Strategic integration areas

Access to health services is important for refugees and asylum seekers arriving in the UK. They may arrive with pre-existing long-term health conditions, or issues may have developed or been exacerbated during the precarious journeys refugees often make to reach safety in the UK. Refugee communities tend to have a higher prevalence of certain health conditions compared to the wider UK population. 

On arrival, health screening and access to emergency treatment is crucial, and refugees and asylum seekers also need support to register with local GPs and dentists. Delays with registrations can prevent timely access to services, especially in the early days following arrival when some refugees and asylum seekers may be housed in temporary accommodation. Some asylum seekers may not access services because of fear and misconceptions about their rights, immigration status and/or asylum claim, and potential costs, which can lead to undiagnosed or untreated health issues in the refugee population. 

The NHS system may differ from healthcare provision that refugees were used to in their countries of origin, so they need information and guidance about how the NHS works and support with accessing services. At the same time, NHS and other relevant staff require specific training about the health and wellbeing needs of refugees and asylum seekers and the barriers that they face. In particular, services should be culturally sensitive and trauma-informed, and use good quality, professional interpreting and translation services. There are significant gaps in the way that some providers in the region deal with language and communication barriers, and the NHS has developed extensive and in-depth guidance about commissioning and using language services in health care settings. The negative impacts of health providers failing to provide good quality interpreting cannot be underestimated. 

Barriers to health and wellbeing

• Fear or mistrust of authority

• Lack of supportive networks such as family and friends

• Language, especially the lack of good quality interpreting in some services

• Lack of information about health care systems and how to access them

• Services are not culturally sensitive or trauma-informed

• Stigma due to different cultural norms and understandings

Health and wellbeing providers also need to be aware of the health needs of specific refugee groups such as women, LGBTQI+, older or young people and people with disabilities. Health and social care advocacy initiatives can play an important role in ensuring that the experiences and perspectives of different refugees are communicated to health professionals, and that services respond and adapt to meet the intersectional needs of all refugees. 

Some health and wellbeing issues such as disability, FGM, sexual health and mental health may be sensitive, or even taboo, subjects for refugees in their countries of origin, which has an impact on their understanding of, and access to, services. Refugees and asylum seekers with disabilities face specific barriers in accessing appropriate services, support and accommodation. In particular, the asylum support system does not always have the capacity or flexibility to meet their needs. 

Mental health issues are common among refugees and asylum seekers as a result of the traumatic experiences of forced displacement. Yorkshire and Humber has developed many examples of best practice in specialist refugee mental health services. However, demand exceeds provision in the region, so more specialist provision is needed as well as more accessible mainstream mental health services where appropriate. In addition to more formal mental health support, social and wellbeing activities can provide a real lifeline to refugees, as they help build on the skills and resilience that refugees already have, at the same time as reducing isolation by creating opportunities for meaningful connections in trauma-informed settings in their new communities. 

Health and wellbeing priorities

• Refugees and asylum seekers are screened as soon as possible after arrival, have access to emergency treatment and immunisations, and are supported to register with local GPs and dentists

• Refugees and asylum seekers, including more vulnerable groups such as women and people with disabilities, know their rights, understand how the NHS and social care works in the region and can access suitable services

• Refugees and asylum seekers have access to good quality mental health and wellbeing services that meet their needs, including wellbeing groups and activities

• All health and wellbeing services provide good quality, professional interpreting and translations services, following NHS guidance

• Refugees and asylum seekers have access to health promotion and awareness services, and providers are actively engaging in eliminating health inequalities