REFUGEE MENTAL HEALTH WORKSHOP – HEALTH HOMELESS AND VULNERABLE GROUPS

1. REFUGEE MENTAL HEALTH WORKSHOP – HEALTH HOMELESS AND VULNERABLE GROUPS January 2009 - Needs Assessment March 2010 - First full Health of Homeless and Vulnerable Groups Plan (HHVG) Client groups covered Asylum Seekers Refugees Gypsy travellers Homeless Migrant workers

2. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS Five Standards Leadership Joint working Health intelligence Access to healthcare Development of local plan

3. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS HSC&WB STRATEGY Needs assessment Strategy document Vision: Everyone is supported to achieve the best level of health and well being possible, living longer healthier lives Appropriate care is delivered in the best location at the right time by a range of organisations working together Communities are well informed and take responsibility for their own health and well being

4. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS Establishment of a multi agency steering group to oversee the development and delivery of the HAVGHAP Establishment of a voluntary sector network Undertaking an in-depth exploration into the key needs of the target populations

5. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS All Groups Mental health issues especially depression and anxiety are raised as health issues particularly affecting these groups The ability to pay for transport to health services creates a barrier to access Information provision and understanding can be difficult due to language or literacy issues

6. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS All Groups – continued Access to dental services is problematic and exacerbated by language and communication difficulties or a chaotic lifestyle in some cases Stigma and discrimination are experienced across all of the groups NHS Direct can be a complex system when needing to access out of hours care for people with chaotic lifestyles and/or for people who speak little English

7. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS Refugees Mental health issues Communicable diseases Incomplete immunisations Barriers Difficulty in understanding the healthcare system (in terms of how to access it), which can lead to inappropriate use of A & E Language and communication difficulties

8. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS Barriers - continued Incomplete medical records or records which are not available Two thirds of refugees have experienced anxiety or depression. Rates of psychosis among white people migrating to predominantly white communities are twice as high as the general population and four times as high among black people migrating to predominantly white communities (Health Challenge Swansea, 2007).

9. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS Undertake a survey of staff working in the provision of health services (to include substance misuse and mental health) to establish any additional barriers to the effective provision of services Evaluate the use and access to dental services for asylum seekers, refugees, gypsies, travellers, migrant workers and homeless people Ensure that the needs of asylum seekers, refugees, gypsies, travellers and migrant workers are considered in the ongoing review of the out of hours service

10. REFUGEE MENTAL HEALTH WORKSHOP - HEALTH HOMELESS AND VULNERABLE GROUPS Review discharges at Cefn Coed for asylum seekers, refugees, homeless people, gypsies, travellers and migrant workers and utilise the results to inform further action plan