable that we will be welcoming increasing numbers of Afghans in coming months who have fled for their lives and witnessed terrible horrors. The children among them deserve to get the help they need.
Lord Dubs is a Labour peer.
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