How can we meet the health needs of child refugees, asylum seekers and undocumented migrants?

Stevens, Amy

doi:10.1136/archdischild-2018-316614

Cited by 18 publications

(24 citation statements)

References 17 publications

(21 reference statements)

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“…GPs are often unaware of current policies and entitlements surrounding healthcare for ASR, as asylum policies can be complex [ 24 , 50 ]. Proof of identity or address are often wrongly demanded [ 23 , 28 ], and rejection creates fears that data would be shared with the Home Office, although data sharing between Home Office and NHS has been abolished [ 41 ]. Healthcare staff rarely have the knowledge of immigration law required to review complex issues of patient eligibility [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…By contrast, unemployed British citizens receive job- seekers allowance of up to £73.10 per week [ 22 ]. However, undocumented migrants or refused asylum- seekers have no access to public funds and cannot open bank accounts or find employment [ 23 ]. Financial assistance gaps are left to charities such as Freedom From Torture, the British Red Cross, and the Refugee Council to fill [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Mental healthcare for asylum-seekers and refugees residing in the United Kingdom: a scoping review of policies, barriers, and enablers

Pollard

Howard

2021

Int J Ment Health Syst

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Background Since 2011, a large influx of asylum-seekers and refugees has put pressure on the UK’s under-resourced national health services and mental health services. Asylum-seekers and refugees (ASR) may experience traumatic events pre-departure, life-threating circumstances on their journeys, and difficulties integrating into host countries related to immigration policies, social isolation, poor living conditions, and unemployment, all of which can significantly affect their mental health. This topic is increasingly important due to the numbers of people seeking asylum and growing concern for their mental health on resettlement. This study examined UK-wide policies and guidance, healthcare practices, barriers, and enablers of mental healthcare for ASR residing in the UK. Methods We conducted a scoping review using Arksey and O’Malley’s 2005 framework, which included semi-structured interviews with stakeholders from non-governmental organisations, academia, UK National Health Service, and community groups. We synthesised and analysed literature and interview data thematically to examine current barriers and potential enablers of ASR mental health support in the UK. Results We included 39 literature sources, of 1,638 identified, and 10 stakeholder interviews. Sources, most published in 2019 (n = 13), included data from England (n = 13), Scotland (n = 3), Wales (n = 3), and Northern Ireland (n = 2) and covered access to care (n = 16), mental health disorders (n = 7), impacts on health (n = 7), barriers to care (n = 13), policies and plans (n = 4), and clinical recommendations (n = 3). Synthesised themes from literature and interviews included existing barriers (i.e. communication difficulties and lack of funding, resources, and political will) and potential enablers (i.e. proposed provision practices, social needs of ASR, and policy changes). Conclusions There is a gap in the literature regarding UK-wide assessment of access and delivery of mental healthcare for ASR in the UK. Time sensitive and culturally appropriate approaches are needed, with greater funding and resource support from the UK Government. This study provides justification for a call to relax hostile environment policies, and for ASR-specific mental health services and support to be considered within the UK. Further research is needed to assess implementation of guidelines across the UK.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mental healthcare for asylum-seekers and refugees residing in the United Kingdom: a scoping review of policies, barriers, and enablers

Pollard

Howard

2021

Int J Ment Health Syst

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“…Em consequência, o aumento na demanda por serviços de saúde e alterações nos padrões de adoecimento e morte da região são problemas que poderão ser observados. Autores afirmam que migrantes são mais vulneráveis, principalmente a adoecimentos por causas infecciosas e parasitárias, o que deve estar relacionado às condições adversas de vida (17)(18)(19)(20).…”

Section: Discussionunclassified

Doenças infecciosas e parasitárias no Brasil de 2010 a 2017: aspectos para vigilância em saúde

