Social exclusion in the UK

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This essay will discuss what asylum policy is, and how it has increased levels of social exclusion in the UK, where I will use specific examples from health and housing. Though, first, one must understand the term asylum seekers which applies to someone who has applied for asylum in this country, their application has been accepted as worthy of consideration and is being processed. In comparison, a refugee is someone who has been granted asylum or ‘exceptional leave to remain’ here. It is important to distinguish between two because refugees have more rights than asylum seekers. For example, a refugee can engage in paid employment.

Again, one must clarify what ‘social exclusion’ is. As defined by Gordon and Townsend (2000), they believe that ‘social exclusion’ is not a state but a process. In December 1997, the Social Exclusion Unit (SEU) was set up for two years in the first instance, based in the Cabinet Office and reporting to the Prime Minister. The aim of the Unit is to develop coordinated policies to address social exclusion, described as joined-up policies for joined-up problems.

It has no spending budget, since its purpose is to make recommendations to the contributory government departments, with a view to directing existing funding more effectively. The ‘socially’ excluded are understood to be a group outside ‘mainsteam society’. Sometimes they are thought as ‘outdide society’ itself. (Gordon and Townsend 2000). Similarly, the DSS report states that “social exclusion occurs where different factors combine to trap individuals and areas in a spiral of disadvantages” (DSS NPI report, 1999, p23).

The United Kingdoms history regarding immigration and asylum seekers policy shows successive immigration acts were aimed at allowing certain people to settle here and exclude others. Two significant ones were. The 1905 Aliens Act: aimed at preventing Jews settling (relevance of wider historical context) and the 1962 Commonwealth Immigration Act: response to immigration from former colonies aimed at excluding ‘black’ immigrants. Effectively this ended primary immigration to Britain. Also, Britain’s international obligations are included in the 1951 UN convention on human rights which states that “those with well-founded fear of persecution must be granted asylum”. However, the word ‘well-founded’ is open to interpretation. Read the answer on what is not a physical security measure for your home?

Social policies aimed at tackling social exclusion of immigrants, asylum seekers and refugees, so that social justice and equality can be achieved. This has two main kinds of benefit:

1. helps them to settle and integrate more quickly and provides them with the support they need to make a life for themselves and their families.

2. helps to nurture socially responsible citizens who will contribute much to the social, political and economic life of this country

The asylum process is administered by the Immigration and nationality Directorate, part of the Home Office. The application process can begin in one of four ways, depending on when and where the application is made:

* Port applications, made at the time of entering the UK. Declaration of intention to claim asylum on entering. Entitled to 90% of income support a week (up to �46) if they do and, if they don’t, must rely on local authorities and charities for vouchers, food parcels and accommodation.

* Applications made after legal entry to the UK, within the period that the applicant is permitted to stay in the country e.g on a temporary visa

* Applications made after legal entry to the UK, but after the period that the applicant is permitted to stay in the country has elapsed.

* Ilegal entry applications, where the applicant has entered the UK illegally.

Accomodation: Asylum seekers who make port applications are usually given temporary admission to the country whilst their applications are being considered. However, if they have come from a third country (i.e. no their country of origin) which is deemed safe, they maybe immediately returned their whilst their application is considered.

If the applicant is allowed to stay in the UK whilst their claim is being processed, there are several options for accommodation. These include:

* being held at a detention centre if it is felt that there is a risk that they will abscond or if their claim is being fast-tracked. Detention is more likely after illegal entry or when the applicant has stayed in the UK beyond the time allowed by their visa. In conjunction with this idea, A government bill is currently being considered by parliament – to allow electronic tagging of adult asylum seekers. It is therefore argued that this would further enforce the exclusion of asylum seekers as they would not be able to integrate into society. Though, the government claims that this would cause few problems as the tags can be hidden under clothing and would not impede on AS lives.

* staying with friends or relatives, but they must provide a single address where they intend to stay throughout the process.

* being housed by the NASS, often in local authority accommodation.

There are a number of common themes in arguments for controls on immigration and asylum. Firstly, the numbers game which states that there is a recurrent imagery of small, overcrowded island nation being swamped. The implication is that we cannot accommodate immigrants and their needs. However, the critique is that there is an exaggeration of numbers (public consistently overestimate size of minority ethnic pop), immigrants meet needs of economy, substantial out migration = net population loss some years. Secondly, competition for employment, taking ‘our’ jobs so create unemployment. On the other hand, AS can fill important gaps in labour market e.g. NHS, traditionally more willing to do undesirable, low paid jobs e.g. 1960s, Asians working in mills, 2000s, refs in catering and hospitality industry

Thirdly, there is competition for housing, this is linked to overcrowding argument – not

enough houses to go round. Also, create slums/ghettoes. However, AS usually occupy sub-standard housing stock of little value in ‘undesirable’ areas thus they would help to regenerate these areas.

