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11 results

  • 2 - Seeking asylum in the United Kingdom

  • Edited by Chris Maloney, Julia Nelki, Alison Summers
  • Book:
    Seeking Asylum and Mental Health
    Published online:
    26 August 2022
    Print publication:
    01 September 2022, pp 29-50

  • Summary

    The UK asylum processat the time of writing is described in detail to illustrate more general practices and effects. Claim handling and the role of immigration detention are discussed.Legal representation is important but hard to find. Asylum claim interviews are described.The decision-making process is outlined. Tribunals, appeals, appeals rights exhaustion, and fresh claims are described.The National Referral Mechanism for people who have been trafficked is outlined.Claiming asylum has a human context.People are excluded from society.Shame can be induced, and ‘retraumatisation’ can occur. Detention without limit of time can distress and destabilise individuals who were mentally stable on arrival.Fear and uncertainty prevail.

    Possible reactions of the host society are reviewed; suspicion and disbelief, and deprivation and demands as part of the ‘hostile environment’.

    The key themes of medical care and the role of medical evidence are introduced.Forms of recognition as a refugee are described, and some of their practical and psychological consequences.

  • 4 - Access to mental health care

  • Edited by Chris Maloney, Julia Nelki, Alison Summers
  • Book:
    Seeking Asylum and Mental Health
    Published online:
    26 August 2022
    Print publication:
    01 September 2022, pp 71-89

  • Summary

    People in the asylum system who might benefit from mental health care frequently find it very difficult to access this.

    Some do not seek help, perhaps because they do not expect mental health services to be helpful or because of fear, stigma, or wanting to avoid the processes of help-seeking.Those who do seek help encounter multiple challenges including language barriers, the limitations of health care provision within the asylum system, difficulties negotiating primary care, NHS charges, practical difficulties in getting to a first appointment, and service eligibility criteria. People may face barriers linked to their age, gender, sexuality, or being destitute.

    The chapter offers a typology of obstacles to reaching effective mental health care as a step towards considering how these may be addressed.This considers the context (resource limitations /ambivalence about providing equal care) and the sources of specific obstacles, including ‘hostile’ asylum policies. Recurring themes include the need for accessible information,friendly compassionate staff, cultural competence, access to qualified interpreters, appropriately trained staff, and a willingness to be flexible.

  • Does striving to succeed come at a physiological or psychosocial cost for adults who experienced child maltreatment?

  • Jenalee R. Doom, Vivienne M. Hazzard, Katherine W. Bauer, Cari Jo Clark, Alison L. Miller
  • Journal:
    Development and Psychopathology / Volume 29 / Issue 5 / December 2017
    Published online by Cambridge University Press:
    22 November 2017, pp. 1905-1919

  • While striving to succeed in the face of adversity may provide individuals with outward benefits, it may come at a cost to individuals’ physical health. The current study examines whether striving predicts greater physiological or psychosocial costs among those who experienced child maltreatment, a stressor that disrupts the caregiving environment and threatens relationship security. Using data from the National Longitudinal Study of Adolescent to Adult Health, we tested whether greater striving after childhood maltreatment would come at a cost, increasing underlying cardiovascular disease (CVD) risk and depressive symptoms despite showing outward success via income and college degree attainment. The study included 13,341 Black, Hispanic, and White adolescents who self-reported striving and their experiences of childhood neglect, physical abuse, and sexual abuse. As young adults, participants reported depressive symptoms, income, and college degree attainment and completed a health assessment from which a 30-year Framingham-based CVD risk score was calculated. Higher striving was associated with lower CVD risk and depressive symptoms, and higher income and college degree attainment, regardless of maltreatment history. These findings highlight the potential for striving as a target for interventions and support the need to examine multiple biological and behavioral outcomes to understand the multifaceted nature of resilience.

  • Food insecurity in veteran households: findings from nationally representative data

  • Daniel P Miller, Mary Jo Larson, Thomas Byrne, Ellen DeVoe
  • Journal:
    Public Health Nutrition / Volume 19 / Issue 10 / July 2016
    Published online by Cambridge University Press:
    10 November 2015, pp. 1731-1740
    • Article
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  • Objective

    The present study is the first to use nationally representative data to compare rates of food insecurity among households with veterans of the US Armed Forces and non-veteran households.

    Design

    We used data from the 2005–2013 waves of the Current Population Survey – Food Security Supplement to identify rates of food insecurity and very low food security in veteran and non-veteran households. We estimated the odds and probability of food insecurity in veteran and non-veteran households in uncontrolled and controlled models. We replicated these results after separating veteran households by their most recent period of service. We weighted models to create nationally representative estimates.

    Setting

    Nationally representative data from the 2005–2013 waves of the Current Population Survey – Food Security Supplement.

    Subjects

    US households (n 388 680).

    Results

    Uncontrolled models found much lower rates of food insecurity (8·4 %) and very low food security (3·3 %) among veteran households than in non-veteran households (14·4 % and 5·4 %, respectively), with particularly low rates among households with older veterans. After adjustment, average rates of food insecurity and very low food security were not significantly different for veteran households. However, the probability of food insecurity was significantly higher among some recent veterans and significantly lower for those who served during the Vietnam War.

    Conclusions

    Although adjusting eliminated many differences between veteran and non-veteran households, veterans who served from 1975 and onwards may be at higher risk for food insecurity and should be the recipients of targeted outreach to improve nutritional outcomes.