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Supporting people with immigration issues in the context of the Mental Health Act 1983 and Mental Capacity Act 2005

Prof Cornelius Katona
Brian Dikoff, Rukyya Hassan, Rohit Shankar, Lucia Chaplin, Andrew Forrester and Piyal Sen
Medicine, Science and the Law, 2023

Providing mental health support to migrants and asylum seekers with uncertain or unresolved immigration status and/or with ‘No Recourse to Public Funds’ (NRPF) can pose a distinct challenge for mental health practitioners within both hospital and community settings. As an outcome of the UK’s 'hostile environment policy', some migrants and asylum seekers are precluded from accessing statutory welfare support and services, such as when a person has been refused permission to stay in the UK but has not yet been able to lodge an appeal against this decision or to submit a fresh claim. Yet such support is integral to ensure holistic and effective care planning, particularly for people with serious mental illness. This includes people who are detained under the Mental Health Act 1983 (MHA), or treated under the Mental Capacity Act 2005 (MCA), who may lack capacity to conduct their immigration case, or challenge their proposed removal or deportation from the UK.

This editorial looks at the importance of health care professionals and NHS trusts in facilitating access to independent immigration advice and support for individuals, given how much of a risk factor unresolved immigration issues are when it comes to mental health. Advice should be considered to be an essential part of the clinical care of the person. The article recommends that there should be an immigration lead or an immigration hub in each mental health service, which can be accessed for advice on immigration-related advocacy and support to patients, such as assistance in finding qualified legal advice and immigration representation and providing information about local charities and advice organisations. It recommends that training and support are made available to mental health staff to ensure a better understanding of the hostile environment, its impact, and how to best advocate on behalf of this patient group.

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