Under the Immigration and Asylum Act 1999, asylum seekers lost their entitlements to benefits or support under provisions of the National Assistance Act. Instead, the Home Office set up a new department called the National Asylum Support Service (NASS) to provide support for asylum seekers outside mainstream UK welfare services. Asylum seekers are supported by a system of vouchers and receive a small amount of cash each week however Increased stigmatisation and difficulties of everyday living.

They are also being dispersed to cluster areas outside London to help ease pressure on services in South East England. Increased local resentment and hostility. AS cannot choose where they go. In April 2000, the UK NASS started a policy of dispersing asylum seekers from London and southeast England to alternative locations around the UK in an attempt to spread the cost of care. Asylum seekers may only receive 48 hours’ notice, and if they decline dispersal, then they face immediate cessation of income, housing and legal support.

Integration: suggestions for tests in English and British citizenship, swear allegiance to the crown in citizenship ceremonies and learn the English language. This is along the lines of procedures followed by potential immigrants to the United States.

The 2004 Asylum and Immigration Act

Create an imprisonable offence of being undocumented without reasonable explanation, and an offence of failing to co-operate with re-documentation Earlier this week, Micheal Howard of the Conservatives put forward the ways to tackle the issue of dealing with AS. For example, Howard would like the UK to withdraw from the UN Refugee Convention to allow the government to adopt tougher measures against asylum seekers. To create quotas, where Parliament would vote each year on how many asylum seekers, economic migrants, and spouses and dependents should be allowed into the country.

Also, to adopt a points system to identify migrants whose skills are most needed and promises round-the-clock security at ports (Daily Mail, January 24th 2005). This is also in conjunction with the 2002 Nationality, Immigration and Asylum Act states the ‘Secure Borders, Safe Haven’ (title of white paper from which it arose), seen as tough but fair. The Act also mentions that ‘accommodation’ or reception centres rather than the dispersal system. Criticised re: institutionalisation and inhibits integration + difficulties re: where to locate. Continuation of Dispersal: more emphasis on dispersing people to areas that best meet their language and other needs and on helping people to integrate.

Furthermore, a report last August revealed Britain to be the world’s asylum capital, attracting more claimants and allowing more to stay than any other country. (Daily Mail, January 24th 2005). In comparison, the www.bbc.co.uk/asylum_day states that only 2% of the worlds asylum seekers come to the UK.

Health: immigrant groups of various kinds have a variety of specific health needs. For example, different groups are particularly prone to different kinds of disease and so have specific monitoring, testing and health education needs. Refugees and asylum seekers in particular are likely to have mental health needs as a result of the traumas that they have experienced. In addition, they ways in which different groups use, or don’t use, health services reflect different cultural understandings and practices. These also need to be recognised and accommodated.

Asylum seekers who alter their stories may not be lying – inconsistent accounts of persecution by asylum seekers do not necessarily mean that they are fabricating their histories and such account should not be used as a reason to refuse asylum. Herlihy (2004) show that discrepancies are common, especially when the person has post-traumatic stress disorder and has to wait a long time between interviews. These findings have policy implications for the assessment of asylum seekers. Hence, failed asylum seekers are not bogus asylum seekers. Of 58 475 decisions on asylum made by the home office in 2003-4, 87% were refused. Most people appeal, and of 79, 385 appeals received, 21% were accepted, leaving 60,000 failed asylum seekers. (BMJ)

People who are seeking asylum are not a homogeneous population. Coming from different countries and cultures, they have had, in their own and other countries, a wide range of experiences that may affect their health and nutritional state. In the United Kingdom they face the effects of poverty, dependence, and lack of cohesive social support. All these factors undermine both physical and mental health. Additionally, racial discrimination can result in inequalities in health and have an impact on opportunities in and quality of life.

