Psychosocial Support

The importance of psychosocial support in the refugee status determination process

Resource Person: Mary Anne Kenny

Associate Professor
School of Law, Murdoch University, Western Australia

Mary Anne Kenny is an Associate Professor in the School of Law at Murdoch University in Australia. She is the Programme Manager of the Graduate Certificate in Australian Migration Law and Practice. She teaches in the areas of migration law, refugee law and international human rights, and her research interests are refugees, immigration, human rights and law reform. Mary Anne has been a legal practitioner and migration agent for over 20 years, and has previously worked in the clinical legal education program at SCALES.  As a legal practitioner she continues to provide pro bono advice and assistance to refugees and asylum seekers.

Email: m [dot] kennyatmurdoch [dot] edu [dot] au

Introduction

There has been much written on the importance of psychosocial support of refugees who were adapting to resettlement or recovering from torture. An issue which has received much less attention is the importance of psychosocial support for asylum seekers during the refugee status determination (RSD) process.

Asylum seekers face many challenges during the process of refugee status determination, particularly if they have experienced torture and extreme trauma.  If lawyers or caseworkers can work in a team with other individuals or organisations that can provide psychosocial support throughout this process, it can reduce the stress for asylum seekers while at the same time improve the quality and credibility of information made available to decision-makers in the RSD process.  By working in a team they can assist the asylum seeker to present a comprehensive and coherent case and support the asylum seeker to actively engage in the process (Fiske & Kenny- this and other sources listed below).

Definitions

It has been noted that there are a variety of definitions of the term psychosocial support used by aid and welfare organisations.  Carola Eyber (2002) has noted that while there are a variety of definitions there are some commonalities.

“Most definitions of the term 'psychosocial' are based on the idea that a combination of psychological and social factors are responsible for the well-being of people, and that these cannot necessarily be separated from one another. The term directs attention towards the totality of people's experience rather than focusing exclusively on the psychological aspects of health and well-being, and emphasizes the need to view these issues within the interpersonal contexts of wider family and community networks in which they are located.”

Issues that may impact upon the preparation of an asylum seekers case

In most RSD cases the issue of credibility is central to the success or failure of their application. Many refusals are on the basis of inconsistencies within an asylum seeker’s claims or that their claims are not credible (Cohen, Kagan and Kneebone).  There are a variety of factors that advocates need to be aware of that may impact upon an asylum seekers ability to present a credible claim.

Refugees and asylum seekers are likely to have had traumatic experiences in, or during their flight from, their home countries.  These traumatic experiences can effect their physical and mental health and can include post-traumatic stress disorder, depression, anxiety, fearfulness and sleeping disorders (Gorst-Unsworth & Goldenberg (1998); Herman (1997) and Turner (2000)).

Unfortunately many asylum seekers who arrive in a country of asylum may also face treatment which can compound or is of itself a traumatic experience.  In the last few decades there has been a deterioration in the manner in which asylum seekers have been treated when seeking refuge, particularly in developing countries.  This can include detention, denial of access to services, poverty, discrimination and denial of access to work. (See for example Silove et al (2000); Steel et al (1998 &2001); Sultan & O’Sullivan (2001))

The presence of these mental health issues obviously has an impact upon the preparation of an asylum seeker’s case.  Interviewing an asylum seeker about their experiences of past persecution may trigger trauma responses and effect their ability to provide information and a coherent narrative.  Typical reactions include: avoidance, delayed disclosure and a breakdown of narrative.  In addition the trauma experience and sequelae will often inhibit an asylum seeker from accessing and negotiating services and supports.

Other factors which may also impact upon the preparation of an asylum seekers claim include: lack of understanding of the RSD system and the complexities of that system; limited access to legal representation; culture; gender and age.

In addition delays in processing, coupled with a lack of social support and little or no meaningful structure to an asylum seeker’s every day existence often have a deleterious effect on the asylum seeker’s mental health. This, in turn, effects their ability to engage in the RSD process.

All of these factors mean that asylum seekers require both legal and psychosocial support in order to maximise their chances of success and to manage the process with the minimum of stress.

Psychosocial supports before, during and after the RSD process

Linking legal and psychosocial support is invaluable at all stages of the RSD process.

1.     Preparation of claims

Lawyers or advocates can conduct interviews jointly with social workers, psychologists or counsellors.  This can assist particularly where an asylum seeker has experienced trauma.  Professionals working together can develop a plan as to how best to elicit and present information from the asylum seeker.  A counsellor’s presence in an interview can assist with maintaining the asylum seeker’s sense of safety during the interview.  In addition if the asylum seeker has provided evidence of trauma to a counsellor or social work there may be no need to obtain the details again and it saves the asylum seeker having to provide multiple accounts. A statement prepared by the advocate can allude to this and the statement can be submitted accompanied by an expert report documenting the evidence provided.  This can be extremely useful as it alerts the decision maker to what are sensitive issues for the asylum seeker and how it may impact upon their recitation of claims. In addition, documentation of symptoms consistent with the claimed traumatic experiences will bolster the asylum seekers credibility.

2.     Awaiting interview and decision

Asylum seekers may have to wait some period of time for a decision or even for the RSD interview.  It is important that the asylum seeker has proper support while they wait for a decision.  During this time psychosocial support is important to assist asylum seekers cope with what may be the slow processing of their case. It is important for all human beings to have a meaningful structure to their day. Asylum seekers in a new country and culture don’t necessarily know how the system works or have contacts that can assist them in rebuilding their lives. Asylum seekers may be socially isolated.  Support workers can assist the asylum seeker to create social networks, participate in their local and/or ethnic community, engage in some form of education and/or training, or to look for work.   Asylum seekers may need to be linked into other services such as medical, physiotherapy, welfare support, social and cultural support, recreation programs and other services as appropriate.

