A therapist working with Afghan refugees has shared an insight into how the situation in the country is impacting people’s mental health.

Our member Jude Boyles said that people who have fled to the UK to escape the Taliban should have access to mental health support to help them rebuild their lives.

Jude, who has worked with refugees and people seeking asylum for 25 years, says there is high levels of distress among people from Afghanistan, who are dealing with a range of issues such as loss, grief, ill health and PTSD.

Therapeutic support

Jude, who is manager of the Refugee Council’s New Roots Therapy Service and Child and Family Wellbeing Project in South Yorkshire, says that people arriving in the UK under the ARAP (Afghan Relocations and Assistance Policy) scheme need access to therapeutic support to help them resettle.

“I’ve recently seen an Afghan family who’ve been in the UK for about a month and the father worked for the British Army,” said Jude. “They’re relieved to be here but they have lost contact with their family in Afghanistan. They are really anxious, overwhelmed, and not sleeping.”

Jude described how her team visit families soon after arrival to tell them about the therapeutic service and to find out how they're managing.

“Having somebody who can ask them what they’re worried about and how they feel, as well as asking about any concerns they might have about their children going to school and reassuring them that what they’re feeling is normal seems to be helpful,” said Jude.

Reassuring

“Families are often managing well despite all they have been through and it can be reassuring to be told that and if that changes, they can contact us. I think it’s really important as the first few months can be overwhelming.

“A lot of the difficulties have been experienced as a family so we have a systemic family practitioner in our small team. Mental health support should be built into resettlement programmes on a local level.”

Jude said that currently families arriving in the UK under the ARAP scheme receive a package of practical support through organisations such as Refugee Council, Refugee Action, local authority teams and other NGO’s like Red Cross.

This includes support such as registering for bank accounts and benefits, enrolling children into school and advice on how to catch public transport.

“The mental health and counselling side of this support is where it tends to fall down in some regions,” said Jude, who has extensive knowledge and experience of working with people who fled Syria via the Syrian Vulnerable Persons Resettlement Programme (VPRS).

“In most areas of the UK there won’t be many services who are able to see those people fairly quickly, who have experience of working with interpreters in a mental health setting and who have an understanding of the Afghan context and the challenges of resettlement.

“In some parts of the UK there are few third sector organisations who have budgets for interpreters and if they do, they’re often specialist refugee therapy services, like ours. Often there are waiting lists and long delays before people can be seen. The mental health needs of resettled refugees are rarely being met.

Therapy

“Another issue for an Afghan family is there’s no culture of having therapy or seeking help for distress by talking to somebody externally. So people are not going to refer themselves to therapy services or to speak to their GP about their mental health. If the therapy service is built into the resettlement package, it is easier for people to access it quickly.

“There’s a need for specialist services to offer appointments soon after people arrive. If there isn’t, they’re likely to come into contact with services only when they are in crisis through their GP. They may then be referred to IAPT, which is often inaccessible to refugees with multiple needs.”

Jude added how important it is that interpreters are trained to work in this setting and they should also receive supervision, in the way that counsellors do.

“We have a supervision group for our interpreters but recently the Refugee Council have set up an extra supervision group for our Afghan interpreters, because of the impact of interpreting in therapy for those sorts of narratives.

“A big part of my work is trauma, but there is also grief and separation from family and worries about what’s happening at home as well as the challenges of resettlement. The refugee context is so multi-layered that we as practitioners need to be really flexible.”