British Red Cross

Barriers and opportunities: improving access to mental health support for refugees and people seeking asylum

This report explores access to and experience of mental health support for refugees and people seeking asylum in England. It finds a need for a person-centred, trauma-informed approach where the specific needs of the individual are considered and the most appropriate mental health support is offered. It also details an opportunity to improve communication with refugees and people seeking asylum in the provision of mental health support, including longer appointment times to overcome language barriers, preference for face-to-face appointments, written and translated communication, and consistent access to professional interpreters.

Podcast

Supporting refugee and migrant health care in England

We know people who are refugees, asylum seekers and migrants can arrive at their destination with complex physical and mental health needs. So how does the health and care system respond when they arrive in England? Take a listen to this King’s Fund podcast as they discuss refugee and migrant health care.

Public Health

Current awareness updates

Drug users urged to be extra careful following a high number of likely heroin overdoses.
Public Health England (PHE); 2021.
[Public Health England (PHE) has issued a warning of a sharp rise in the number of overdoses linked to people using drugs in several areas across England. To date, there have been at least 46 poisonings resulting in 16 deaths but investigations are still ongoing. The areas affected include South London, the South East, South West and East of England.]

Mental Health Crisis Care Profile.
PHE Fingertips; 2021.
[The Crisis Care Profile collates and analyses a wide range of publicly available data on associated prevalence of mental health crisis. Risk factors include access to care, treatment, and outcomes. Includes risk factors around age, deprivation, illness and disabilities, crime and social isolation. Other topics – urgent and emergency care, quality of treatment, access to support. Data available by local authorities.]

Dental health: migrant health guide.
Public Health England (PHE); 2021.
[Advice and guidance on the health needs of migrant patients for healthcare practitioners. 17 August 2021: New model of care to support refugees and asylum seekers to access NHS dental services.]

Cervical screening: support for people who find it hard to attend.
Public Health England (PHE); 2021.
[Guidance on support for people who find it hard to attend cervical screening due to having a mental health condition, or having experienced trauma or abuse. 16 August 2021: Clarification that this guidance is based on research conducted with users of mental health services and addition of signposting to guidance to support other underserved groups.]

Oral healthcare: model for asylum seekers and refugees.
Public Health England (PHE); 2021.
[This model of care provides professionals with guidance to support access to NHS dentists. Asylum seekers and refugees can face barriers when accessing NHS dentists. This model of care details the processes, rights and entitlements to care and includes supporting information and links to forms and guidance. It is designed for local authorities, support services and health professionals who work with asylum seekers and refugees.]

Antenatal care.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers care for healthy women and their babies during pregnancy (up to 42 weeks). It covers routine antenatal care in primary, community and hospital settings. It describes high-quality care in priority areas for improvement. In August 2021, changes were made to align this quality standard with the updated NICE guideline on antenatal care.]


Service specification: Cystinosis diagnosis and co-ordination of management (all ages).
NHS England; 2021.
[This service specification covers the provision of services for patients with Cystinosis, all ages.]

Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome.
National Institute for Health and Care Excellence (NICE); 2021.
[Evidence-based recommendations on continuous positive airway pressure for treating obstructive sleep apnoea/hypopnoea syndrome in adults. August 2021: The recommendation on continuous positive airway pressure (CPAP) for mild obstructive sleep apnoea/hypopnoea syndrome (OSAHS) has been updated and replaced by recommendation 1.5.2 on CPAP for mild OSAHS in the NICE guideline on obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.]

Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers the diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome (OSAHS), obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease with OSAHS (COPD–OSAHS overlap syndrome) in people over 16. It aims to improve recognition, investigation and treatment of these related conditions.]

Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.
Woolf K. The Lancet Regional Health – Europe 2021;8(-):100180.
[Using a nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK healthcare workers (HCWs) researchers analysed ethnic differences in SARS-CoV-2 vaccine hesitancy. Of the 11,584 HCWs included in the cohort analysis, 23% (2704) reported vaccine hesitancy. Ethnicity was a significant predictor of hesitancy.]

Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019–20 data.
Addiction; 2021.
[Following the March 2020 COVID-19 lockdown, smokers and high-risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high-risk drinking prevalence increased post-lockdown and use of evidence-based support for alcohol reduction by high-risk drinkers decreased with no compensatory increase in use of remote support.

Everybody active, every day: 5 years on.
Public Health England (PHE); 2021.
[Summary of the 5 year review to the national physical activity framework, ‘Everybody active, every day’ and the PHE response.]

Quality in Qual: a proposed framework to commission, judge and generate good qualitative evaluation in wellbeing impacts.
whatworkswellbeing; 2021.
[Based on interviews with ten leading organisations and individuals who have in-depth evaluation and methodological expertise this report sets out why work on qualitative evaluation is valuable and important, what resources already exist. The report identifies six prompts for potential uses of qualitative research in evaluations.]

Genomics nation: A benchmark of the size and strengths of the UK genomics sector.
UK Bioindustry Association; 2021.
[The NHS Long Term Plan promised greater focus on prevention to help people stay healthy and ease the burden on the health service. The early detection of disease, rather than merely the diagnosis and treatment of illness, will be critical to achieve this objective. The NHS Genomic Medicine Service (GMS), launched in 2018, provides a single, national coordinated approach to genomic testing and genomic research in the NHS.]

A joint thematic inspection of community-based drug treatment and recovery work with people on probation.
HM Inspectorate of Probation (HMIP); 2021.
[Probation services across England and Wales supervise nearly 156,000 people in the community. HM Inspectorate of Probation estimates that almost 75,000 of these individuals have a drugs problem, yet fewer than 3,000 people were referred by probation services to specialist drug misuse treatment in 2019/2020. HMIP partnered with the Care Quality Commission to examine how probation services supervise this cohort and found probation services are responding poorly to drugs misuse and addiction cases.]

Covid 19

Current awareness updates

Inequalities in healthcare disruptions during the Covid-19 pandemic: Evidence from 12 UK population-based longitudinal studies.
medRxiv; 2021.

[The research, led by UCL and the University of Glasgow, found further evidence that minority ethnic groups were more likely to have their healthcare affected by the Covid crisis than white people, with the combined results of the 12 studies suggesting minority ethnic groups reported 19% more problems during the epidemic. This article is a preprint and has not been certified by peer review.]

An obesity strategy to reduce COVID-19 morbidity and mortality.
Glasper A. British Journal of Nursing 2021;30(10):612-614.

[In 2020 Prime Minister Boris Johnson launched a series of policy initiatives as part of his government’s new obesity strategy. The prime minster himself was admitted to an intensive care unit after being infected with the SARS-CoV-2 coronavirus and succumbing to COVID-19. Following his successful treatment and discharge from hospital he acknowledged that his deterioration was probably linked to his own excess body weight.]

Importance of patient bed pathways and length of stay differences in predicting COVID-19 hospital bed occupancy in England.[Abstract]
Leclerc QJ. BMC Health Services Research 2021;21(1):566.

[We identified five bed pathways, with substantial variation in LoS by bed type, pathway, and geography. This might be caused by local differences in patient characteristics, clinical care strategies, or resource availability, and suggests that national LoS averages may not be appropriate for local forecasts of bed occupancy for COVID-19.]

Delivering routine immunisations in London during the Covid-19 pandemic: lessons for future vaccine delivery.
Skirrow H. British Journal of General Practice Open 2021;(18 May)

[Mixed-methods study of immunisation delivery in London including an online survey of GP practices and interviews were used to explore new immunisation delivery models which built on existing local knowledge, experiences and networks.]

Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees.
Deal A. Journal of Migration and Health 2021;4(-):100050.

