People seeking sanctuary, including refugees and asylum seekers, are struggling to access health and wellbeing services in Wales, according to a new Public Health Wales and Swansea University report.

People seeking sanctuary reported feeling their needs were not recognised, and that they had experienced problems navigating through services, including language difficulties and a lack of appropriate interpretation.

Some respondents said the stress of being an asylum seeker or refugee contributed to their poor physical and mental health.

In a survey conducted as part of the study, nearly a quarter (23 per cent) of respondents said they did not know how to contact, or had not heard of, the 999 ambulance service.

The study – The Health Experiences of Asylum Seekers and Refugees in Wales – was conducted to investigate the health, wellbeing and healthcare experience of adult asylum seekers and refugees in Wales, including the views and experiences of both healthcare recipients and providers.

People seeking sanctuary formed part of the research team, and the British Red Cross, Displaced People in Action, Welsh Refugee Council and the Ethnic Youth Support Team also supported.

Health professionals from both secondary and primary care said they often found it difficult to meet the needs of people seeking sanctuary effectively.  Issues included a lack of adequate consultation time, a lack of specific knowledge relating to people seeking sanctuary, and a lack of patient information in appropriate languages.

Gill Richardson, Assistant Director for Policy, Research and International Development, said:

“Refugees and asylum seekers make a huge contribution to Welsh society.  However, the experience of seeking asylum can be very traumatising adding to existing bereavement, transition, loss and stress. We have a responsibility to ensure that services meet the needs of all in our communities, and that no one is left behind. 

“This report finds that Wales needs to build on existing action if it is to achieve its ambition of being the world’s first Nation of Sanctuary, following the recent publication of the Welsh Government’s Refugee and Asylum Seeker plan.” 

Dr Ashra Khanom, Lead Researcher for this study at Swansea University, said:

“While there is good practice across Wales, the experience of often vulnerable individuals of the health and wellbeing system in Wales should be improved to address issues around access to care.  This report makes key recommendations to help policy-makers and practitioners improve the experience of people seeking sanctuary in accessing health and wellbeing services.”  

Key recommendations in the report include the need for:

  • Improved access to services, with written and translated introductory information about rights and entitlements for refugees and asylum seekers
  • Improved training of health professionals on health, social and legal issues associated with seeking sanctuary
  • Work to address the social determinants of health using a multi-agency approach, with partners including the voluntary sector to maximise support for people seeking sanctuary, including refused and destitute asylum seekers

Cathrin Manning, Policy and Public Affairs Officer for British Red Cross, said:

“This research reveals that whilst there is a lot of positive work being undertaken in Wales to make health services more accessible to refugees and people seeking asylum, there are still areas for improvement.

“The voluntary sector and health partners need to keep working together, and with people seeking asylum themselves, to increase the use and understanding of NHS facilities and services so more people can access the help they need. We have welcomed the opportunity to work with our partners to produce this report.”

The research included a review of existing evidence, along with survey and focus group activity, and interviews with healthcare professionals to establish what helped or hindered the healthcare access, and experiences of those seeking sanctuary.

Assembly Members will have the opportunity to discuss the report at this year’s Sanctuary in the Senedd event on Wednesday 3 April.  The event will be attended by the First Minister Mark Drakeford AM, Deputy Minister and Chief Whip Jane Hutt AM, and Minister for Housing and Local Government Julie James AM.

The report will form part of a wider conversation about how services and communities can work together to make Wales a Nation of Sanctuary.

Executive Summary of the HEAR study

Technical Report of the HEAR study

Executive summary of the HEAR study (Arabic)