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Prior research has highlighted important healthcare access and utilization issues among new forced immigrants. We aimed to explore the role that public and patient involvement (PPI) might play in enhancing accessibility and specific contributions to migration health studies. We conducted open and in-depth interactive virtual discussions with asylum seekers and refugees from Eritrea and Syria in Switzerland. The PPI establishment consisted of three phases: inception, training and contribution. Prior to training, the concept of PPI was not straightforward to grasp, as it was a new approach—however, after training and consecutive discussions, participants were ardent to engage actively. We conclude that PPI holds promise in regard to raising awareness, improving healthcare system accessibilities and utilization, and enhancing and strengthening migration health research. Indeed, PPI volunteers were keen to raise their community's awareness through their networks and bridge an important gap between researchers and the public. [ABSTRACT FROM AUTHOR]

People seeking asylum are susceptible to head injury (HI) due to exposure to various forms of violence including war, torture, or interpersonal violence. Yet, the extents to which clinicians assess HI, and if so, what the associated characteristics are, are not well known. We analyzed 200 U.S.-based medico-legal affidavits using descriptive, multivariate regression, and thematic analysis. Head injury was documented in 38% of affidavits. Those who experienced physical violence were eight times likelier to experience HI than those who did not experience physical violence. Five themes emerged: (1) HI occurred commonly in the context of interpersonal violence (44%), followed by militarized violence (33%); (2) mechanisms of HI included direct blows to the head and asphyxiation, suggesting potential for both traumatic brain injury and brain injury from oxygen deprivation; (3) HI was often recurrent and concurrent with other physical injuries; (4) co-morbid psychiatric and post-concussive symptoms made it challenging to assess neurological and psychiatric etiologies; and (5) overall, there was a paucity of assessments and documentation of HI and sequelae. Among individuals assessed for asylum claims, HI is common, often recurrent, occurring in the context of interpersonal violence, and concurrent with psychological and other physical trauma. Physical violence is an important risk factor for HI, which should be assessed when physical violence is reported. [ABSTRACT FROM AUTHOR]

In this article, we argue that Direct Provision in Ireland is a state approved form of gendered carcerality which creates and exacerbates conditions of gendered violence. Direct Provision is a system of processing asylum seekers in Ireland where they are temporarily provided accommodation while they wait for a decision on their refugee status claim. This article shows how carceral practices are layered and gendered, making some spaces and bodies more carceral than others. These carceralities increase the institutional burden which agglomerates in human bodies and makes the lives of an already precarious population unliveable. Through a review of the strategies adopted by the government in relation to migrants, undocumented workers and asylum seekers, this article shows how the gendered experiences of certain asylum seekers like mothers and sexual violence survivors become the political site where state approved carceral practices and gendered violence merge. [ABSTRACT FROM AUTHOR]

Over the past decade, scholarly attention has increasingly focused on what is known as the 'refugee gap', which refers to the great difficulty asylum seekers and refugees face in entering the labour market in the host country. This poses a grave threat of social and occupational marginalisation for this group and highlights the role of systemic factors in facilitating resilience outcomes. By adopting a systemic perspective, this research aims to provide a critical reflection on the key features that should be considered when designing and implementing effective career counselling interventions for asylum seekers and refugees. To this end, a systematic review of the international applied research published by October 2022 has been carried out, using the PRISMA model. The 20 selected publications are grouped according to three main career research strands that reflect the core aspects to be addressed within career interventions in order to assist asylum seekers and refugees in their life and career transition in the host country, namely (i) psychosocial resources, (ii) identity transformation processes, and (iii) lived experiences and meaning-making processes. The main findings of the studies are discussed by looking into common themes that emerge from the literature, namely challenges related to migration contexts, self-regulating personal resources and skills, and sense of self and identity in career transitions, as well as considerations on the design aspects of career counselling and research targeting As&R. Finally, some guidelines and directions for action are provided for the purpose of developing inclusive career counselling interventions for As&R. [ABSTRACT FROM AUTHOR]

Asylum seekers, refugees, and migrants are central concepts in news coverage of immigration. However, these three terms refer to distinct groups with different meanings and potentially different frames, which could be negative, victim-based, or positive. Additionally, it is uncertain to what extent these groups are given a voice and how this is linked to the news frames used. To address this, a content analysis of 503 articles about asylum seekers, refugees, and migrants in a Belgian elite newspaper and a popular newspaper was conducted for the period from 2015 until 2020. We focus specifically on differences between the crisis years and the non-crisis period thereafter. Our results indicate that if asylum seekers, refugees, and migrants are given a voice, they are more likely to be framed positively or as victims. However, if they are only mentioned, a negative frame is more common. Asylum seekers are also more likely to be negatively framed than migrants and refugees. Moreover, we find no differences between the elite and popular newspapers in how they frame and give a voice to these three actors. [ABSTRACT FROM AUTHOR]

Access to healthcare is a fundamental human right for all people, including refugees and asylum seekers. Despite the provision in the Refugee Act of South Africa, which allows refugees to enjoy the same access to health services as the citizens of the Republic, refugees still encounter challenges in accessing such services in Gauteng province. This protocol aims to develop strategies to improve access to health care services for refugees and asylum seekers in Gauteng province, South Africa. The study will be conducted in three phases. An exploratory sequential mixed methods design will be employed in phase 1 of the study; the initial study will be based on a qualitative approach followed by a quantitative approach. Phase 1 (a) of this study will employ a qualitative approach in Gauteng province among conveniently sampled health practitioners as well as purposively sampled refugees and asylum seekers. Interviews will be used to collect data that will be analyzed thematically. Phase 1 (b) will adopt a quantitative approach based on the findings from the initial qualitative study. The ethical principles of informed consent, anonymity, privacy, confidentiality, and avoidance of harm will be adhered to throughout the research process. Phase 1 (c) will be meta-inference and conceptualization. Phase 2 will focus on the development of strategies using strength, weakness, opportunities, and threats analysis and a build, overcome, explore, and minimize model to guide the process. In Phase 3, the Delphi technique will be used to validate the developed strategies. The conclusion and recommendations will be based on the findings of the study. [ABSTRACT FROM AUTHOR]

