Written evidence submitted by Da’aro Youth Project (CYP0121)

Introduction

1. Da’aro Youth Project is a registered charity established in 2018 in response to the deaths of a number of teenage asylum-seekers and refugees by suicide. We work predominantly with asylum-seeking children and young people from countries in the Horn of Africa.

2. Eritreans and Ethiopians taken together were the largest nationality group of unaccompanied minors to arrive in the UK in 2017, 2018 and 2019. These asylum-seeking children arrive here after traumatic journeys through the Sahara Desert, Libya, the Mediterranean Sea and after crossing borders in Europe, such as in Calais.

3. We aim to promote the wellbeing of these migrant young people living in the UK, through direct support, through building bridges in the community and through advocating for changes to unfair and discriminatory systems which undermine their wellbeing. We believe that building sustainable relationships of trust and support within refugee communities is the best way to empower young people and enable them to overcome their marginalisation within society. Towards this aim, we currently run a weekly youth club in London and also provide some casework support to particularly vulnerable young people dealing with a problem.

Mental health and suicide

4. Our organisation has identified eleven teenage asylum-seekers and refugees from Eritrea, Ethiopia and Afghanistan who have died by suicide in the UK since 2016. Some of them were known to our service and our staff, whilst others were identified as being friends of young people who access our service[1].

5. Seven coroner’s inquests have taken place relating to these deaths, with four inquests still outstanding. Due to there being no family members in the UK to advocate for these young people after their deaths, several of these inquests were held with no witnesses present and no family representation. We have attended two inquests that lasted only half an hour.

6. We think that these deaths speak to there being a hidden mental health crisis – we do not know whether there are others that have died in similar circumstances. Due to the lack of publicly available data that is able to show deaths by suicide amongst asylum-seekers and refugees, or amongst care-leavers. Only one of these 11 deaths has resulted in a serious case review – as there is no statutory requirement to do so in deaths of care-leavers – and there has been no other form of independent inquiry outside of an inquest.

7. In the absence of a full and proper inquiry, it is not possible to fully know whether there are common factors which have impacted on these young people. No single reason can be provided to explain why eleven teenage asylum-seekers and refugees have taken their own lives, but we strongly believe that there are connecting factors between those young people who have died.

8. We know some information about those who we have identified as having died – of these eleven, some young people were still awaiting the outcome of asylum applications and were worried about a negative decision; some had experienced age disputes that had found them to be adults, before they were later brought back into the care system as children; some had difficulties with post-traumatic stress, serious mental health issues and with misuse of drugs and alcohol. All of them arrived here as unaccompanied asylum-seeking children, and almost all of them were either children in the care system or care-leavers at the time of their deaths. Their ages range from 16 to 19 years old – though most were 18 or 19 years old.

Traumatic journeys to the UK

9. Most, if not all, of those young people we have identified as having died by suicide would likely have experienced significant trauma in their home countries and on their journeys to the UK. Many Eritrean, Ethiopian and Afghan young people will have travelled through areas where human rights abuses are occurring, such as in Libya[2] and in Northern France[3]. Children making these journeys to Europe are routinely exposed to violence, sexual abuse, torture and exploitation. Unaccompanied children survive these experiences by existing in a state of high adrenaline, imagining a safe destination they will one day arrive at. Young people expect their bad experiences to end upon arrival at the country of destination – and when they encounter problems in those destination countries in accessing safety through secure accommodation and care, this can have a serious negative impact on the wellbeing of young people. Post-migration stress factors can be as significant as traumatic events prior to or during migration, to the emotional wellbeing and mental health of this group.

Problems with accessing mental health care

10. Some of those who died had significant mental health issues – depression, anxiety, PTSD and symptoms of psychosis – but struggled to access care. For some young people from countries in Africa and the Middle East, there is significant stigma around mental health that prevents frank and honest conversations being had with caring professionals. Those in caring professions – social workers, personal advisors, foster carers, and accommodation keyworkers – are often not identifying evidence of mental health difficulties and not identifying when difficult or negative behaviours are actually a sign that a young person has experienced trauma. Additionally, when young people are identified as needing mental health care, there is quite often resistance to this by the young people themselves. Research by the Children’s Society showed that “The Looked After Children’s (LAC) health and other assessment models to identify initial mental health need among young people are currently inadequate in identifying the mental health needs of unaccompanied young people who are seeking asylum having fled war and persecution, or those who are recovering from human trafficking and modern slavery”[4]. In addition, there are systemic issues preventing access to mental health care for children in care, such as long waiting times and issues with the transition from child to adult mental health services.

