At the age of 13, Janan witnessed his father being beaten to death by members of the Taliban in and his mother dragged off into the night. Recognising the danger to Janan, his relatives sold his parents’ land and paid traffickers to take him to safety. Traumatised and vulnerable, he set off on a horrific nine-month journey. He recalls gruelling marches over mountains in the snow and witnessing the shooting of fellow travellers who fell behind through hunger and fatigue. Every new day that dawned, Janan thought would be his last. Sadly, his story is not uncommon.
Fortunately, once arrive in the UK, our health and social care systems offer excellent support, and usually they settle well into their new lives here. However, as a clinical psychologist who has worked in the for the last 15 years with many young people like Janan, I have become increasingly troubled by what happens as they approach 18 – the age at which they must . Their temporary leave to remain expires at this age, and they must return to court to argue their case again. This process can have a devastating impact on their mental health. All the good work done since their arrival in the UK to heal trauma and help them to settle rapidly unravels.
In the child and family refugee service at the , we see many young people who arrive alone in the UK. Most travel for more than a year or more from places such as Afghanistan, the Middle East or East African countries, experiencing appalling and dangerous journeys to reach our shores. With the right mental health intervention, they are able to come to terms with the multiple losses and trauma they have experienced, and usually demonstrate the most extraordinary resilience. They rebuild “families” within their networks of support and develop dreams for their future, which motivate them to work hard in school.
One part of our system – mental health care – is acting to repair the damage done by another part - the asylum process
Izat had been an excellent student, polite to staff and popular with his peers. He was referred to our service aged 17, when teachers noticed him becoming increasingly withdrawn and angry. When I first met him, he was reapplying for asylum, and in despair about the possibility of losing the life he had built here. He had left one life behind already in , and the prospect of that loss being repeated was unbearable.
He had started having night terrors – dreams where he relived the murders he had witnessed, accompanied by the smells, sounds and intense fear he had experienced at the time. He would wake, covered in sweat and crying out, unable to get back to sleep. These memories began to intrude into his days in the form of flashbacks, which made it impossible to concentrate at school. He started thinking about killing himself.
Although psychological treatment has helped Izat to manage the worst of his symptoms, it has been impossible to address his traumatic memories in any significant way while the insecurity of his hangs over him. Izat has been to court several times, but his case is still unresolved after four years. Three times, he has been granted leave to remain in the UK, and each time this is contested by the Home Office, at which point Izat becomes suicidal again. In the refugee service, we feel we are constantly firefighting with cases such as Izat’s.
These young people are forced to recount their stories which are then scrutinised for any possible evidence of fabrication. This makes them feel like they are not believed by the government to which they turned for protection; and often generates anger and despair. The uncertainty about their future can take many months or even years to resolve; they become suspended in a state of limbo, unable to study or work, with recurring thoughts of past loss and traumas. This comes at a time when their transition to adulthood means they lose the support networks of school, foster carers, and social workers, all of whom have often come to be their new extended families. We see this repeated time and again in our service, and for some children, the emotional deterioration is so bad we fear for their lives. This is all the more tragic given what they have survived.
In effect, one part of our system – care – is acting to repair the damage done by another part of the system – the asylum process. Our current system is retraumatising children and therefore represents a breach in our duties under the Geneva conventions. With the imminent arrival of a huge number of vulnerable children fleeing , on top of those who are already coming from other parts of the world, we need to act quickly to address this situation. We need a system that is able to make more permanent decisions about the asylum applications of children when they arrive in the UK, because their need for protection does not disappear once they reach 18. And we need health and social care services that operate more seamlessly from childhood through to adulthood, so that these highly motivated young people can be supported into becoming functional adults with the potential to contribute a great deal to our society.