New Scots refugee integration strategy 2018 to 2022: engagement analysis

Chapter 8 Health and Wellbeing

A large majority of responses raised points about the health and wellbeing of refugees and asylum seekers. The points covered were:

• Access to health services
• Trauma and mental health
• Communication in healthcare settings
• Better understanding by service providers of the health needs of refugees and asylum seekers.

Each of these points is covered in more detail below.

8.1 Access to health services

Many responses indicated that they would like refugees and asylum seekers to have improved access to health services.

• It was highlighted that refugees and asylum seekers should have quicker access to GPs. One response highlighted the need for female refugees and asylum seekers to have access to female GPs.
• Responses emphasised the need to shorten the currently perceived long waiting times for hospital and dental appointments as well as mental health services. One participant put it the following way: "We wait so long for help. Six months to a year. People can kill themselves in that time. They have no idea how bad the trauma is that we are dealing with." In addition, it was felt that the referral process for emergency care was slow.
• Responses suggested that refugees' and asylum seekers' travel costs to medical appointments should be provided.

8.2 Trauma and mental health

Many responses raised points about the trauma and mental health problems that many refugees and asylum seekers experience.

• Responses highlighted the mental health problems – such as anxiety and depression - of refugees and asylum seekers. They highlighted that many suffer from poor mental health due to their experiences of conflict and persecution in their home countries, the separation from their family, and/or the uncertainty about their future during the asylum process.
• It was also highlighted that the inability to work as an asylum seeker (see Chapter 3) and potentially poor and inadequate housing (see Chapter 5) can in addition have negative effects on the mental health of asylum seekers.
• Responses highlighted the importance of mental health service provision for refugees and asylum seekers, in terms of specialist services, third sector organisations that provide emotional support, and peer support. This was a point that was also raised by two women-only groups at different engagement events. Further comments about mental health services covered:
  • The need for all services in Scotland ( i.e. services other than specialist mental health services) to become trauma-informed.
  • The possibility of mental health services being provided in languages widely spoken by refugees and asylum seekers was emphasised.
  • The importance of shortening the waiting times for mental health services.

8.3 Communication in healthcare settings

Many responses raised points about the importance of appropriate communciation with refugees and asylum seekers about healthcare.

• Responses highlighted the need for refugees and asylum seekers to be better informed about health services and their rights and entitlements to gain access to these. This included information on Scotland's healthcare system in general, how to access primary care and register with a GP, and their rights in relation to accessing health services. It was highlighted that refugees and asylum seekers should be informed about these aspects upon their arrival in Scotland – a point further covered in Chapter 9.
• Responses suggested that all the information the NHS provides – ranging from information leaflets, letters about appointments, to screening tools – should be available in multiple languages.
• The need for interpreters to be available during medical appointments – particularly during GP appointments but also specialist and emergency services - was highlighted.

8.4 Better understanding by service providers of the health needs of asylum seekers and refugees

Some responses suggested that health service providers and frontline staff should be given more training about the specific health needs of refugees and asylum seekers.

• It was highlighted that health staff, particularly frontline staff, should be made aware of the rights and entitlements of refugees and asylum seekers to access health services. This was seen as important in ensuring that refugees and asylum seekers have a positive experience during their first point of contact with the Scottish healthcare system.
• Responses suggested that refugees' and asylum seekers' health records should be shared between different health service providers, considering that it can be difficult for refugees and asylum seekers to share personal information about their health with staff during their appointments.