Previous studies in the United Kingdom have found that one in six refugees has a physical health problem severe enough to affect their life and two thirds have experienced anxiety or depression. In Britain, new arrivals should be screened for tuberculosis at the port of entry, but in practice only a small proportion is screened, and tuberculosis in those who apply for asylum after arrival will not be identified until later. Currently no screening is carried out at the channel ports, or at cargo ports, where some asylum seekers may arrive. Some areas with large numbers of refugees have set up screening programmes, but their coverage varies. A study in Blackburn of a sample of 1085 immigrants found 11 cases of tuberculosis at the port, and a further 40 cases subsequently, of which seven (17%) were lost to follow up.

Children and adults may be incompletely immunised, from lack of opportunity, and which immunisations they have received may be unclear (P Le Feuvre, S Montgomery, personal communication, 2000). Access to dentists is important, as dental problems are common.

Social isolation and poverty have a compounding negative impact on mental health, as can hostility and racism. If medication is indicated, it should be kept to a minimum. Reducing isolation and dependence, having suitable accommodation, and spending time more creatively through education or work can often do much to relieve depression and anxiety. Positive changes can be seen as immigrants adjust, are reunited with families, and take up educational and employment opportunities. But there are many barriers preventing people from rebuilding their lives.

Many refugees wish to tell their story, which in itself may be therapeutic, but it should not be assumed that people must go through this in order to recover, as some find it extremely distressing. Every culture has its own frameworks for mental health and for seeking help in a crisis. Mozambican refugees describe forgetting as their usual cultural means of coping with difficulties. Ethiopians call this “active forgetting”. Counselling may be an unfamiliar concept for many refugees who are not accustomed to discussing their intimate feelings with a stranger outside the close family circle. Counselling is currently a Western-orientated concept; its usefulness depends on an individual’s socioeconomic background and cultural orientation and for it to work, a trust building and befriending relationship must develop first.

Asylum seekers have problems of their own, i.e. communication, it takes nearly 35 to 40 mins to establish their problems. There is considerable delay in the running of surgeries. List size is too much to cope with. (BMJ 1st Feb 2003) It is important to for the services of a trained advocate or interpreter to be available unless patient and health worker speak the same language. Refugees may bring a family member or friend to interpret.

Though this may help in obtaining background information, it may result in inaccurate interpreting and also make it difficult to discuss sensitive issues such as sexual health, gynaecological problems, sexual violation, domestic violence, or torture. Using children to interpret may place inappropriate responsibilities on them. Using the same interpreter for all consultations can help the development of trust. Telephone interpreting can be useful when there are no local interpreters. Also, health workers may need training in working with interpreters.

The needs of women may not be identified, especially in cultures where the man is traditionally the spokesperson. Women are less likely to speak English or to be literate, but it is important to speak to them directly, using an independent interpreter rather than a family member. They are more likely than men to report poor health and depression. They may be lonely and isolated but often welcome the opportunity to belong to a group, where they may benefit from the contact and support.

Children may be living in a fragmented family, be with unfamiliar carers, or have arrived alone. They may have experienced violence or torture themselves or have witnessed atrocities; some may have been abducted to become child soldiers and forced to commit violent acts themselves. They may have developmental difficulties, seeming to be mature beyond their years and in a caring role with their parents yet be immature in other situations such as school. They may show anxiety, nightmares, withdrawal, or hyperactivity but few need psychiatric treatment. Support for children needs to be multifaceted, aiming to provide as normal a life as possible, imparting a sense of security, promoting education and self-esteem. It is also important to support parents, as they may be facing difficulties themselves.

The most therapeutic event for a refugee child can be to become part of the local school community, to learn, and to make friends, though there is always a possibility of bullying. For a health worker, contact with the school can be very helpful. Some areas have employed refugee support teachers who provide help to refugee children in school and may be alert to any problems. Unaccompanied minors are especially isolated and vulnerable. Ongoing contact with social services is important to ensure that they have a needs assessment and care plan, and this should be regularly monitored.

In conclusion, the basic health and housing needs of asylum seekers and refugees are broadly similar to those of the host population, although previous poor access to health care may mean that many conditions have been untreated. Symptoms of psychological distress are common but do not necessarily signify mental illness. Many refugees experience difficulties in expressing health needs and in accessing health care. Poverty and social exclusion have a negative impact on health. Initially refugees will need help to make contact with health and social support agencies. Professional interpreters are essential. Time, patience, and a welcoming approach will break down many barriers, but some refugees have problems that need specialist help and support for which there are few resources, especially outside London. It is crucial that these resources are developed before larger numbers of asylum seekers are dispersed.

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