Asylum-seeking migrants represent a vulnerable segment of the population, and among them, women constitute an even more vulnerable group. Most of these women and girls have been exposed to threats, coercion, and violence of many kinds, including rape, forced prostitution, harassment, sexual slavery, forced marriage and pregnancy, female genital mutilation/excision, and/or other violations of their rights (e.g., deprivation of education, prohibition to work, etc.). The perpetrators of the violence from which they flee are often their own families, partners, and even institutional figures who should be in charge of their protection (such as police officers). In the process for the acceptance/rejection of an asylum application, the forensic and psychological certification can make the difference between successful and unsuccessful applications, as it can support the credibility of the asylum seeker through an assessment of the degree of compatibility between the story told and the diagnostic and forensic evidence. This is why constant and renewed reflection on the ethical, forensic, and methodological issues surrounding medico-legal and psychological certification is essential. This article aims to propose some reflections on these issues, starting from the experience of the inward healthcare service dedicated to Migrant Victims of Maltreatment, Torture, and Female Genital Mutilation operating since 2018 at the Institute of Forensic Medicine of the University Hospital of Palermo. [ABSTRACT FROM AUTHOR]

Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated people, patients with psychiatric disorders, and migrants. A narrative review of literature was performed using key electronic databases (Scopus, Pubmed—MEDLINE) and search engines (Google Scholar). Peer-reviewed publications, grey literature on HCV, and recent models proposed for micro-elimination in underserved populations were included. An insight into the COVID-19 pandemic and its influence on HCV micro-elimination pathways will be also provided. Regarding prison settings, a progressive reduction in HCV epidemiology among incarcerated people in the last years was found (one-third of the level it had been before). People suffering from psychiatric disorders have a high anti-HCV prevalence, but there is a lack of data on active infections. A bidirectional relationship between HCV and psychiatric disorders was found. Migrants showed a very inconsistent assessment of HCV. Furthermore, available studies recorded data from populations with high heterogeneity of anti-HCV prevalence, Therefore, the reported results need caution in their evaluation. [ABSTRACT FROM AUTHOR]

Introduction: The 'senses'—our sight, sound, taste, smell, and touch—are intrinsic components of our human experience. Trauma recovery practitioners afford the senses to foster healing and draw into awareness the sensations of the traumatised body. Therefore, if the senses are valuable in trauma recovery, then they must also be important in the initial traumatic acts—such as violence. Aim: This ongoing PhD project explores the role of senses in violence committed towards refugees and asylum seekers in Europe. Method: A sensorial model is developed through semi-structured interviews and key engagement with literature and research. Results: An excess and absence of senses are critical in understanding violence endured by refugees and asylum seekers, but also in how violence is witnessed and perceived by others. It is clear people on the move experience violence sensorially throughout their journey. Conclusions: The senses are evidently part of the violence. At times, violence is in sensorial excess: the sounds of camps; the smell of tear gas. Alternatively, a concealment or deprivation of senses can also be violent: camps on the periphery; violence out of sight. Notably, senses (in excess or through concealment) can also be vital components in the survival of violence. "Vio-lense" is a suggested model for considering 'violence' and 'senses' as being essentially interwoven rather than separate. This, in turn, is important for development of collective healing mechanisms and, more widely, defining and understanding violence. [ABSTRACT FROM AUTHOR]

Refugees and asylum seekers often confront particular challenges when accessing essential services in host countries. The difficulties these vulnerable groups face in meeting educational needs are documented in numerous studies. Although Romania experienced mainly transit migration, it is recently becoming a destination for refugees and irregular migrants. Most people entering the country are young or minors, and access to education is crucial for their economic future and a successful integration process. The present paper primarily explores the challenges and difficulties asylum seekers and people with refugee backgrounds experience in accessing educational services in Romania. It is framed within an interpretive paradigm using qualitative interviews with asylum seekers, people with refugee backgrounds, and NGO representatives to collect data. This exploratory research is designed on thematic analysis: four themes and eight subthemes were identified, capturing participants' perceptions about the Romanian education system and their barriers to accessing education programs. The findings suggest that access to education for refugees and asylum seekers was restricted primarily by language-related or bureaucratic and legal obstacles. Therefore, efforts should be made to raise awareness among the general population and specialised educational institutions. Additionally, creating more opportunities for interactions between people of different backgrounds can alleviate the persisting inequalities experienced by this vulnerable population. [ABSTRACT FROM AUTHOR]

The forced migration of nearly 6 million Venezuelans is a global issue that is transforming urban contexts, particularly in Latin America. Ecuador is the third main recipient country of displaced Venezuelans. The lack of State migration policies and the deteriorating economic situation throughout the region have had significant impacts on migrants. While food security and migration have been studied extensively in Latin America, their intersection remains under-explored. Through a systematic review and focus group research, this exploratory study analyzes the food security conditions of Venezuelans in Ecuador and the impacts of the COVID-19 pandemic on the levels of food insecurity using an intersectional approach. Quantitative, systematic review results demonstrate that demands for food assistance outweighed the planning and provisions supplied by both state and non-state actors. Focus groups results support the findings from the systematic review and demonstrate that in the medium-sized port cities of Manta and Machala, food demands during the pandemic lockdown measures were met through the direct food supply and resilience strategies, including the securing of personal loans and bartering. In contrast, in the cities of Quito and Huaquillas, strict enforcement of COVID-19 lockdown measures, reduced access to work and systematic food access and increased reliance on food assistance from non-governmental actors. This study also found that the impacts of food (in)security in the context of COVID-19 disproportionately affected women in all cities, as they offered their food rations to meet the needs of their children, grandchildren, or other dependents. [ABSTRACT FROM AUTHOR]

