Supporting Refugee Mental Health

Cover_TTOct15_LRThe work of Touchstone’s IAPT team has been featured in an article in Therapy Today discussing the services who are trying to meet the mental health needs of refugees arriving in this country. Below is a small extract from the article.

Richard Garland is Manager of Touchstone IAPT in Leeds, one partner in the consortium of NHS and voluntary sector organisations providing the IAPT service across the city. He is very open about the limitations within which he is working when he tries to reach refugees and asylum-seekers. Touchstone IAPT’s remit is to improve access to talking therapies to black and minority ethnic communities, and he has specifically included refugees and asylum-seekers as one of his primary target groups, but it is hard, he admits, to accommodate their needs and circumstances within the IAPT model. ‘IAPT is what it is. We are working within strict parameters,’ he says. ‘It’s CBT-based and works primarily with anxiety and depression. We are very clear about what we offer and what it helps with, and we do what we can to be as flexible as possible in order to engage with these clients. It’s my job to explore the limits of these parameters to fulfil our remit to widen access to all.’

They deliver services from community venues in the parts of the city where there are large BME populations, their team is trained to work with interpreters, and they try to be more flexible about appointments. ‘Some may struggle to attend sessions because they have much more important appointments to do with issues like housing or their asylum status, so we for instance tend to give them more chances than IAPT usually would before we de-activate their cases,’ Richard says. ‘And we have maintained our own direct referral route so we can manage referrals in the way we see as most effective in fulfilling our remit to improve access.’

Touchstone IAPT has managed to access funding for a mental health assessment worker to conduct assessments at the weekly drop-in run by PAFRAS (Positive Action for Refugees and Asylum-Seekers), an advice and advocacy service for refugees and asylum-seekers in Leeds. A key aspect of the role is to refer people on to appropriate therapy services, including IAPT and the step 4 NHS psychological therapy service. But the waiting time for step 4 psychology is up to a year, and it has within it no specialist trauma service. ‘There is no service in Leeds that can hold trauma clients and work to stabilise them while they are waiting for step 4 treatment,’ Richard says. ‘Touchstone IAPT has tried to fill this gap in the past but our hands are ultimately tied by factors such as the number of people IAPT therapists are expected to see every week and our recovery targets.’ He was able in 2012 for six months to allocate one CBT therapist to work with refugees and asylum-seekers but the resulting drop in the therapist’s outcomes figures and anxiety among her NHS clinical supervisors about supervising this work meant he had to end the arrangement.

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