Structural barriers to refugee, asylum seeker and undocumented migrant healthcare access. Perceptions of Doctors of the World caseworkers in the UK

Asif, Zara; Kienzler, Hanna

doi:10.1016/j.ssmmh.2022.100088

Cited by 24 publications

(22 citation statements)

References 73 publications

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“…Due to a lack of research regarding health-care barriers, particularly those affecting those seeking asylum rather than broader migrant groups, and a lack of research into access for asylum seekers and refugees to secondary care, however, our study has also brought to light obstacles less reported in the literature. Some of these are systemic, like the disconnect in the nature of different health services, the need for proof of a fixed address to be able to access services (Asif and Kienzler, 2022), or the frequent moves at short notice for asylum seekers living in government accommodation (Koca, 2021), which make the continuity of care near to impossible. Whilst some of the material obstacles identified in this study, such as a lack of financial resources to be able to travel to medical appointments or afford certain health services, are reflected in other studies (Kang et al , 2018), the specific concerns that participants raised about being able to afford data and technology to access health services have not received as much recognition.…”

Section: Discussionmentioning

confidence: 99%

A mile in their shoes: understanding health-care journeys of refugees and asylum seekers in the UK

Talks,

Al Mobarak,

Katona

et al. 2024

IJMHSC

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Purpose Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate access to and the navigation of the health system in the UK is small. This study aims to address this gap by analysing 14 semi-structured, in-depth interviews with refugees and asylum seekers of different countries of origin in the UK to identify where, when and how they came into contact with the health-care system and what the outcome of these interactions was. Design/methodology/approach Semi-structured, in-depth interviews were chosen as the key method for this study. In total, 14 individual interviews were conducted. A trauma-informed research approach was applied to reduce the risk of re-traumatising participants. Findings The paper identifies key obstacles as well as “facilitators” of refugees’ and asylum seekers’ health-care experience in the UK and suggests that host families, friends and third-party organisations all play an important role in ensuring refugees and asylum seekers receive the healthcare they need. Originality/value To the best of the authors’ knowledge, this is the first qualitative study in the UK that looks at comprehensive health journeys of refugees from their first encounter with health services through to secondary care, highlighting the important role along the way of facilitators such as host families, friends and third-party organisations.

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Section: Discussionmentioning

confidence: 99%

A mile in their shoes: understanding health-care journeys of refugees and asylum seekers in the UK

Talks,

Al Mobarak,

Katona

et al. 2024

IJMHSC

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show abstract

“…It is well established that RASs face many barriers in relation to accessing healthcare (Asif and Kienzler, 2022;Crawley et al, 2011;Kibondo et al, 2000). In line with previous studies, our study found that language and culture, including religious beliefs and health beliefs, were identified by RASs and staff as key issues when considering barriers to healthcare.…”

Section: Discussionmentioning

confidence: 99%

“…Structural barriers include charging regulations, the refusal to register patients at general practitioner (GP) practices without proof of ID, and the complexities of navigating the UK healthcare system. Asif and Kienzler (2022) found that these barriers lead to risky help and health seeking, lack of or inadequate healthcare, and worse health outcomes among this population. RAS patients encountering negative experiences of seeking healthcare often report feelings of discrimination and a lack of confidence in healthcare services, leading to reduced uptake of services (Kibondo et al, 2000).…”

Section: Cultural Competency Training In Healthcarementioning

confidence: 99%

Cultural competency and mental health training for medical students: Learning from refugees and asylum seekers

Silver

Williams

Forty

2023

Health Education Journal

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Objective: Studies suggest that healthcare professionals often feel unprepared to deal with mental health issues in refugees and asylum seekers. The aim of this qualitative study was to examine the experiences of refugees and asylum seekers in relation to mental health and healthcare, to inform cultural competency training for undergraduate medical students. Method: Focus groups were conducted with 16 refugees and asylum seekers and staff from relevant charity organisations in Wales. We explored participants’ experiences in relation to mental health and healthcare, and training for healthcare professionals. The data were thematically analysed using an inductive approach. Results: Three overarching themes were identified: (1) recognition of the specific mental health needs of refugees and asylum seekers, (2) barriers preventing effective mental healthcare delivery for refugees and asylum seekers and (3) authentic learning experiences for medical students. Conclusion: To our knowledge, this is the first study to actively involve refugees and asylum seekers, along with individuals who work closely with this population, in considering the development of cultural competency training for healthcare students and professionals in relation to mental health. If we are to reduce the risks of exclusion from healthcare for refugees and asylum seekers, training in this area is essential. Findings from this study have informed the development of a guide for healthcare educators with a focus on refugee and asylum seeker mental health.

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“…They encounter immediate everyday challenges related to social and economic determinants of health, including substandard housing conditions, unemployment or occupational downgrading, access and language barriers to healthcare, social isolation, racism and discrimination ( Carter and Osborne, 2009 ; Hynie, 2018 ; Lumley-Sapanski, 2021 ; Mangrio and Sjögren Forss, 2017 ). Anti-immigration policies of deterrence, such as the UK's “hostile environment”, make access to basic care and opportunities very difficult despite their being entitled to such support by law ( Asif and Kienzler, 2022 ; Goodfellow, 2020 ). Refugees must navigate an evolving set of structural and bureaucratic difficulties that present risks of marginalisation and poverty with implications for mental health ( Abdelhady et al, 2020 ; Allsopp et al, 2014 ; Fassin, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Refugee mental health and the role of place in the Global North countries: A scoping review

Ermansons¹,

Kienzler²,

Asif³

et al. 2023

Health & Place

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Structural barriers to refugee, asylum seeker and undocumented migrant healthcare access. Perceptions of Doctors of the World caseworkers in the UK

Cited by 24 publications

References 73 publications

A mile in their shoes: understanding health-care journeys of refugees and asylum seekers in the UK

A mile in their shoes: understanding health-care journeys of refugees and asylum seekers in the UK

Cultural competency and mental health training for medical students: Learning from refugees and asylum seekers

Refugee mental health and the role of place in the Global North countries: A scoping review

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