Introduction: Sexually minoritized men in the East, Horn, and Central Africa continue to flee from their countries, because of actual or feared persecution, to neighboring Kenya to seek protection and safety. However, there is limited research on their experiences and needs. Therefore, this study aimed to describe the persecution experiences of gay and bisexual asylum seekers and refugees in the Nairobi Metropolitan Area. Methods: We adapted McAdam's Life-Story Interview (LSI) to develop a semi-structured interview guide. We used the interview guide to conduct one-time anonymous in-depth interviews with 19 gay and bisexual men recruited by purposive sampling. The study also included a photovoice component and written reflections. We transcribed the interviews verbatim, uploaded them to NVivo 12 plus, and analyzed the data using Braun and Clarke's six-step thematic analysis framework. Results: The mean age of the participants was 26, with the largest age group being 18–24 (n = 9, 47%). We found six major themes: (1) The Anti-Homosexuality Act, (2) death punishment, (3) physical abuse, (4) sexual violence, (5) discrimination, and (6) injuries. Conclusions: Continued multi-layered discrimination across borders may have adverse physical health outcomes for gay and bisexual asylum seekers and refugees in the Nairobi Metropolitan Area. Further collaborative strategies may help to understand and develop culturally sensitive interventions to improve their health and well-being. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a significant impact particularly on the most vulnerable populations, including immigrants, asylum seekers and refugees in the EU. The article depicts the results of the comparative research project "Local Alliance for Integration (LION/GSRI/University of West Attica/81018): Migrant and Refugee integration into local societies in times of the COVID-19 pandemic in Spain and Greece" implementing a qualitative methodology. This article analyses via 32 in-depth interviews the experiences of immigrants, asylum seekers and refugees in Greece, the increased barriers towards integration due to racial and ethnic inequalities, precarity and health disparities during this period which function as a means of perpetuating exclusion in five sectors: (a) formal employment, (b) healthcare, (c) formal education and language training, (d) housing and social care/protection, and (e) intercultural coexistence as well as the new rise of a hostile rhetoric and anti-migrant attitudes under a COVID-19 pandemic populism. The unravelling of the narratives revealed perceptions and practices of inequality and uncertainty as well as of hope. The socioeconomic impact of the pandemic on immigrants, asylum seekers and refugees, similarities and differences that occurred and evidence of the ongoing obstacles they encountered during the pandemic are presented. Policy and practice implications include the implementation of prevention measures by the institutions that are tasked with the responsibility to remove hindrances, address unequal treatment, racial/ethnic and social inequalities and raise awareness on multiple ways in which the COVID-19 pandemic has intensified vulnerability. [ABSTRACT FROM AUTHOR]

Traditionally a country of emigration, Romania recently experienced an increased migration influx, although it is more a country of transit than a destination for refugees and irregular migrants. Refugees often face difficulties when trying to meet their needs and access essential services. This study aims to explore the experiences and barriers of asylum seekers and people with refugee backgrounds in accessing healthcare services in Romania. It is an exploratory study with a qualitative research design, which uses an inductive and deductive approach, with thematic analysis being applied in order to grasp the difficulties and barriers that asylum seekers and people with refugee backgrounds experience in accessing essential social services. The research was based on seven in-depth interviews with representatives of significant national or international non-governmental organisations assisting refugees and asylum seekers in Romania and 129 semi-structured interviews with different categories of people with refugee backgrounds from Southwest Asia, Eastern Africa and Ukraine. One of the most salient themes we identified relates to accessing the healthcare system. Participants talked about what information they needed to access medical services, where they looked for this information, and what barriers they faced in the process. Cultural, linguistic, structural, and financial barriers were perceived as the most significant. Improved public awareness, a better understanding of asylum issues, and stronger community support are essential to addressing inequalities experienced by this vulnerable population. [ABSTRACT FROM AUTHOR]

Measuring disability among migrants is a significant challenge; however, there is no consensus on how to measure disability and functional limitations. The present study reports a methodological approach to measure disability in refugees and asylum seekers using Washington Group (WG) tools, namely the WG Short Set (WG-SS), the Short Set Enhanced (WG-SS-E), and the Extended Set on Functioning (WG-ES). We interviewed 161 migrants in different regions of Italy. The recommended threshold for each WG tool was used. We identified 13.7% of migrants with disabilities using the WG-SS, 21.7% using the WG-SS-E, and 31.6% using the WG-ES. Anxiety and depression were the main weights to identify migrants with disabilities (11.8%). The WG-SS does not measure mental health, and therefore we do not suggest its use in the field. However, the WG-SS-E, together with some questions on pain and fatigue, should be considered to identify migrants with a greater risk of disability. [ABSTRACT FROM AUTHOR]

This study made a claim that perceived discrimination, socio-economic strain, and structural strain on displaced people have an adverse impact on their mental health. Our claim also acknowledges that these people potentially have a unique set of strengths and abilities that they rely on to overcome their immediate and future problems. The aim of this study is thus to examine the relationship between post-migration life adversity and mental health problems, and assess the potential mediating role of resilience among asylum seekers and refugees (219 asylum seekers and 42 recognized refugees) living in South Korea. Structural equation modelling was used to examine hypothesized pathways between post-migration life adversity, mental health and resilience. Fit indices showed adequate to excellent fit of the examined models with mental health as the outcome. Mental health was positively regressed on PMLA and negatively regressed on R. In addition, R partially mediated the association between PMLA and MH. In addition to providing the academic contributions of this study to the ongoing study of resilience and its social welfare implications, the result of the study indicated the necessity of improving the present and future socio-environmental factors that foster resilience among refugees and asylum seekers. [ABSTRACT FROM AUTHOR]

Introduction: The rise in armed conflicts has contributed to an increase in the number of asylum seekers. Prolonged asylum processes may negatively affect asylum seekers' health and lead to inactivity. Studies show that physical activity interventions are associated with improvements in health outcomes. However, there are a limited number of studies investigating the associations of physical activity on asylum seekers' health. Methods: Participants (263 males and 204 females), mostly from Syria, were assessed before and after a 10-week intervention for VO2 max, body mass index (BMI), skeletal muscle mass (SMM), body fat, and visceral fat. Linear mixed models were used to test differences within groups, and a linear regression model analysis was performed to test whether physiological variables predicted adherence. Results: Participants' VO2 max increased: males by 2.96 mL/min/kg and females 2.57 mL/min/kg. Increased SMM percentages were seen in both genders: females by 0.38% and males 0.23%. Visceral fat area decreased: males by 0.73 cm2 and females 5.44 cm2. Conclusions: Participants showed significant increases in VO2 max and SMM and decreased visceral fat. This study provides an insight into asylum seekers' health and serves as a starting point to new interventions in which physical activity is used as a tool to promote and improve vulnerable populations' health. [ABSTRACT FROM AUTHOR]

