Managing migrant mental health

Assisting citizens with mental illness is one of the most complex areas of consular work. Consuls gathered at the US Embassy for a seminar on mental health organised by Rowland Brothers International to discuss practical strategies. Sheila Reid reports

The festive period is supposed to be ‘the season to be jolly’ but those suffering from mental illness often find this time difficult. Living far from family and friends exacerbates the stress and anxiety for migrants.

Mental Health Strategies
There are over 6,000 suicides in UK annually with immigrants among the most vulnerable especially Eastern European men, David Mosse, Professor of Social Anthropology, SOAS told consuls.

He recommended mental health first aid training for all consular staff, such as SafeTalk (suicide alertness training) and ASIST (Applied Suicide Intervention Skills Training) programmes. Public Health England’s free booklet, Help is at Hand, has helpful advice for bereavement, he added.

Consuls were given advice on managing a mental health crisis from Dr Ranga Rao, South London and Maudsley NHS Foundation. Consuls should seek an urgent GP appointment; phone 111, a crisis helpline or 999; visit A&E; or contact social services.

Under Section 2 of the Mental Health Act 1983, if there is a suspicion of a mental health problem after assessment, the person will be admitted to hospital for up to 28 days.

Section 136 is pertinent to consuls where police have powers to pick up anyone they suspect have a mental health problem, and take them to a place of safety or A&E (commonly known as ‘being sectioned’).

Inspector Elaine Usher, Metropolitan Police Mental Health stressed that detaining a person suffering from mental health at a police station was only used in exceptional circumstances, adding that around 4,000 people were detained under Section 136 in London in 2016.

Consuls were told that an assessment could be complete within 10 days if family members were able to take the patient to a place of safety.

They also said it was sometimes difficult to get information from the hospital due to confidentiality considerations. Provided a patient has given consent, hospitals can talk to a family or embassy without breaking confidentiality, consuls were told.

Improving mental health outcomes
Mark Harris of The Samaritans said their vision is that fewer people die by suicide through listening, which is non-judgemental and confidential.

They provide emotional telephone support to suicidal, depressed, isolated and lonely people every day plus a face-to-face drop in service and email and text support. Their work with Network Rail has seen rail suicides drop by 18% in the past two years. Samaritans can provide material to consuls for their nationals and can arrange for a volunteer who speaks their language.

Dave Atkinson, governor of Maidstone Prison explained that although only 12.5% of the UK prison population are foreign nationals, mental health problems among them is 14.9% higher, one factor being isolation.

He has a dedicated mental health team which manages attempted suicides and resettlement planning of the 85 nationalities in his prison. He made a plea to consuls to help by providing him with information about the types of services available to ex-convicts when they are deported back to their home country.

Legal capacity and travelling home
Richard Copson of Slater and Gordon focused on two key pieces of legislation: Care Act 2104 in which local authorities have a duty to promote wellbeing and must assess whether an adult needs care and support; and Mental Capacity Act 2005 where everyone is assumed to have the ability to make decisions about their lives and, if a person is deemed to lack capacity, all decisions made on their behalf must be done in their best interests.

Dr Finn Morgan, medical director, Healix, explained that the company looks after patients who have fallen sick or been injured in a foreign country. Initially they provide non-medical assistance, for example, extending a visa and arranging medical repatriation.