3.     The interview

During an interview a support persons role may be limited to just being present.  However prior to an RSD interview a social worker or counsellor can work with the asylum seeker to assist them to identify and predict possible trauma triggers and responses; methods to help them manage their symptoms during a time of elevated stress, and rehearse what to do if they feel they cannot proceed.

4.     Post decision

a.     Acceptance of claim

If an asylum seeker is found to be a refugee psychosocial support does not end with that decision but will change from one of maintenance and symptom management within a legal framework, to one of longer term healing within more traditional therapeutic models.

b.     Refusal

A rejection will have a profound psychological impact upon an asylum seeker.  It will be important for the lawyer and social worker or counsellor to work through the reasons for the refusal with the asylum seeker together.  An asylum seeker may lose hope and believe that they will be returned to their country of origin. This can trigger strong traumatic responses for them, and lead to feelings of fear and hopelessness. The support worker needs to maintain an awareness of a heightened risk of suicide in the period following a refusal.  A discussion and plan needs to be formulated whether that involves negotiating an appeal of the decision or formulating a plan for return to their country of origin.

Conclusion

All across the globe work with asylum seekers is an area that is significantly under-funded and there are great demands on scarce resources. Asylum claims are often very complex and it is never easy to get through an RSD system.  Funding issues may mean agencies focus upon prioritising the work of lawyers.  In spite of this, provision of psychosocial should be regarded as just as important as the legal assistance.  By working together the contributions and effectiveness of both professions are strengthened.  Most importantly there is an improved service and support for asylum seekers as well as a likely increased success rate.  Longer term benefits toward refugees and asylum seekers will lead to reduced costs to the community.

References

Cohen ‘Questions of credibility: omissions, discrepancies and errors of recall in the testimony of asylum seekers’ (2001) 13 International Journal of Refugee Law 293

Carola Eyber, Psychosocial Issues, Forced Migration Online Research Guide, October 2002, available at http://www.forcedmigration.org/guides/fmo004/

Gorst-Unsworth C and Goldenberg E ‘Psychological Sequelae of Torture and Organised Violence Suffered by Refugees from Iraq” (1998) 172 British Journal of Psychiatry 90

Herman J Trauma and Recovery. The Aftermath of Violence – from Domestic Abuse to Political Terror. Basic Books, New York 1997

Michael Kagan, M, ‘Is truth in the eye of the beholder? Objective credibility assessment in refugee status determination’ (2003) 17 Georgetown. Immigration Law Journal 36

Kenny & Fiske, “Marriage of convenience or match made in heaven? Lawyers and Social Workers working on asylum seeker cases” (2004) 10 Australian Journal of Human Rights 137-159 http://www.austlii.edu.au/au/journals/AJHR/2004/21.html

Susan Kneebone, ‘The Refugee Review Tribunal and the Assessment of Credibility: An Inquisitorial Role?’ (1998) 5 Australian Journal of Administrative Law 78

Silove D, Steel Z and Watters C. ‘Policies of deterrence and the mental health of asylum seekers in Western countries’ (2000) 284 Journal of the American Medical Association 604

Steel Z and Silove D ‘The mental health implications of detaining asylum seekers’ (2001) 175Medical Journal of Australia: 596

Steel, Z., Silove, D, McGorry, P, and Mohan, P. ‘The Tamil Survey’ in Silove, D. and Steel, Z. (1998) The Mental Health and Well-Being of On-Shore Asylum Seekers in Australia. Psychiatry Research and Teaching Unit, University of New South Wales, Liverpool.

Sultan A and O’Sullivan K ‘Psychological disturbances in asylum seekers held in long-term detention: a participant-observer account’ (2001) 175 Medical Journal of Australia 593

Turner, S. (2000) 'Discrepancies and Delays in Asylum Seekers' Paper given at a UNSW Department of Psychiatry and Liverpool Hospital Joint Conference Mass Violence and Displacement. Recent Advances in Early Intervention and Training for Mental Health Workers, Sydney, NSW

See Also

Psychological and Psychiatric Aspects of Recounting Traumatic Events by Asylum Seekers

'Advocate or Adjudicator? Mental Health Professionals and Refugee Status Determination'

by Melis Gazioglu, Psy.D. Adjunct Professor, Bosphorous University, Istanbul, Turkey, Adjunct Professor, Dogus University, Istanbul, Turkey; and Courtney Mitchell, M.A. Adjunct Professor, American University in Cairo, Cairo, Egypt. 

Unpublished paper presented at International Symposium on Torture, Berlin, Germany (December, 2006). 

Ethical dilemmas often arise for mental health professionals when working with asylum seekers and refugees. This is especially true in resource poor environments such as developing countries. The unique role of the therapist in refugee status determination (RSD) is addressed, with attention to the importance of following profession-wide ethical standards of care, especially in RSD settings potentially involving conflicts of interest.

by Evert Bloemen, Erick Vloeberghs and Celine Smits.

Forced Migration Online 'Psychosocial issues': http://www.forcedmigration.org/browse/thematic/psychosocial.htm

Psychosocial Working Group: http://www.forcedmigration.org/psychosocial/

Rights-based approaches to mental health services with refugees: An annotated bibliography. Prepared by Alia Bloom, this annotated bibliography provides an overview of literature relating to the area of mental health work with refugees.

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