Poor local authority care

11. Some of the young people who died had very negative experiences of care and their poor emotional wellbeing was exacerbated by uncaring or hostile care-providers. Social workers, personal advisors, accommodation keyworkers and foster carers all have an important role to play in supporting young people and helping them to recover from traumatic experiences. We have worked hand-in-hand with many caring and competent care professionals. However, the focus of some social workers appears to be on ‘ticking boxes’ rather than understanding the needs of young people arriving in the UK after traumatic experiences. We find that often, difficult behaviour is treated as the individual fault of a young person, rather than the natural consequence of trauma and related mental health issues. The lack of ‘trauma-recovery’ as a central part of care-planning is concerning. In a 2013 report by the Joint Committee on Human Rights, the provision of local authority support for unaccompanied asylum-seeking children was said to be “extraordinarily varied,” with the government itself commenting at the time that there was an “issue with local authority consistency – some are very effective and others not so”.[5]

12. The provision of quality accommodation with well-trained care professionals is also a concern to us. Unaccompanied children are disproportionately accommodated in unregulated placements, leaving them vulnerable to exploitation and harm. This is independent or semi-independent accommodation with limited support, and is not regulated by the quality inspectorate. The number of children in care placed in unregulated accommodation has increased from 2,900 in 2009 to 6,100 in 2019[6]. The proportions of children who were unaccompanied asylum seekers (UASC) living independently and in semi-independent accommodation were 43 per cent and 36 percent respectively. This is considerably higher than the proportion of LAC who were UASC at 31 March 2019 (6 per cent). We see children and young people in desperate need of care, being housed in accommodation without any support and with very limited access to a social worker or personal advisor – who themselves are often supporting a large caseload of other young people.

Stress and difficulties in the asylum system

13. Young asylum-seekers face a complex and stressful asylum process which puts their welfare at risk. Unlike other children who experience traumatic events or abuse, children undertaking an asylum claim are often required to disclose their personal experiences of abuse and exploitation to asylum officials during an interview. Direct or harsh questioning of these events by officials in austere environments can be retraumatising – and young people are often unsupported after the interview and while they wait for a decision. Enormous delays in asylum decision-making has an extremely negative impact on the wellbeing of the young people that we work with. Issues with securing leave to remain impacted on several of the young people who died by suicide. It is obvious to anyone working with young asylum-seekers, the intense pressure put on them by the asylum system, and the broader implications for their mental health. In a review of evidence on the subjective wellbeing of children subject to immigration control in England, commissioned by the Children’s Commissioner, experiences within the asylum system “were largely negative; they perceived the system as adversarial, confusing and stressful, with few exceptions” and “young people describe[d] the process as overwhelmingly hostile, inaccessible and difficult to understand”[7]. Importantly, the review found that “children’s experiences within the immigration system have detrimental impacts on their experiences accessing other services and support through eroding their trust in authorities and institutions”.

Stress and difficulties through age disputes and age assessments

14. At least one of the young people who died had issues with evidencing that he was an unaccompanied child after his arrival in the UK. This young person underwent multiple age assessments before it was decided that he was a child, during which time the care he received as a minor was withdrawn and then reinstated, having enormous consequences for his life in the UK. Children who arrive alone in the UK are regularly disbelieved about how old they are and can spend many years without access to education or appropriate support, or end up in unsupervised accommodation with adults or in adult immigration detention centres. The only way to challenge this treatment is to pursue costly and protracted legal proceedings. Additionally, age assessments create distrust between young people and social services, which has a knock-on effect on their access to support and care. Despite evidence of children regularly being assessed incorrectly to be adults, thinking still appears to be guided by the “entrenched belief that the majority of age disputed young people are adults posing as children”[8].

