Mental health policy and practice across Europe: an overview

Care of asylum seekers and refugees 359
Refugees in Europe
Refugees are thus a particular category of migrants, one occupying a specific
political and legal position. A refugee is defined in Article 1 of the 1951 UN
convention as any person who:
owing to a well founded fear of being persecuted for reasons of
race, religion, nationality, membership of a particular social group or
political opinion, is outside the country of his nationality and is unable, or
owing to such fear, is unwilling to avail himself of the protection of that
country ...
The immediate concern of those who drafted the Convention was the situation
in Europe following the end of the Second World War and the Convention
originally only referred to those who became refugees ‘as a result of events
occurring before 1 January 1951’. However, this time limitation was removed
in 1967 and the 1951 Convention and the 1967 Protocol are still the most
important, and the only universal, instruments of international refugee law.
The fundamental challenge for those seeking refugee status is to demonstrate
that they have a well-founded fear of persecution while receiving countries
have their own systems of deciding whether a person fits the UN definition,
and national courts may interpret the Convention differently. Some countries,
for example, interpret the Convention as referring only to state persecution and
do not accord refugee status to those suffering from persecution from non-state
agencies. Other countries include both state and non-state persecution when
considering the granting of refugee status (Justice 2002).
The term ‘refugee’ is often used in a generic sense to include both asylum
seekers and those who have achieved refugee status. It is also, on occasion,
used to refer to ‘undocumented migrants’ who enter countries clandestinely
and do not actively seek asylum. Here the term will be used to include asylum
seekers and refugees except where specific issues relating to one or other category
are addressed, in which case the more precise terminology will be used.
Undocumented migrants occupy a quite different legal, political and social
position. Their rights to welfare benefits, health and education may be significantly
different to those of refugees and asylum seekers and they may be
largely ‘invisible’ to service providers. In short, with respect to mental health
care, being an asylum seeker or refugee will affect the context and content of
the care provided and this may be significantly different in content and availability
to that which undocumented migrants may have access to (PICUM
2001).
Despite this, there are important reasons for considering the position of
undocumented migrants in an examination of the mental health care of
refugees. Firstly, there is an interrelationship between asylum-seeking and
undocumented migration. In many European countries with low numbers seeking
asylum (for example, most of the countries in southern Europe), there is
evidence of very high numbers of undocumented migrants. Bernal (2003: 85),
for example, cites evidence of between 200,000 and 300,000 undocumented
migrants in Spain while the number of asylum applications annually since 1995
never exceeded 10,000. In the years 2001 and 2002 Spain received 9200 and