Mental health policy and practice across Europe: an overview

chapter
fifteen
The mental health care of
asylum seekers and refugees
Charles Watters
The mental health care of asylum seekers and refugees in Europe is a highly
specific and complex area of investigation. To do justice to the field, it is essential
to adopt a multi-disciplinary approach that embraces the study of political
processes and social policies relating to migrants and refugees, and the impact
these may have on the contexts in which refugees receive mental health care.
These political and social factors should not be examined solely at the level of
nation states but include significant developments at an international level led
by bodies such as the European Commission (EC). The Treaty of Amsterdam
(1997) raised the issue of asylum and immigration to the ‘first pillar’ of policymaking
within the European Union (EU). The implication of this is that all
member states should work to achieve common minimum standards in the area
of immigration and asylum, including standards relating to health and welfare
provision for asylum seekers.
At the time of writing there is a growing convergence in procedures for
processing asylum applications and the nature of the support received by asylum
seekers once they enter an EU country. Under a 2003 EC Council Directive
all member countries of the EU are required to adhere to explicit minimum
standards for the reception of asylum seekers. National governments within
the EU were required to have incorporated the Directive into national laws by
February 2005 (EC 2003).
Analysis at the social and political levels informs us of the contexts in which
mental health care is offered. To form a complete picture it is also important to
examine the micro level at which individuals and families experience mental
health problems and may have direct contact with service providers. Here consideration
must be given to the impact of stressors in the pre-migration, flight
and post-migration contexts as these may have a significant effect on the mental
well-being of refugees (Ager 1993, 2000). It is also important to focus on the