Enforced family separation

15. Being separated from one’s family can have a devastating impact on the mental wellbeing of asylum-seeking children and young people. Research by the Refugee Council, Save the Children and Amnesty International has shown the devastating impact that the UK’s policy of family reunification for child refugees has on their emotional wellbeing: “constant anxiety, fear for the safety of their families, and in some cases serious damage to their mental health”[9]. This policy leaves vulnerable children separated from their parents at a time when they need their families most. We have supported several young people who were granted refugee status to go on and make ‘outside-of-the-rules’ visa applications for family members to come to the UK and be reunited with them. Decisions to grant such applications are made at the discretion of the Home Office as unaccompanied child refugees in the UK are excluded from immigration rules around refugee family reunion. Existing Immigration Rules do have a provision for ‘exceptional or compassionate circumstances’ but it is rarely accessible. Only 65 family reunion visas were granted outside of the Immigration Rules between 2013 and 2015. Most children will remain separated from their family and suffer worries and stress about their safety and wellbeing. A number of those who have died were overwhelmed with stress because of worries for family members in precarious situations in other countries. A number who died had requested to be returned to their countries of origin before their deaths.

Sudden drop-off in support at the age of 18

16. The difficulties in the care system are often more pronounced with unaccompanied minors age out of the care system and become care-leavers. The drop-off of support at 18 for especially vulnerable young people can be debilitating. Most of those who have been identified as having died by suicide, did so shortly after leaving care, aged 18 or 19 years old. This may speak to the sudden drop-off in support received by those who age out of care and the additional pressures that they face at 18, including from immigration processes. Children who aren’t granted refugee status or other forms of durable international protection before they turn 18, can then face an immigration cliff edge as they approach their birthday. Removing services from unaccompanied care-leavers without leave to remain undoubtedly increases their vulnerability. Even those with refugee status, receive reduced support at 18 as reflected in the statutory offer to care-leavers. The Becoming Adult project, a three-year ESRC-funded research project on the lived experiences of young men and women who migrated alone to the UK as children as they make the transition to ‘adulthood’ interviewed over one hundred unaccompanied young migrants and found that “Significant stress and anxiety were associated… with transitions at 18 years. Mental health difficulties could impact all other aspects of young people’s lives including sleeping and eating patterns, their educational pathways, relationships with friends and significant others, and their ability to function on a daily basis. Suicidal ideation and attempts at suicide were described by some young people in the study.”[10]

Recommendations

17. Da’aro Youth Project has recently written to the Minister for Suicide Prevention, requesting cross-government action to safeguard unaccompanied child and young adult asylum-seekers and refugees. We do not believe that the particular issues resulting in poor mental health amongst unaccompanied refugee youth can be addressed by general policy relating to children and young people’s mental health. One of our primary concerns is that there appears to be currently no way to know whether other young people have been affected or to monitor trends in suicide and self-harm amongst this demographic. The UK government has a responsibility to prevent suicide but it is unclear how it can do that when there is no record or follow up to the deaths of young people leaving care or in the asylum system. We therefore make the following recommendations:

18. All local authorities must be alert to the risk of suicide in this group, and to train all persons working with unaccompanied asylum-seeking children and young people in trauma-informed practice and to centre trauma-recovery in care planning.

19. All coroner’s courts must be required to collect and return information on nationality and immigration status to the Office of National Statistics (ONS) to begin to record and monitor immigration status in deaths by suicide.

20. All local authorities must be required to send the Department for Education a notification in response to any serious incident involving serious harm or death of a care-leaver (up to the age of 25).

21. The government should provide ring-fenced funding to local areas for specialist mental health support for refugee and asylum-seeking children and young people.

22. The government should identify the common areas for concern in the asylum process for children and what actions to take to ensure better outcomes, including addressing delays in decision making, intrusive interview processes and the inappropriate overuse of age assessments.

23. The government should put in place an urgent and independent inquiry into deaths by suicide within the asylum system, that considers the mental health needs and care provision for unaccompanied asylum-seeking children and young people.