The devastating impact of COVID-19 on individuals and communities has accelerated the development of vaccines and the deployment of ambitious vaccination programmes to reduce the risks of infection, infection transmission and symptom severity. However, many people delay or refuse to get vaccinated against COVID-19, for many complex reasons. Vaccination programmes that are tailored to address individual and communities' COVID-19 concerns can improve vaccine uptake rates and help achieve the required herd-immunity threshold. The Maximising Uptake Programme has led to the vaccination of 7979 people from February–August 2021 in the South West of England, UK, who are at high risk of severe illness from COVID-19 and/or may not access the COVID-19 vaccines through mass vaccination centres and general practices. These include: people experiencing homelessness; non-English-speaking people; people from minority ethnic groups; refugees and asylum seekers; Gypsy, Roma, Travelers and boat people; and those who are less able to access vaccination centres, such as people with learning difficulties, serious mental illness, drug and alcohol dependence, people with physical and sensory impairment, and people with dementia. Outreach work coupled with a targeted communication and engagement campaign, co-designed with community leaders and influencers, have led to significant engagement and COVID-19 vaccine uptake among the target populations. [ABSTRACT FROM AUTHOR]

Culturally and linguistically diverse populations, particularly asylum seekers, face challenges in accessing healthcare services. Pharmacists need to be capable of identifying and responding appropriately to the needs of diverse population groups. The aims of this study were to clarify student pharmacists': knowledge of, and attitudes to, asylum seekers; their understanding of themselves with regard to cultural competence; their exposure to culturally and linguistically diverse clinical settings; their potential receptivity to learning opportunities directed towards cultural competence; and the extent to which they interpreted the current curriculum as improving their cultural competence. Pharmacy students' viewpoints and perspectives were essential as emerging pharmacy professionals. This study employed mixed methods and convenience sampling. There were no significant (p > 0.05) associations between demographics and any of the survey items. Five themes emerged from the interviews: namely, exposure, formal vs. informal, positive views, conflict, and sufficiency. Pharmacy curriculum should ideally provide sufficient knowledge to meet culturally diverse healthcare consumers' needs, especially asylum seekers. The most efficacious models for teaching cultural competence are as yet still undetermined. Interactive learning in cultural competence was recommended as essential. [ABSTRACT FROM AUTHOR]

This present study concerns refugees and asylum seekers who have been referred to a Mobile Mental Health Unit (MMHU-Ch) in rural Greece on a Northeast Aegean Island during the refugee crisis in 2015. Our objective is the examination and recording of psychopathology characteristics', the presentation of the therapeutic interventions provided, and the difficulties. The sample is composed of 418 requests made by refugees, asylum seekers, adults, and children. The clinical and demographic data have been gathered from the MMHU-Ch's charts. The study is retrospective, descriptive with quantitative and categorical variables. The data has been analyzed with the utilization of SPSS. The dominant diagnosis in children involves anxiety disorders, developmental disorders, and PTSD. One noteworthy finding is the high percentage of suicide behavior regardless of psychiatric diagnosis, which should be further examined. As far as interventions are concerned, the conclusions which have arisen are the gradually stronger commitment of the referents, but also the high percentage of requests that dropped out. Further examination of the interventions and their efficiency is recommended as well as probing the features of psychopathology in the long term with a view to clarifying the patronizing and aggravating factors. [ABSTRACT FROM AUTHOR]

The number of people forcibly displaced worldwide is increasing. It is an imperative challenge to provide mental health training for non-health professionals and volunteers who work with those vulnerable populations. The objective is to identify mental health training programs for non-health professionals and volunteers, without mental health training, to work with asylum seekers or refugees in any context. Literature about mental health training programs for adults, non-health professionals and volunteers without mental health training, working, or who have worked, or will work, with asylum seekers or refugees will be considered. Literature published in English, Swedish, Portuguese, Spanish, and French will be considered. Literature reporting training programs exclusively for professionals or volunteers in the health or mental health domains will be excluded. The following electronic databases will be searched: MEDLINE, CINAHL, PsycINFO, Psychology & Behavioral Sciences Collection, SCOPUS, ERIC, RCAAP, and OPEN GREY. Other sites to be searched: ClinicalTrials, UNHCR, IOM, WHO, Save the Children, IMISCOE, and IFRC. The screening process will entail two steps carried out by two independent reviewers: firstly, screening by title and abstract, and secondarily, by full text. Data will describe the literature according to the review research questions that were defined following the PPC mnemonic, and presented graphically with a narrative. [ABSTRACT FROM AUTHOR]

Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020 and compare these to the prevalence of risk factors in the 12 months before they left their country of origin. A cross-sectional study was conducted between 2019 and 2020 of all refugees, asylum seekers, and subsidiary protection beneficiaries attending a Lisbon, Portugal refugee center. Behavioral and biological risk factors were assessed using the WHO STEPwise modified questionnaire. A descriptive statistical analysis was conducted, which included 80 respondents, mainly men, with an average age of of 30.3 ± 9.8 years. The prevalence of several behavioral risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries was higher at the time of the study than in the 12 months before leaving the country of origin. Differences between men and women were noted in tobacco (49.1% vs. 25.9%) and alcohol use (43.4% vs. 18.5%) in the receiving country. Overweight and obesity also showed differences by gender (7.5% vs. 11.1% and 39.6% vs. 48.1%). The prevalence of suicidal ideation and suicidalplanning was high, and varied from 6.3% and 20% in the country of origin to 16.3% and 38.5% respectively in the receiving country, however the prevalence of suicide attempts was lower in the receiving country (66.7%) compared to the country of origin (100.0%). Information on health and social determinants is critical to identify priorities and increase access to access to gender-specific health and community level interventions, including mental health, to reduce risk factors associated with refugee relocation and resettlement.

Despite the existence of significant research on the mental health care challenges of migrants, particularly refugees and asylum seekers, less attention has been paid to treatment approaches. We used a case study from the UK to look at the topic from a cultural models approach (which comes from cognitive anthropology) to analyse migrants' experiences with mental health care. Twenty-five refugees and asylum seekers living in North East England and Northern Ireland were interviewed who had used at least six sessions of talking therapy during the last three years. Our results suggested that adopting a 'cultural models' approach, which offers a new conceptual and methodological framework of migrants' experiences and their underlying schemas and expectations, would significantly contribute to building therapeutic alliances and provide relevant and appropriate treatments for migrant clients, particularly for unrecognised pre- and post-migration traumatic experiences.

