Mental Health of Refugees and Asylum Seekers

Thoughout the world the number of refugees and asylum seekers continues to increase at an astonishing rate. Given that most will have left their country due to persecution, war, or appalling violations of their human rights, many will have specific mental health needs. Cultural and socioeconomic factors play a major role in expressions of distress, help seeking, pathways into care, and acceptance or rejection of treatments. Being a refugee or asylum seeker raises questions about an individual's self respect and altered identity. Too often though, the needs of this population are ignored by policy makers and clinicians, and these people are left to fend for themselves.

Mental Health of Refugees and Asylum Seekers presents both the theoretical and practical aspects of the mental health needs of refugees and asylum seekers. It looks at the impact of migration on mental health and adjustment, collective trauma, individual identity, and diagnostic fallacies. A practical section highlights cultural factors, ethnopsychopharmacology, therapeutic interaction, therapeutic expectation and psychotherapy. The final part of the book focuses on special problems - such as bereavement, sexual violence, and post traumatic stress disorders, as well as considering mental health problems in special groups, such as child refugees.

This book will be an essential resource for all mental health professionals- helping them better understand the needs of refugees and asylum seekers, how their problems can be managed, and how they can best be helped.

Professor Dinesh Bhugra is Professor of Mental Health and Cultural Diversity at the Institute of Psychiatry, King's College London. He is also an Honorary Consultant at the Maudsley Hospital, where he runs the sexual and couple therapy clinic.

Professor Bhugra's research interests are in cultural psychiatry, sexual dysfunction and service development. He has authored/co-authored over 300 scientific papers, chapters and 20 books. His recent volumes are Textbook of Cultural Psychiatry (awarded a recommendation in the BMA Book Awards in 2008), Culture and Mental Health, Handbook for Psychiatric Trainees and Management for Psychiatrists. His most recent monograph, Mad Tales from Bollywood: Portrayal of Madness in Conventional Hindi Cinema, was published in 2006.

He is the Editor of the International Journal of Social Psychiatry, International Review of Psychiatry and International Journal of Culture and Mental Health.


Tom Craig is Professor of Social Psychiatry at the Institute of Psychiatry and with the South London and Maudsley NHS Foundation Trust. His interests concern the development and dissemination of innovative community-based psychiatric services with an emphasis on practical interventions to tackle social exclusion and promote quality of life for people suffering from severe mental illness. These programmes have included the establishment and evaluation of psychiatric services for homeless mentally ill people, residential alternatives to the hospital asylum, the development of clinical case management models and specialised interventions for young people suffering from the first episode of a psychotic illness.


Professor Bhui was born in Kenya to a Punjabi Sikh family. He was schooled at the Vale and Aylesbury Grammar School in Aylesbury. He qualified in medicine (MBBS) from United Medical Schools of Guys & St Thomas' (UMDS) in 1988.

Professor Bhui is Consultant Psychiatrist in Psychotherapy, and has worked in Community Mental Health Teams, Assertive Outreach Teams, and with a team working with homeless people in East London. Current work involves specialist assessment of referrals to tertiary psychotherapy service, especially the assessment and management of complex culturally influenced presentations.

As Director of the Innovative Cultural Consultations Service commissioned by NHS Tower Hamlets, Professor Bhui contributes to workforce development and provision of high quality and culturally capable care.

1. Introduction: Refugees and asylum seekers: conceptual issues, Dinesh Bhugra and Pedro Ruiz
2. Mental distress and psychological interventions in refugee populations, Tom Craig
3. Pre-migration and mental health of refugees, Thomas Stompe, David Holzer, and Alexander Friedmann
4. Post-migration and mental health in Australia, Helen Herrman, Ida Kaplan, and Josef Szwarc
5. Psychiatric diagnoses and assessment issues for refugees and asylum seekers, K.S. Bhui and Nasir Warfa
6. Complex mental health problems of refugees, Daya Somasundaram
7. International refugee policy, Sean Cross, Jim Crabb, and Rachel Jenkins
8. Dealing with cultural differences, Pedro Ruiz, Susham Gupta, and Dinesh Bhugra
9. Therapeutic skills and therapeutic expectations, Pedro Ruiz
10. Treatment goals and therapeutic actions, J. David Kinzie, John Mark Kinzie
11. Psychopharmacology for asylum seekers and refugees, Keh-Ming Lin, Tonya Fancher, and Freda Cheung
12. Psychotherapy and refugees, Russell Lim and Alan Koike
13. Post-Traumatic Stress Disorder, Nick Grey, Damon Lab, and Kerry Young
14. Suicide in refugees and asylum seekers, Lakshmi Vijayakumar amd A. T. Jotheeswarma
15. Loss and cultural bereavement, Wojtek Wojcik, Dinesh Bhugra, and Tom Craig
16. Child refugees and refugee families, Julia Huemer and Panos Vostanis
17. Sexual violence and refugees, Gill Mezey and Ajoy Thachil
18. Paternalism or autonomy?: ethics, ideology and science in refugee mental health interventions, Derrick Silove and Susan Rees
19. Impact on clinicians, Sean Cross and Jim Crabb
20. Mental health service provision for asylum seekers and refugees, K.S. Bhui, Nasir Warfa, and Salaad Mohamud
21. Conclusions, Dinesh Bhugra, Tom Craig, and K.S. Bhui