The Health and Wellbeing of Unaccompanied Minors, Elaine Chase


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Elaine Chase, of the Institute of Education, draws on interviews with child migrants to explore their health problems and concerns.

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The Health and Wellbeing of Unaccompanied Minors, Elaine Chase

  1. 1. A Right to Security? Young people seeking asylum alone in the UK <ul><li>Migration and the right to health conference </li></ul><ul><li>27 May 2010 </li></ul><ul><li>Elaine Chase </li></ul>
  2. 2. Methodology <ul><li>In-depth interviews with 54 children and young people seeking asylum alone (DH-funded study) </li></ul><ul><li>Review and analysis of 45 legal case files </li></ul><ul><li>Qualitative thematic analysis </li></ul>
  3. 3. Key research questions <ul><li>What factors promote/inhibit mental health? (DH Study) </li></ul><ul><li>Wider Analysis </li></ul><ul><li>What rights do unaccompanied/separated young people have? </li></ul><ul><li>How do young people experience asylum, immigration and other formal support systems as they move from the category of ‘child’ to ‘adult’? </li></ul><ul><li>To what extent can young people sustain a sense of ontological security? </li></ul>
  4. 4. Age <ul><li>Male Female </li></ul><ul><li>Age at interview </li></ul><ul><li>Under 16 7 3 </li></ul><ul><li>16/17 3 7 </li></ul><ul><li>18+ 16 18 </li></ul><ul><li>Age on arrival </li></ul><ul><li>Under 14 10 3 </li></ul><ul><li>Under 14/15 7 10 </li></ul><ul><li>16/17 9 15 </li></ul><ul><li>* about one quarter of the sample were age disputed </li></ul>
  5. 5. Ontological security <ul><li>Ontological security stems from a sense of order and continuity to life which in turn gives life meaning. Meaning is derived through stability and predictability in our experiences . </li></ul><ul><li> Giddens (1991) </li></ul>
  6. 6. Insecurity <ul><li>Chaos and disruption threaten a sense of ontological security and can create a state of anxiety.... The predictability of life is broken. </li></ul><ul><li>....‘the inability to sustain a biographical narrative’ </li></ul><ul><li>(Giddens, 1991) </li></ul>
  7. 7. Relevant Rights Frameworks <ul><li>Rights as refugees (Refugee Convention 1951) </li></ul><ul><li>United Nations Convention on the Rights of the Child (UNCRC) </li></ul><ul><li>European Convention on Human Rights (1950) </li></ul><ul><li>Human Rights Act 1998 </li></ul><ul><li>Children Act (2004) </li></ul><ul><li>Children (Leaving Care Act) 2000 </li></ul>
  8. 8. Rights as moral claims <ul><li>From a legal to sociological lens on rights </li></ul><ul><li>Access to social rights is constituted around notions of ‘merit and demerit’. (Morris, 2006; 2009) – the ‘ stratification of rights ’. </li></ul><ul><li>Rights are social claims for institutionalised protection. ..It is because of collective sympathy for the plight of others that moral communities are created which support the institution of rights. (Turner, 1993) </li></ul><ul><li>‘ Human Rights not belong to humans; they help construct who and how one becomes human’. </li></ul><ul><li>(Douzinas, 2009) </li></ul>
  9. 9. Threats to ontological security <ul><li>Previous trauma </li></ul><ul><li>Ongoing-control exercised by Home Office </li></ul><ul><ul><ul><li>Dispersal </li></ul></ul></ul><ul><ul><ul><li>Threat of detention </li></ul></ul></ul><ul><ul><ul><li>Fear of deportation </li></ul></ul></ul><ul><ul><ul><li>Silence </li></ul></ul></ul><ul><ul><ul><li>Stigma </li></ul></ul></ul><ul><ul><ul><li>Uncertainties about the future – ‘ where will I go?/ where do I belong?’ </li></ul></ul></ul><ul><ul><ul><li>Losing access to education, a life plan </li></ul></ul></ul><ul><ul><ul><li>Losing access to social support (age disputes, reduction in social care support, losing access to allowances/entitlements ) </li></ul></ul></ul>
  10. 10. <ul><li>I’m afraid, my papers are nearly finished. Before they gave me two years but it finishes in June – I don’t want to go back to my country.. I think about it every day. </li></ul><ul><li>(Faith, age 17, Nigeria) </li></ul><ul><li>Most of the time it feels darker than other days. I just want to go to the light, make myself happy. I am fighting too much to make my baby and myself happy – I am fighting every day. The feelings just come in front of me killing all the feelings of being happy. But the status thing gets in the way, affects everything. I feel like it is a big mountain in front of me and I can’t shift it.. .it stops me from being myself. </li></ul><ul><li>(Rakeb, age 21, Eritrea) </li></ul>