[Report of in-depth semi-structured qualitative interviews (n=32) of recently arrived migrants (foreign-born, >18 years old; <10 years in the UK) to the UK with precarious immigration status, seeking their input into strategies to strengthen COVID-19 vaccine delivery and uptake.]

Community-based volunteering in response to COVID-19: the COV-VOL project.
NIHR Applied Research Collaboration, Kent, Surrey and Sussex; 2021.

[A study by a team from the University of Kent, Brighton and Sussex Medical School and Sussex University shows how voluntary community and social enterprise (VCSE) organisations have made a significant, positive impact on the well-being of older people self-isolating at home during the first COVID-19 lockdown. The pandemic has highlighted the importance of volunteers and community and the role VCSE organisations can play as key and essential partners in our health and social care systems.]

The 3 R’s of Social Care Reform: How constructive risk taking, respectful relationships and a sense of reciprocity characterised a positive response to the Covid-19 pandemic.
Think Local Act Personal; 2021.

[TLAP has been talking to people across social care, and including those who draw on care and support, about their experiences during the pandemic. This paper reflects on these conversations and identifies drivers of the promising examples of practice, marked by changes in behaviour and increased levels of trust. It suggests that positive risk-taking, respectful relationships and a sense of reciprocity are key ingredients in characterising a positive response to the pandemic.]

Unlocking the digital front door – keys to inclusive healthcare.
National Voices; 2021.

[This report explores how the move to remote service models impacted people and how the Voluntary, Community and Social Enterprise sector (VCSE) has led innovative ways to deliver healthcare and support to people during the COVID 19 pandemic. Also available is a literature review and insight data, personal narratives and recommendations for better practice, better policy, and better innovations.]

School closures and parents’ mental health.
Institute for Social and Economic Research (ISER); 2021.

[In this study, researchers from the universities of Essex, Surrey and Birmingham, funded by the Nuffield Foundation, consider the dynamics of parents’ mental health during the pandemic. The study is the first of its kind to look specifically at the impact of having children at home as a result of school closures, separating it from other factors affecting parents’ mental health during the pandemic.]

Outsourcing as a threat to public health: the case for insourcing public sector cleaners and facilities management.
New Economics Foundation; 2021.

[The evidence cited in this report suggests that outsourced health facilities management services pose a threat to public health. This represents a major weakness in the UK’s ability to cope with subsequent waves of Covid-19. As a matter of public health, this paper recommends that the government should launch an urgent and independent inquiry into the outsourcing of key workers.]

Targeted AF detection in COVID-19 vaccination clinics.
Getting It Right First Time (GIRFT), Oxford AHSN; 2021.

[This document brings together learning from several pilot sites which have been carrying out targeted detection of atrial fibrillation (AF) in COVID-19 vaccination clinics. The aim is to provide guidance for systems wishing to develop a standard operating procedure for offering targeted rhythm checks for AF detection in mass vaccination clinics.]

Coronavirus and vaccination rates in people aged 70 years and over by socio-demographic characteristic, England : 8 December 2020 to 9 May 202.
Office for National Statistics (ONS); 2021.

[Difference in vaccination rates by sociodemographic group, sex, ethnicity, religion, main language, living in areas of deprivation, and disability.]


The Global Mental Health Assessment Tool (GMHAT) pilot evaluation: Final report

Public Health England, April 2019
The Global Mental Health Assessment Tool (GMHAT is a computerised clinical assessment tool developed to rapidly assess and identify mental health problems in a range of settings. The tool was tested with 200 Syrian refugees aged 18+ years in one clinic in Beirut, Lebanon who were being processed for resettlement to the UK as part of the Vulnerable Persons Resettlement Scheme.
This report summarises the evaluation findings on how this tool worked in practice at identifying immediate mental health needs requiring urgent attention prior to departure and in facilitating diagnoses, referrals and treatment once in the UK.
Click here to view the report.