Souza

Oliveira

Santos

et al. 2020

Revista Panamericana De Salud Pública

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Objetivo. Apresentar um método para identificar áreas críticas relativas a doenças infecciosas e parasitárias selecionadas para fins de vigilância em saúde, analisando a sua associação a indicadores de pobreza no Brasil. Métodos. Foram mapeadas as taxas de incidência de dengue, doença de Chagas aguda, esquistossomose, hanseníase, hepatite A, leishmaniose tegumentar, leishmaniose visceral, leptospirose, malária e tuberculose. Foram realizadas análises para os anos de 2010 a 2017 a partir de um indicador síntese, calculado como a média dos coeficientes médios de incidência para cada agravo normalizada pela média e desvio padrão durante o período analisado. A estimativa da base populacional foi de 2014. Os coeficientes calculados foram estratificados para classificação dos municípios em criticidade muito alta, alta, média, baixa ou muito baixa conforme cada doença. Também foram selecionados indicadores de diferentes dimensões que expressassem desigualdades socioeconômicas e segregação espacial nos municípios brasileiros, sendo testada a sua associação às doenças em estudo. Resultados. O indicador mostrou que 40,5% dos municípios brasileiros apresentam alta criticidade, sobretudo nas regiões Norte, parte do Nordeste e Centro-Oeste. Os indicadores “proporção de pobreza”, “lixo no entorno”, “esgoto no entorno” e “famílias chefiadas por mulheres” podem aumentar a chance de a localidade apresentar maior criticidade para as doenças. O indicador “esgoto adequado” pode ser considerado potencial fator de proteção. Conclusões. A técnica utilizada foi adequada para orientar ações de vigilância no país e permite a articulação entre vigilâncias locais e demais setores para contornar os problemas de saúde causados por doenças infecciosas e parasitárias e fatores relacionados.

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“…It is estimated that 52% of the world's 25.4 million refugees are children, with 173,800 being unaccompanied or separated from their original families. In the UK alone, the total number of undocumented child migrants in 2017was estimated to be over 120,000 2 . Surprisingly, despite the fact that medical issues concerning this fragile population are discussed in many countries, the subject of refugee and asylum seekers' access to health care and physical and mental outcomes has only been scantly studied 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Pediatric Refugees Require More Hospitalizations and Longer in-Patient Stay than the Local Population

Oziri¹,

Schnapper²,

Ovadia³

et al. 2020

Preprint

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Background: The ongoing global refugee crises have raised concerns among medical communities worldwide.Methods: We compared data from refugee and Israeli children admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017.Results: 104,244 visits (0–18 years) to the pediatric emergency department (PED) were recorded. Admission rate to the PD for refugees was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli patients (P < 0.001). After matching for age groups (0–5 years), the hospital stay duration for the 0–2 years age was 3.22 (± 4.80) days for the refugees and 2.78 (± 3.17) for the local population (P < 0.03). For 0–2 year old children, re-admission rates within 7 days, were 1.3% for refugees and 2.6% for Israelis, (p < 0.05). Dermatological diseases (mainly impetigo and cellulitis) were more frequent in refugees (23.30% vs. 13.15%, p < 0.01), however, acute gastroenteritis and respiratory diagnoses were more common in Israeli children (11.72% vs. 18.52%, p < 0.05 and 6.26% vs. 14.84%, p < 0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli patients (7.7% vs. 3%, P < 0.05). Very significantly, 23% of refugees had no health care coverage, while only 0.2% of the Israeli patients had no medical coverage (P < 0.001).Conclusion: We found evidence for significant morbidity in refugees as compared to the local Israeli pediatric population, highlighting the need for tailoring different approaches to this fragile population.Key notes· The subject of refugees’ access to health care has been scantly studied so far even though refugees are considered to be a medically high-risk group.· The results indicated a higher rate of hospitalization and morbidity in refugee patients.· These findings highlight the need to tailor a specific approach to treating this population.

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How can we meet the health needs of child refugees, asylum seekers and undocumented migrants?

Cited by 18 publications

References 17 publications

Mental healthcare for asylum-seekers and refugees residing in the United Kingdom: a scoping review of policies, barriers, and enablers

Mental healthcare for asylum-seekers and refugees residing in the United Kingdom: a scoping review of policies, barriers, and enablers

Doenças infecciosas e parasitárias no Brasil de 2010 a 2017: aspectos para vigilância em saúde

Pediatric Refugees Require More Hospitalizations and Longer in-Patient Stay than the Local Population

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