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Mental health morbidity among people subject to immigration detention in the UK: a feasibility study

Published online by Cambridge University Press:  22 June 2017

P. Sen ,
J. Arugnanaseelan ,
E. Connell ,
C. Katona ,
A. A. Khan ,
P. Moran ,
K. Robjant ,
K. Slade ,
J. Tan  and
K. Widyaratna
...Show all authors
P. Sen*
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
J. Arugnanaseelan
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
E. Connell
Affiliation:
Oxleas NHS Foundation Trust, London, UK
C. Katona
Affiliation:
Helen Bamber Foundation, Bruges Place, 15-20 Baynes Street, London, NW1 0TF, UK
A. A. Khan
Affiliation:
Oxleas NHS Foundation Trust, London, UK
P. Moran
Affiliation:
Centre for Academic Mental Health, School of Social & Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN, UK
K. Robjant
Affiliation:
Helen Bamber Foundation, Bruges Place, 15-20 Baynes Street, London, NW1 0TF, UK
K. Slade
Affiliation:
Division of Psychology, Rm 4113 Chaucer Building, Nottingham Trent University, Nottingham, NG1 4BU, UK
J. Tan
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
K. Widyaratna
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
J. Youd
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
A. Forrester
Affiliation:
Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, 2.304 Jean McFarlane Building, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
*
*Address for correspondence: Dr P. Sen, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK. (Email: piyal@freeuk.com)
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Abstract

Aims.

The UK has one of the largest systems of immigration detention in Europe.. Those detained include asylum-seekers and foreign national prisoners, groups with a higher prevalence of mental health vulnerabilities compared with the general population. In light of little published research on the mental health status of detainees in immigration removal centres (IRCs), the primary aim of this study was to explore whether it was feasible to conduct psychiatric research in such a setting. A secondary aim was to compare the mental health of those seeking asylum with the rest of the detainees.

Methods.

Cross-sectional study with simple random sampling followed by opportunistic sampling. Exclusion criteria included inadequate knowledge of English and European Union nationality. Six validated tools were used to screen for mental health disorders including developmental disorders like Personality Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD) and Intellectual Disability, as well as for needs assessment. These were the MINI v6, SAPAS, AQ-10, ASRS, LDSQ and CANFOR. Demographic data were obtained using a participant demographic sheet. Researchers were trained in the use of the screening battery and inter-rater reliability assessed by joint ratings.

Results.

A total of 101 subjects were interviewed. Overall response rate was 39%. The most prevalent screened mental disorder was depression (52.5%), followed by personality disorder (34.7%) and post-traumatic stress disorder (20.8%). 21.8% were at moderate to high suicidal risk. 14.9 and 13.9% screened positive for ASD and ADHD, respectively. The greatest unmet needs were in the areas of intimate relationships (76.2%), psychological distress (72.3%) and sexual expression (71.3%). Overall presence of mental disorder was comparable with levels found in prisons. The numbers in each group were too small to carry out any further analysis.

Conclusion.

It is feasible to undertake a psychiatric morbidity survey in an IRC. Limitations of the study include potential selection bias, use of screening tools, use of single-site study, high refusal rates, the lack of interpreters and lack of women and children in study sample. Future studies should involve the in-reach team to recruit participants and should be run by a steering group consisting of clinicians from the IRC as well as academics.

Keywords

Discriminationepidemiologyhealth service researchmaltreatmentminority issues and cross-cultural psychiatry
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 27 , Issue 6 , December 2018 , pp. 628 - 637
Copyright
Copyright © Cambridge University Press 2017 

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