We Need to Talk about Mental Health …

Professor Marie Gillespie, Ahmad Al-Rashid and Kelly Wearing argue that while there has been a surge in mental illness during the pandemic, it remains a taboo subject for many asylum seekers and refugees, so it’s time to challenge the stigma, seek support and #LeaveNoOneBehind.

During the pandemic, most of us experienced higher levels of stress, anxiety, depression and other forms of mental ill-health. The COVID-19 pandemic has either worsened pre-existing mental health conditions among marginalised adults and children, or created new vulnerabilities. The main sources of distress are psycho-social stress factors, such as fear of eviction; loss or reduction of livelihood; different forms of discrimination; sexual and gender-based violence; confinement measures; overloaded residential resources or homelessness; and stigmatisation due to mental health issues.

What is Mental Health Awareness Week? 

As we launch our exhibition space for mental health awareness week, we draw attention to the effects of the pandemic on marginalised groups. Over the last year our Covid Chronicles project has highlighted how those living the extremes of precarity, including asylum-seekers and undocumented workers, the homeless and destitute, suffer disproportionately with mental ill-health.

During the pandemic, most of us experienced higher levels of stress, anxiety, depression and other forms of mental ill-health. The COVID-19 pandemic has either worsened pre-existing mental health conditions among marginalised adults and children, or created new vulnerabilities. The main sources of distress are psycho-social stress factors, such as fear of eviction; loss or reduction of livelihood; different forms of discrimination; sexual and gender-based violence; confinement measures; overloaded residential resources or homelessness; and stigmatisation due to mental health issues.

What is Mental Health Awareness Week? 

As we launch our exhibition space for mental health awareness week, we draw attention to the effects of the pandemic on marginalised groups. Over the last year our Covid Chronicles project has highlighted how those living the extremes of precarity, including asylum-seekers and undocumented workers, the homeless and destitute, suffer disproportionately with mental ill-health.

Nature and Mental Health

Who could not be thrilled by the swell of birdsong in cities, peacocks dancing at traffic crossings and the silence in the skies” Arundhati Roy, The Pandemic is a Portal.

Nature has provided some solace for all during the pandemic. Understanding the links between nature and mental health has never been more important. Nature is also the theme of Mental Health Awareness Week 2021, a campaign run by the Mental Health Foundation that aims to inspire us all to connect with nature and feel the mental health benefits. Better access to nature is not only a matter of mental health, it is also a social justice and environmental policy issue. In 2021 a new Environment Bill will be debated in the UK Parliament that will shape our future natural world. The UK will also host the G7 nations putting creating a greener future. And the UN Climate Change Conference of the Parties (COP26) will be hosted in Glasgow in November. 

The Mental Health Foundation’s research on the mental health impacts of the pandemic confirmed what many of us already experienced –  that walking and being in nature even for only 20 minutes can make a big difference to our mental health. As we turned to nature over the last year, many of us had a heightened awareness of the changing seasons, of flowers and trees. As traffic diminished, we heard birdsong like never before and even watched out for bright starry skies at night. In lockdown, as the pace of life slowed down, we started noticing things that previously we ignored, rediscovering a child-like enchantment with the natural world.

The stigma attached to mental ill-health

There is no doubt that the pandemic has had a profound effect on our mental health and wellbeing. MIND reported a mental health emergency. In the report, Habiba Khan, a lived experience consultant, stated: “As a Bangladeshi woman, I have experienced the stigma that mental health issues carry within our South Asian communities. It is an immensely taboo subject, rarely spoken about and remaining very hidden. Black, Asian and Minority Ethnicity communities have been significantly and disproportionately affected by coronavirus and this will have an impact on mental health. Understanding the specific challenges and barriers that certain groups are facing will allow the mental health toll of the pandemic to be confronted”. 

Ahmad al-Rashid, a member of the Covid-19 Project research team, shares a similar view about the impact of Covid-19 on the mental health of refugees from the Middle East region. Having worked with various communities hit by war and displacement in Iraq and Syria, he recognises the social and cultural sensitivity around such a touchy topic as mental health. Ahmad says:

Mental health is still one of the most heavily stigmatised subjects in the region. Many people associate mental health with being mad or crazy. This is the prime factor behind why many people in region suppress their feelings and would not feel comfortable about opening up or discussing issues related to mental health.

He says having a deep understanding of these communities’ backgrounds and their perceptions about mental health, the negativity that surrounds it, and how to sensitively approach/discuss it, is vital in order to support people who are suffering from mental ill-health.