  11. 11. Manifestations of ‘insecurity’ <ul><li>A wide spectrum of emotional difficulties from disturbed sleep patterns, anxieties and isolation to severe illness requiring hospitalisation </li></ul><ul><li>Young men less likely than young women to talk about or seek advice and support </li></ul><ul><li>Older young people indicated far higher levels of anxiety than the younger children </li></ul><ul><li>Older young people likely to experience other stresses and anxieties which exacerbate emotional problems. </li></ul>
  12. 12. Response – focus on mental health <ul><li>The language surrounding mental health is not well understood by young people from other cultures </li></ul><ul><li>Many young people come from cultures where the concept of focusing services and therapies specifically on emotions and feelings is very alien. </li></ul><ul><li>Young people have concerns about the ‘over’ use of medication </li></ul><ul><li>Resistance to counselling and talk therapies </li></ul><ul><li>Some young people can benefit from the right therapeutic intervention </li></ul>
  13. 13. <ul><li>Allusions to emotional problems through difficulties in concentration: </li></ul><ul><li>‘ the brain is, you know, small because it is thinking, thinking, finished… there is no power there’. </li></ul><ul><li>Situating emotions in ‘heart’ not in the ‘mind’ </li></ul><ul><li>‘ You have the thinking and it is in the heart’ </li></ul><ul><li>‘ a sickness of the heart, not of the mind’ </li></ul><ul><li>Understandings of ‘mental’ as: </li></ul><ul><li>‘ out of control’ , ‘crazy’ ‘ talking out loud’ or ‘hearing things’ </li></ul>
  14. 14. <ul><li>C: ‘Its different here… everything when you say you are stressed, they going to say you are mental… something like that.. .for me it’s shit, I don’t like someone to call me mental. Mental is one who become like crazy or can’t think, who fight you if you move close….this is the one we call mental. Even like counselling, they may think I’m mental that’s why I don’t like to use those types of services because I don’t want anyone to say I’m mental ..cos I don’t think I’m mental’ </li></ul><ul><li>R: ‘ I don’t think they would call you mental’…. </li></ul><ul><li>C: ‘Is it? ( seems surprised) because the way I hear on the radio or read in the newspaper is that if someone is stressed or have anorexia, they call it mental, mental, mental’ </li></ul><ul><li>R: Well, what they say is that people have mental health problems or difficulties. </li></ul><ul><li>C: Yeah, mental health problems… that is what make me feel like …because when they going to write, they going to write you got mental health problems isn’t it’ </li></ul><ul><li>(Claude, 18, Burundi) </li></ul>
  15. 15. <ul><li>They offered me counselling twice. I don’t want it.. I felt like they just make you crazy – they just treat you like a crazy person, like you are just losing your mind or that kind of thing . But if I don’t help myself, no-one is helping me … I didn’t see the point. I keep busy by education, it makes me forget everything ...just keep busy, clean house everything, downstairs/upstairs…. If I sit I start to think . </li></ul><ul><li>(Mahlet, 16, Ethiopia) </li></ul>
  16. 16. <ul><li>I will never forget. He said if you keep things in like you know where we keep the clothes – if we put wet clothes or dirty clothes in the drawer and don’t take them out and wash them, then all the horrible things are going to stay there and smell. So we have to take out the bad thoughts, clean them, iron them and put them back. </li></ul><ul><li>(Aliya, age 21,Somalia ) </li></ul>
  17. 17. Things that promote ontological security <ul><li>Informal </li></ul><ul><ul><ul><li>Friends </li></ul></ul></ul><ul><ul><ul><li>Religion </li></ul></ul></ul><ul><li>Formal </li></ul><ul><ul><ul><li>Continuing with education </li></ul></ul></ul><ul><ul><ul><li>Access to housing, social support, benefits </li></ul></ul></ul><ul><ul><ul><li>Having your status determined – a sense of what the future holds </li></ul></ul></ul><ul><li>Personal resolve – taking back control </li></ul><ul><ul><ul><li>Bracketing the past </li></ul></ul></ul><ul><ul><ul><li>Resisting elements of the system </li></ul></ul></ul>