Effective interventions for trauma-related psychopathology exist but there are considerable barriers to access and uptake by refugee groups. There is a clear need for culturally appropriate and accessible interventions designed in collaboration with refugee groups. Islamic Trauma Healing is a lay led, group intervention specifically targeting healing the mental wounds of trauma within local mosques. Using Prophet stories and turning to Allah about traumatic experiences, this program incorporates cognitive and exposure principles into an Islamic-informed intervention. In Study 1, following a community event describing the program, 39 Somali participants completed a brief trauma screening and interest measure. In Study 2, pre- to post-group pilot data related to PTSD, depression, somatic symptoms, well-being, and satisfaction was examined for men's and women's groups (N = 13). Qualitative analysis of group and leader feedback was conducted. Both studies suggest a strong perceived need and match with the Islamic faith for the intervention, with large effects from the pre- to post-group (g = 0.76 to 3.22). Qualitative analysis identified themes of community, faith integration, healing, and growth. The program was well-received by participants and offers a promising model for the delivery of trauma-focused intervention to Muslim refugee communities. [ABSTRACT FROM AUTHOR]

This paper seeks to report how Greek-Cypriots view migrants, asylum seekers, and refugees in Cyprus, compared with their views on the first migratory wave in the late 1940s, taking into account the influence of the media. More specifically, the paper investigates the lack of integration and local acceptance of asylum seekers and migrants in the host countries both in Europe and in Cyprus, giving special emphasis on the role of the media and the language used and how this affects the perception of civil society on refugees. The paper led us to the conclusion that this group of people faced in Cyprus, both previously in the 1940s as well as today, racism, exploitation, and marginalization from Greek-Cypriots due to the language used by the media and the lack of policies towards integration of refugees and asylum seekers. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop an occupation-centered and client-centered assessment tool for refugees and asylum seekers. A preliminary tool outline was produced based on a literature review, while considering previous published tools' strengths and limitations. A qualitative study was undertaken via focus groups to improve on the tool's design and adequacy for its purpose, resulting in the creation of a pilot version of the tool. Convenience sampling included 8 Greek and Cypriot professional and student occupational therapists with experience in the field, 8 international expert occupational therapists, 4 laypeople, 4 humanitarian professionals, and 5 refugees and asylum seekers. Basic qualitative content and thematic analysis led to topics regarding tool modifications that concerned categorization, formation/structure, wording, administration, and assessment scale. Corresponding tool revisions ensued. This study led to the development of the pilot version of the Refugees and Asylum Seekers Occupational Satisfaction (RASOS), which can also be used to identify underlying personal and environmental factors that contribute to self-perceived low satisfaction. A future quantitative study is required to establish the psychometric properties of the tool.

In recent years, European countries have made their asylum systems increasingly stricter. Norway has been no exception, taking additional measures to tighten its asylum system to make it less attractive to seek asylum. How does the asylum procedure and living in asylum centres influence psychosocial well-being and, in turn, the prospects of incorporation into a new society? This article identifies the main challenges that a group of women face while seeking asylum and living in asylum centres in Norway, and it explores the influence that these challenges have on their mental health and well-being. To do this, it draws on ethnographic fieldwork conducted during approximately one year (2017-2018) with nine women-of different nationalities, ages and backgrounds-living in asylum centres in Norway. The analysis shows five main elements of the Norwegian asylum and reception system that result in the main challenges that the women deal with during their wait in the asylum centres. These elements are the wait and uncertainty around their asylum application coupled with the inability to influence their circumstances, the limitations to engage in meaningful activities as well as the financial and mobility limitations imposed by the Norwegian authorities. The interconnections of these five elements make the women often feel powerless, unable to influence their circumstances and feel stuck in the present, unable to plan their future, thus, experiencing high levels of uncertainty and existential immobility (Hage 2009). This, in turn, leads to frustration, apathy and even depression in the women, which can have a negative effect on their future incorporation into the Norwegian society.

Background: Sexual violence (SV) literature on applicants for international protection (AIPs) shows that they are at high risk of victimization. The study objectives are to provide an exploratory overview of the occurrence of SV in AIPs in Belgium and their help-seeking behavior (HSB). This overview is crucial to develop prevention strategies and care paths focusing on providing adequate care to AIP SV victims in Belgium., Methods: Quantitative data from structured interviews with AIPs ( n = 62) triangulated with qualitative data from in-depth interviews with AIP SV victims ( n = 11) served to explore the nature and impact of SV in AIPs in Belgium and their HSB., Results: A total of 83.9% of respondents have experienced SV. A total of 61.3% were victimized within the past year. Victimization seems more gender-balanced than in the general population. AIPs link SV to their legal status and their associated vulnerable situation. HSB upon SV was very limited in this sample. Help-seeking barriers interfering with the decision-making process to consult (in)formal resources were identified., Conclusions: AIPs in Belgium are at high risk of SV. Despite the impact of SV on AIPs' lives, HSB upon SV is rare. The provision of age-appropriate sexual education and development of policies that will reduce help-seeking barriers is needed., Competing Interests: The authors declare no conflict of interest.

There are 26 million refugees globally, with as many as 80% facing food insecurity irrespective of location. Food insecurity results in malnutrition beginning at an early age and disproportionately affects certain groups such as women. Food security is a complex issue and must consider gender, policies, social and cultural contexts that refugees face. Our aim is to assess what is known about food security interventions in refugees and identify existing gaps in knowledge. This scoping review followed the guidelines set out in the PRISMA Extension for Scoping Reviews. We included all articles that discussed food security interventions in refugees published between 2010 and 2020. A total of 57 articles were eligible for this study with most interventions providing cash, vouchers, or food transfers; urban agriculture, gardening, animal husbandry, or foraging; nutrition education; and infant and young child feeding. Urban agriculture and nutrition education were more prevalent in destination countries. While urban agriculture was a focus of the FAO and cash/voucher interventions were implemented by the WFP, the level of collaboration between UN agencies was unclear. Food security was directly measured in 39% of studies, half of which used the UN's Food Consumption Score, and the remainder using a variety of methods. As substantiated in the literature, gender considerations are vital to the success of food security interventions, and although studies include this in the planning process, few see gender considerations through to implementation. Including host communities in food security interventions improves the refugee–host relationship. Collaboration should be encouraged among aid organizations. To assess intervention efficacy, food security should be measured with a consistent tool. With the number of refugees in the world continuing to rise, further efforts are required to transition from acute aid to sustainability through livelihood strategies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exposed health and social inequities among migrant populations. Less empirical evidence exists about the impact of COVID-19 lockdown measures on migrants. This study aimed to investigate the impact of the first lockdown in France between March and May 2020 on migrants' lives and livelihoods. We adopted a social vulnerability framework to conceptualize how the pandemic and the consequential lockdown in France contributed to a 'compounded crisis' for asylum seekers and undocumented migrants. This crisis encompassed health, protection, and socio-economic challenges for migrants and exposed the shortcomings of existing government policies that exclude migrants and do not address the root causes of health inequities. The study draws on in-depth qualitative interviews conducted with 75 asylum seekers and undocumented migrants during the pandemic lockdown in the French regions of Auvergne-Rhône-Alpes and Île-de-France. The findings of this paper highlight the importance of implementing a cohesive pandemic response approach that views health as a fundamental inclusive right for all human beings and all policies as health policies to promote well-being for all.