Lack of access to services and coping strategies

GP surgeries across the UK report a massive rise in numbers of people seeking mental health support but the services are not adequate to the need. One asylum seeker artist and contributor to our project (who wished to use a pseudonym) poignantly expressed her desperation at the lack of access to mental health services for asylum seekers: she declared “I am my own psychologist”. This powerful video underscores the ways in which the arts have provided a safety net for those who have found it impossible to access the mental health services they need. As another of our contributors said:

During those weeks [of lockdown], my books became my weapon to fight my boredom, anxiety, worries about the future and feelings of immobility. I used my plenty of time in doing the thing I love most – reading books.

Creativity and mental health

Creativity and the arts – whether reading, drawing, painting, taking photos, making videos and using our phones as creative tools – have become powerful coping strategies, as indeed this project has highlighted. Across our collections there is a firm recognition that both nature and the arts (in whatever form) are available to all of us and can help us – even if they provide no solutions. As another contributor put it pointedly:

If you think artists are useless, try to spend quarantine without music, books, poems, movies and paintings.

The therapeutic benefits of the arts for mental health are well documented. Emma Schofield in Wales Arts Review argues that after a year of the pandemic:

The mental health crisis is no longer an abstract concern which hovers somewhere in our future; it is real, and it is happening right now in Wales.

Many promises are being made by the Labour government in Wales (newly elected in May 2021), about supporting our mental health in Wales but, she says, “it’s very unclear what the commitments really mean, whether they go far enough.” Clearly, mental health matters greatly for the arts sector in Wales. In fact, the very artists who might offer psychotherapeutic arts workshops are themselves struggling to survive. The arts sector has been greatly affected by the pandemic with many artists not being eligible for furlough and finding it impossible to make ends meet. So what’s the solution?  Emma Schofield advocates a ‘cradle to grave’ approach to mental health which draws on existing arts and cultural opportunities and creates new ones. She believes that these opportunities can work alongside other plans, as a powerful component in improving health and wellbeing in Wales and adds:

The arts have a vital part to play in representing mental health and wellbeing in Wales and need to be a central part of the conversation.

Kelly Wearing, at Swansea Asylum Seeker Support, has worked tirelessly to support asylum seekers throughout the pandemic. She says:

Mental health for most people is something that affects other people, never us, even though mental health problems will usually affect 1 in 4 of us. The pandemic has really brought mental health and especially ways of maintaining it into daily conversations and news, in a way not seen before.
During lockdown we realised the value of nature and the open air and how good it made us feel. It was so much more than the vitamin D effect. We appreciate nature more, we feel we are calmer when watching a honey bee in a flower, or when taking time to make something amazing. For some of us though who experience racism in public spaces, we have had to overcome our fears of going out. This fear is something real for many asylum seekers and refugees.

Call to Action

#LeaveNoOneBehind: What do we need to put in place?

  • Ensure socially, culturally, religiously, and  linguistically appropriate support when designing awareness and information platforms.
  • Take into account the richly diverse background of cultures, religions, and languages which may help increase access to these interventions and promo-tion programmes
  • Overcome key barriers like low digital literacy and reduced access to  technological means when designing online mental health services
  • Provide support in multiple language
  • Design helplines to be proactive, rather than merely reactive, when  offering some kinds of psychological relief to those in distress
  • Create and adapt form home health care delivery to reinforce first-line, specifically-trained mental health care providers in times of pandemic. 
  • Campaign for governments and institutions proactively to address working, regulatory, migratory, health, and  economic conditions to reduce the psychosocial burden
  • Address mental health as a global challenge that requires a complete rethink about the delivery of appropriate mental health services
  • Tackle privacy concerns arise
  • Campaign for increased involvement of patients, families, and communities in the design and delivery of mental health services 
  • Conduct further study and research to “leave no one behind” during the current COVID-19 pandemic and beyond

Kelly Wearing (SASS) has kindly compiled a list of the sources of support that she and the asylum-seekers that she works with have found most useful:

Mental Health Support Resources

UK wide 

  1. Everyone
  1. Asylum-seekers and refugee specific support
  • Freedom from Torture – psychological therapy – 020 7697 7777

Wales, especially Swansea

  • BAWSO – support around FGM, forced marriage, trafficking…01792 642003 / bawso.org.uk
  • African Community Centre – free counselling for people seeking asylum + other activities 01792 470298
  • Centre for African Entrepreneurship – wellbeing and transport services e.g. ‘walk and talk’ – Israa Mohammed 07735 602481 /   https://www.caentr.org/transport[email protected] / 01792 475933
  • SCVS Mental Health Information Service – mental health directory and lots of help!

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