91心頭

[Published by Dr Alison Strang, Senior Research Fellow at the Institute for Global Health and Development, July 2020]

How has lockdown been for you? We know that some people have had a much tougher time than others. I recognise that (so far) I am one of the very lucky ones: I have not been ill, I have not lost anyone close to me, I have not lost my job, I have not had to shield, I have even had a garden where I could get some fresh air and listen to the birds sing! And yet like many equally privileged people like myself it has been hard! There have been times when I have felt low and found it difficult to motivate myself when I have felt that there is not much point to anything. This experience is widespread. According to the latest , depression and anxiety have been higher than average throughout the pandemic lockdown particularly among young people, those living alone, with low incomes, a pre-diagnosed mental illness, living with children and/or in an urban area. 

Now I picture myself, not as one of the privileged, but in the shoes of someone who is in the UK to seek asylum, to escape danger and fear, to be safe and live in peace. I am tempted to say that these are ordinary people no different from the average person settled in the UK. However, the truth is that it takes courage to leave everything that you have known and look for somewhere else to be safe. Asylum seekers have made very difficult decisions and taken risks in leaving so much behind. They and their families have made sacrifices too. For many, the journey itself has been so terrible that they cant bear to talk about it. They set their hopes on arrival, and a fair chance to make their case and to start a new life. 

So, what is it like when you arrive as a refugee and follow the correct official procedures to apply for asylum? Bewildering and unnerving! You know that your future safety depends on the asylum decision, but also that those making that decision will be scrutinising every detail of your life. You cannot afford to make a mistake, but you dont know what the rules are. The majority of people seeking asylum speak very little or no English, the place is unfamiliar, the way people behave is similar, yet different. It feels easy to offend the locals, but difficult to feel understood or make a friend. You are far away from the people who care about you, support you, and understand you. 

Working as a researcher at 91心頭 in Edinburgh for the past 20 years I have had the opportunity to meet with refugees and asylum seekers in Scotland, across the UK and in other resettlement and humanitarian settings. A consistent picture emerges as to what people need in order to rebuild their lives: People, of course, need to be able to meet their own basic needs (food, shelter, toiletries etc.), they need to be secure in their right to ask for refuge and be dealt with justly. They need to feel safe and able to live with some stability - and not forced to keep moving location. Those seeking refuge need to interact with society at large through shared language, culture and communication technologies. They need to be able to be independent through education, training and work. Most of all asylum seekers and those already accepted into the country as refugees desperately need along with the entire human race to connect with other people. These factors, shown to be consistent across many different contexts in many different countries, have become known as the Indicators of Integration (, 2008; , 2019). 

The same principles emerge, not only in the literature on asylum and refugee resettlement but also in humanitarian and post-conflict settings. The respected psychiatrist and academic Stevan Hobfoll brought together a worldwide panel of experts to identify the principles of supporting people who had been exposed to disasters and mass violence (, 2007). He identified five essential elements to wellbeing: a sense of safety; calming (through access to accurate and timely information); the ability to make choices about your own life; connectedness to with other people; and last, but definitely not least, hope. 

The details of the tragic events in Glasgow on Friday 26th June will emerge over time. However, we already know that many of the inhabitants of the Park Inn hotel had been abruptly moved there at the beginning of the COVID-19 pandemic lockdown. They were uprooted (sometimes with no more than 20 minutes warning) from their homes in the community where they had been settled. In exchange for a shared flat, they found themselves in a single room in a hotel. The daily allowance, of 贈5 was immediately stopped and replaced by hotel meals provided in shared dining areas. As , with such little money asylum seekers were already reporting choosing between food and phone connection, sanitary products or pain relief. With no money at all, the choice to stay connected by phone has been completely taken away. In hotels, people have felt that even going to collect your meal is taking a risk with COVID and concluded that the only safe option is to stay in your room. This has gone on just as it has for the rest of us - not for weeks, but for months. Already in the past few weeks, one such asylum seeker was found dead in a Glasgow hotel, feared suicide. On Friday the 26th, reports suggest that the stress and distress boiled over and left one man dead and six people seriously injured. 

Whilst we will have to wait for the outcomes of official enquiries to understand the details of these events, organisations working with refugees have been that these harsh conditions are a severe threat to mental health. From my perspective as an academic, rather than a campaigner, it is clear to me that we are breaking every rule in the book. We are subjecting people who have already experienced multiple losses to a whole series of events and circumstances known to undermine mental health. We have uprooted people yet again, confirming a sense of powerlessness at every turn: no choice where to live, no choice what to eat, no choice who to mix with, compromised capacity to protect their health during the pandemic. We have allowed people to become completely cut off from those who know them and care for them. We have created a situation without hope and without distraction from that lack of hope. Every one of Stevan Hobfolls essential supports is missing. 

A few years ago, my colleague Neil Quinn and I talked with refugee men in Glasgow about their experiences of mental health (, 2019). We found that far from being helpless, many refugee men were able to talk about effective strategies they would use to protect or improve their mental health, like taking exercise, getting out, meeting people. However, at the same time, we were shocked at the levels of social isolation most of them were living in. Without family in Glasgow some managed to build friends like brothers, yet most had very little access to support services, and said that they didnt know any local people. 

Right now, we can be very sure that accommodating asylum seekers in hotels with no access to money is damaging. The practice is isolating people, creating an unbearable sense of powerlessness and insecurity and destroying the hope that has enabled them to endure. Whatever the situation or political or economic pressures, peoples lives cannot be put on hold. No human life can safely be held in limbo, every human being will always strive to grow, and if they cant grow, they may struggle to breathe and may crumble. 

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Institute for Global Health and Development

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