Background: Emerging evidence suggests that the COVID-19 pandemic is widening pre-pandemic health, social, and economic inequalities between refugees, migrants, and asylum seekers and the general population. This global scoping review examined the impact of the pandemic on community-based asylum seekers and undocumented migrants in high- and upper-middle-income countries., Methods: We conducted a systematic search of peer-reviewed articles in PubMed , Scopus , Web of Science , and ProQuest Central . We applied Katikireddi's framework of understanding and addressing inequalities to examine the differential impact of the pandemic across exposure, vulnerability to infection, disease consequences, social consequences, effectiveness of control measures, and adverse consequences of control measures., Results: We included 32 articles in the review. The analysis showed that asylum seekers and undocumented migrants experienced greater exposure to the COVID-19 virus and higher infection rates. They also experienced differential social consequences in the form of job loss and lost and/or reduced work hours. The effectiveness of pandemic response measures on asylum seekers and undocumented migrants was also affected by pre-pandemic social and economic marginalisation, exclusion from pandemic-induced policy measures, lack of appropriate pandemic communication, and variable trust in governments and authority. Pandemic control measures had greater adverse consequences on asylum seekers and undocumented migrants than the general population, with the majority of studies included in this review reporting worsened mental health and social isolation conditions and reduced access to health care., Conclusions: Asylum seekers and undocumented migrants experienced a disproportionate impact of the COVID-19 pandemic across the six thematic areas of comparison. Policies that reduce exposure and vulnerability to the infection, grant equitable access to health and social care, and build capacities and resilience, are critical to enable asylum seekers and undocumented migrants to cope with and recover from pre-pandemic and pandemic-induced inequalities.

The resettlement and integration of a displaced population into a new society faces a plethora of challenges. These range from lack of national legal frameworks to plan and implement planned relocation, to the absence of a long-term vision, inadequate funds, and poor institutional structures. The 3-year EU Erasmus+ funded REGARD Project (REbuildinG AfteR Displacement) set out to address some of these challenges and develop guidance with a focus on the roles and responsibilities of the host and the resettled community in order to understand the needs of both. This paper focuses on the Swedish experience (one of four case studies in the project) in the aftermath of the mass influx of Syrian refugees in 2015. A needs assessment conceptual framework of both host and displaced communities guided the multi-method approach applied in the Sweden case where data was drawn from a scoped literature review on issues related to integration and social cohesion complimented and validated by in-depth interviews with a number of municipalities and non-governmental organizations all working with asylum seekers resettlement. The results of the research indicate that while the Swedish case was a relative success by comparison to others in Europe, there was still systemic shortcomings that needed attention. First, cooperation and coordination between government and non-governmental actors and at different levels up and down the chain of services provided for resettled refugees is still lacking where the reality on the ground is not fully grasped by centrally driven policy and decision-making. Second, what determines the effectiveness of resettlement and integration efforts is focusing on the individuality of each displacee's needs and circumstances where one-size does not fit all, and recognizing that integration is a two-way process that has to involve both host and guest community and not simply the absorption of one into the other. Finally, the paper concludes that the pressured and often highly politicized situations both host and guest community are put into usually force rapid responses, while long-term visions and sustainable solutions when adequate time is taken to establish trust and build viable networks between the two communities can lead to far better results. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has severely restricted global movement, thus affecting migration processes and immigrants themselves. The paper focuses on the evaluation of bordering procedures and practices introduced by the Polish government in the time of the pandemic. The aim is to highlight the duality in the admission processes at Polish borders between labour and forced migrants, which have been driven, as I argue, by economic interests and the xenophobic attitudes of the government. The paper is based on interviews with experts assisting migrants during the pandemic in Poland, whose direct contact with thousands of clients has allowed them to acquire broad knowledge of how the new legal provisions have affected different groups of immigrants. The data confirms that the Polish border is very porous. It has been almost completely closed to asylum seekers, especially those fleeing from Muslim countries, for whom the only option is to cross the border illegally. Only one exception was made for Belarusians, who were cordially welcomed at the border while escaping persecution in their home country in the wake of their protests against Lukashenko's regime. Economic migrants, on the other hand, exist on the other side of the spectrum. For immigrant workers, borders have remained open throughout the whole pandemic. Moreover, some further measures facilitating their arrival were introduced, such as de facto lifting of quarantine for seasonal farm workers. [ABSTRACT FROM AUTHOR]

This five-year cross-sectional study mapped the prevalence of several known risk factors for adverse perinatal outcomes in asylum-seeking women in The Netherlands. Characteristics of 2831 registered childbirths among residents of asylum seekers centers (ASCs) in The Netherlands from 2016 to 2020 were included. Results showed a high general and teenage birthrate (2.15 and 6.77 times higher compared to the Dutch, respectively). Most mothers were pregnant upon arrival, and the number of births was highest in the second month of stay in ASCs. Another peak in births between 9 and 12 months after arrival suggested that many women became pregnant shortly after arrival in The Netherlands. Furthermore, 69.5 percent of all asylum-seeking women were relocated between ASCs at least once during pregnancy, which compromises continuity of care. The high prevalence of these risk factors in our study population might explain the increased rate of adverse pregnancy outcomes in asylum seekers compared to native women found in earlier studies. Incorporating migration-related indicators in perinatal health registration is key to support future interventions, policies, and research. Ultimately, our findings call for tailored and timely reproductive and perinatal healthcare for refugee women who simultaneously face the challenges of resettlement and pregnancy.