  18. 18. <ul><li>For me, the better things that helped me is that I go to college... that help me a lot. I used to concentrate on my study and forget everything. I just want to be someone for me and my son. I don’t want to be ... I don’t want to live this life every year. I want to change something in my life. And when you go to college, you see people – different people – it is not only from this country. You have a lot of people come from any other place. Everybody have their own problems. When I stay at home, all the thing I think about is family, myself and what I have been through with these problems. But now I have college, I think ‘what am I going to do next year? What is my progress now?’ </li></ul><ul><li>(Nanu, 20, Eritrea) </li></ul>
  19. 19. <ul><li>I’m trying to leave the past. If I’m going to think about the past, there’s no point. There are bad things in the past- I can’t think about it. I just have to let it go. The past is the past and you have to leave it to the past and look to the future... What’s gone is gone. </li></ul><ul><li> (Alban, 20 from Albania) </li></ul>
  20. 20. No security <ul><li>I have no husband, no food, no benefits, no status, no job. I can’t see any light in front of me. I feel that everything is just blank. Sometimes I don’t know what to do even. I tried to suicide lots of times. My baby stops me. I am fighting too much to make my baby and myself happy. I am fighting every day. Otherwise the feelings just come in front of me killing all the feelings of being happy. But this status thing gets in the way, it affects everything. I feel like it is a big mountain in front of me and I can’t shift it... it stops me from being myself. </li></ul><ul><li>(Rakeb, 21 from Eritrea) </li></ul>
  21. 21. <ul><li>But last year January, it was too much for me, you know? , with the Home Office as well. I was doing well, but when the papers ran out and I started going to the Home Office, I didn’t know what to do... my plans collapsed. After all I have experienced, I feel like I’m 50 years old. I don’t feel like I’m 20. I don’t have the heart to carry lots of things more </li></ul><ul><li>(Innocent, 20, Nigeria) </li></ul>
  22. 22. <ul><li>It’s really, really stressful. I ask, ‘what I am doing this for?’. Two months before I graduate, they might ask me to leave the country. You just don’t know. It’s really horrible. You tell yourself to try and build up your life but then it all comes back, you can’t ignore it all the time. There are two different sides of your life – on the one side you are trying to build it up ....and on the other side, you don’t know if you’ll be able to live here the day after tomorrow. I don’t enjoy thinking about the future at the moment. I just want to take it step by step. Not knowing doesn’t make me feel more motivated – it actually puts me off. You think ‘Why?’. They don’t even have to kick me out of the country: it’s enough to get an interview just before my finals... I just don’t want to think about it’. </li></ul><ul><li>(Maryam, 21, Iran) </li></ul>
  23. 23. <ul><li> ‘ I can’t sleep here because no college, no nothing.. only sleep here.. I can’t do anything, I’m not allowed to work. I’m not allowed to do anything you know because three years have finished and I am still .....And I go to doctor and he gives me tablets and I have depression. The Home Office, they don’t listen. I went to the Home Office because I was crazy and mad you know and I said, ‘you know my problems’. I said ‘I don’t understand’. I said , ‘have been coming here every month for 3 years.. this is not freedom, it’s like I’m in jail’. </li></ul><ul><li>(Ibrahim,19, Pakistan) </li></ul>
  24. 24. Implications <ul><li>‘ Health’ is grounded in security </li></ul><ul><li>Security not provided solely through ‘mental health interventions’ </li></ul><ul><li>Mental health services should continue to offer targeted support which is culturally sensitive ...but </li></ul><ul><li>Need to engage with the wider issues which generate ‘insecurity’ </li></ul><ul><ul><ul><ul><li>A right to ‘ontological security?’ </li></ul></ul></ul></ul><ul><ul><ul><ul><li>A right not to be in limbo? </li></ul></ul></ul></ul><ul><ul><ul><ul><li>A right to belong/ have attachment to? </li></ul></ul></ul></ul><ul><ul><ul><ul><li>A right to ‘become’ rather than just to ‘be’? </li></ul></ul></ul></ul>