Title : Systemic barriers to mental health care for asylum seekers and refugees in the UK: A literature review

Background: Asylum seekers and refugees (ASR) experience disproportionately high rates of post-traumatic stress disorder (PTSD), depression, and anxiety due to experiences of conflict, forced displacement, and post-migratory stressors. In the UK, concerns remain regarding the accessibility and suitability of mental healthcare services for this population.

Aim: To explore the systemic barriers to mental healthcare experienced by asylum seekers and refugees in the UK and evaluate interventions aimed at improving mental health outcomes.

Methods: A literature review was conducted using PubMed, Embase, and APA PsycINFO. Studies published after 2010 investigating barriers to mental healthcare or interventions targeting ASR mental health in the UK were included. Twenty-five studies met inclusion criteria and were analysed thematically.

Results: Five key barriers were identified: hostile immigration policy and the ‘hostile environment’, language and communication barriers, culture and stigma, poverty and social isolation, and limited NHS service availability. These barriers interacted to worsen psychological distress and reduce engagement with services. Interventions including culturally adapted cognitive behavioural therapy (CBT), Narrative Exposure Therapy (NET), imagery rescripting, and community-based support services demonstrated improvements in PTSD, anxiety, depression, and social connectedness.

Conclusions: by wider structural and socio-political systems. Culturally sensitive and trauma-informed interventions show promise; however, further investment, research, and policy reform are required to improve equitable access to mental healthcare for this population.

Ohene Frimpong is an F1 doctor with academic interests in global health, refugee health, and mental health inequalities. He completed an intercalated BSc in Global Health at the University of Bristol, where his research focused on systemic barriers to mental healthcare for asylum seekers and refugees in the UK.