The Sustainable Development Goals 2030 call for an end to poverty in all its forms everywhere through the adoption of integrated social protection policies. However, recent literature suggests an implicit and explicit discrimination towards asylum seekers and refugees (ASRs) in United Kingdom social policy, leading to high rates of destitution, poor health and isolation. Due to the limited nature of UK government support, many ASRs become involved with semi-formal and informal social protection. This systematic literature review synthesizes existing qualitative literature that documents the impact of these interventions on the wellbeing of adult ASRs in the United Kingdom. The literature offers useful insights into asylum seeker and refugee perceptions of wellbeing, agency, and support responsibility, and how their interaction with social protection providers constrains or enables the realization of their fundamental human needs. The findings demonstrate that government support is inadequate to meet the needs of many asylum seekers and refugees, leading to disempowerment, lack of agency and exploitation. Positive wellbeing outcomes are linked to semi-formal and informal interventions, summarized into six categories: the positive impact of volunteering; physical space and intentional gathering; practical and material support; training and skills development; solidarity, inclusion and understanding; and peer support and advice. [ABSTRACT FROM AUTHOR]

In the last ten years, the settlement and integration of refugee families and asylum seekers have represented some of the main challenges faced by European territories. People in need of international protection can face challenges in being settled and integrated into rural areas where it is often difficult to find co-ethnic support networks. This case study provides relevant data on how the settlement of young asylum seekers is carried out in the main town of a rural area in Catalunya. It explores the impact of a mentoring programme which consists of providing informal support to newcomers in language acquisition (Catalan), as well as inclusion in the job market and social capital. We interviewed almost all participants of that programme in this rural area, gathering in-depth interviews with mentees (with eight young asylum seekers) and two discussion groups with their mentors (living in the main town of the region). Our findings showed that whereas the main objectives of the programme are providing linguistic support, social capital and inclusion to the job market, mentoring is more focused on providing emotional support and cultivating a sense of belonging. Various outcomes will be discussed which consider the types of support that were present in mentoring relationships and how bonding and bridging social capital were fostered, namely the elements that can promote a more inclusive and welcoming rural community. [ABSTRACT FROM AUTHOR]

This article considers the impact of COVID-19 on international protection applicants in the Irish asylum system. It presents a critical reflection on the failings of direct provision and how the experience of COVID-19 has further heightened the issues at stake for asylum seekers and refugees living in Ireland. In Ireland, international protection applicants are detained in a system of institutionalized living called direct provision where they must remain until they receive status. Direct provision centres offer substandard accommodation and are often overcrowded. During the pandemic, many asylum seekers could not effectively socially isolate, so many centres experienced COVID-19 outbreaks. This article examines these experiences and joins a community of scholars calling for the urgent end to the system of direct provision. [ABSTRACT FROM AUTHOR]

Migrants are at an increased risk of HIV acquisition. We aimed to use phylogenetics to characterize transmission clusters among newly-diagnosed asylum seekers and to understand the role of networks in local HIV transmission. Retrospective chart reviews of asylum seekers linked to HIV care between 1 June 2017 and 31 December 2018 at the McGill University Health Centre and the Jewish General Hospital in Montreal were performed. HIV-1 partial pol sequences were analyzed among study participants and individuals in the provincial genotyping database. Trees were reconstructed using MEGA10 neighbor-joining analysis. Clustering of linked viral sequences was based on a strong bootstrap support (>97%) and a short genetic distance (<0.01). Overall, 10,645 provincial sequences and 105 asylum seekers were included. A total of 13/105 participant sequences (12%; n = 7 males) formed part of eight clusters. Four clusters (two to three people) included only study participants (n = 9) and four clusters (two to three people) included four study participants clustered with six individuals from the provincial genotyping database. Six (75%) clusters were HIV subtype B. We identified the presence of HIV-1 phylogenetic clusters among asylum seekers and at a population-level. Our findings highlight the complementary role of cohort data and population-level genotypic surveillance to better characterize transmission clusters in Quebec. [ABSTRACT FROM AUTHOR]

Background: An EU directive holds the EU member states responsible for implementing the provision of health care for asylum seekers. However, current literature indicates insufficient care for asylum seekers in the German health system. This article aims to characterize the situation of the client population on the waiting list of a psychosocial center (PSZ)., Methods: We conducted a retrospective observational study based on client files in Halle (Saale), Germany. We included 437 adults who were on the PSZ waiting list between 2016 and 2019. Questionnaires that collected information on the clientele at two different times were analyzed., Results: The average waiting time for psychotherapy was 50 weeks. In total, 85.6% of the 188 respondents reported sleep disorders ( n = 161), 65.4% of clients reported pain ( n = 123) and 54.8% suicide attempts/suicidal thoughts ( n = 54). In the 16-week waiting period in which the clients waited for an initial appointment with a psychologist, the residence status deteriorated in 21.3% ( n = 40)., Conclusion: Improving asylum seekers' access to the German health system is urgently needed in order to prevent unnecessary suffering in the future and to comply with EU law.

Asylum seekers in Israel from East Africa frequently experienced traumatic events along their journey, particularly in the Sinai Peninsula, where they were subjected to trafficking and torture. Exposure to trauma has implications for rights that are contingent on refugee status. This retrospective chart review aimed to characterize the types of traumas experienced by 219 asylum seekers (149 men) from Eritrea and Sudan who sought treatment at a specialized mental health clinic in Israel, and to compare the mental health of trauma victims ( n = 168) with that of non-trauma victims ( n = 53). About 76.7% of the asylum seekers had experienced at least one traumatic event, of whom 56.5% were diagnosed with post-traumatic stress disorder (PTSD). Most reported traumas were experienced en route in the Sinai, rather than in the country of origin or Israel. Few clinical differences were observed between trauma victims and non-trauma victims, or between trauma victims with and without a PTSD diagnosis. Our findings emphasize the importance of accessibility to mental and other health services for asylum seekers. Governmental policies and international conventions on the definition of human trafficking may need to be revised, as well as asylum seekers' rights and access to health services related to visa status.

The health of urban refugees and asylum seekers (URAS) in Bangkok has been neglected and health policies for USAR have not materialized. This study aimed to explore the views of stakeholders on policies to protect URAS well-being in Thailand. This study conducted a mixed-methods approach comprising both in-depth interviews and Delphi survey. The interview findings revealed six main themes: (1) the government position on URAS; (2) opinions on Thailand becoming a party of the 1951 Refugee Convention; (3) NGOs on health promotion for URAS; (4) options on health insurance management for URAS; (5) working potential of URAS; and (6) uncertainty of future life plans for URAS. The Delphi survey showed that URAS should have the right to acquire a work permit and be enrolled in the public insurance scheme managed by the Ministry of Public Health. Moreover, the ideology of national security was more influential than the concept of human rights. The ambiguity of the central authorities' policy direction to take care of URAS creates haphazard legal interpretations. The Delphi survey findings suggested the need for a more inclusive policy for URAS, however actual policy implementation requires further research on policy feasibility and acceptance by the wider public.

How do advocacy organizations from the San Diego—Tijuana area contest and resist Trump's immigration policies? What resources and tactics do they use to externalize their demands at the local and international levels? Based on semi-structured interviews with eight advocacy organizations—with a local, binational, and international presence—that have mobilized to externalize their demands on different local and international arenas, this research aims to answer these questions by applying the transnational advocacy networks literature to the mentioned case study. Our main findings show that transnational relations between advocacy organizations represent a counterbalance to Trump's immigration policies. Some organizations have adapted to react to a set of new policies implemented by the administration, and, at the same time, they have diffused information, values, and ideas as part of their resistance tactics. Through transnational advocacy networks, local organizations have accomplished international relevance, turning into key players of advocacy in the region. These networks demonstrate that, despite Trump's restricting immigration policies, transnational channels between these actors remain open for collective action. [ABSTRACT FROM AUTHOR]

When seeking asylum in Norway, asylum seekers are usually placed in asylum centers, where their everyday life is filled with uncertainty and few meaningful activities. Despite the importance of religion for many residents, little attention is paid both by authorities as well as by scholars to the role of religious beliefs and practices in their everyday life within this context. This article is based on ethnographic research with women living in asylum centers over the course of one year. Through the lens of 'everyday lived religion', it explores the role and significance of their religious beliefs and practices in their everyday life in the center, as well as the changes that they experience to these. It argues that religion acts as a compass and provides a sense of continuity in the everyday life in the asylum center. The women also experience certain changes to their religious beliefs and practices due to being in a new socio-cultural environment. [ABSTRACT FROM AUTHOR]

Academic evidence on the health of urban refugees and asylum seekers (URAS) in Thailand is extremely sparse, especially for neglected problems such as mental health disorders. This study aimed to investigate the prevalence of anxiety and depression and factors associated with these problems among URAS in Bangkok. A cross-sectional study was conducted in 2019. The URAS were randomly selected from the roster of the Bangkok Refugee Centre (BRC). A self-administered questionnaire was used and 180 samples were recruited. Descriptive statistics and multivariable logistic regression were used for the analysis. We found a prevalence of 70.0% for anxiety and 39.5% for depression. Compared to Southeast Asia and China, URAS from other regions were 3.4 times (95% CI 1.5-7.5, p < 0.05) and 4.0 times (95% CI 1.1-14.0, p < 0.05) more likely to experience anxiety and depression, respectively. URAS with chronic co-morbidities (OR = 3.4, 95% CI 1.2-9.4, p < 0.05) and being divorced or widowed (OR = 11.1, 95% CI 2.1-57.2, p < 0.05) faced greater odds of depression than those without co-morbidities and being single. Related health authorities should play a proactive role in providing mental healthcare services for URAS, with greater consideration for those of certain nationalities and with chronic diseases.

Asylum seekers frequently experience potentially traumatic events (PTEs), but the type and frequency vary depending on the country of origin. The cumulative effect of multiple PTEs and other stressors expose asylum seekers to a significant risk of mental ill health. The aim of the study was to examine the prevalence of PTEs, depression and anxiety symptoms, risk for psychological trauma, psychotropic medication use and previous mental health diagnoses among adult asylum seekers in the Asylum Seekers Health and Wellbeing (TERTTU) Survey ( n = 784 respondents, participation rate 78.6%). A substantial majority (88.7%, 95% CI 86.9-90.3) of asylum seekers reported one or more PTEs before arriving to Finland. PTEs during the asylum-seeking journey were reported at 12.0% (95% CI 10.7-13.4), however, when examined by region of origin, the proportion was 34.5% (95% CI 29.5-39.8) for asylum seekers from Africa (excluding North Africa). Significant symptoms of depression were reported by 41.7% (95% CI 39.6-43.9) of asylum seekers and symptoms of anxiety by 34.2% (95% CI 32.1-36.2). Half of the asylum seekers were assessed as having at least a medium-risk for psychological trauma. Prevalence rates were higher among females and asylum seekers from Africa. This study highlights the importance of using screening tools to identify asylum seekers with severe mental health problems that may need referral to further assessment and treatment. Asylum seekers from Africa (excluding North Africa) should be given additional attention in initial health screenings and examinations.

Female refugees are frequently exposed to sexualized, gender-based violence and harassment before, during, and after their flight. Yet female refugee-specific care and protection needs are rarely addressed in host countries. This study aimed to evaluate a mother and child center (MUKI) for female refugees in a reception and registration center in Germany. In 2017, we conducted semi-structured qualitative interviews with 16 female refugees attending the MUKI and with its five main staff members. We asked the participants about the MUKI's relevance, encountered difficulties, and suggestions for improvement. The interviewees appreciated the MUKI's sheltered environment, care services, and socializing opportunities, as well as its women-only concept. Overall, the participants saw overexertion, social engagement-related difficulties, and the MUKI's noisy environment as key attendance barriers. Interviewed staff primarily reported problems regarding the working conditions, including the high staff and attendee turnover and low general service awareness. The participants advocated an expansion of the MUKI program. The MUKI project underlines that providing newly arrived, vulnerable female refugees with sheltered surroundings and psychosocial services is an essential step toward addressing female refugees' specific care needs.