Impact of the increased asylum seeker population on a UK mental health crisis service

Background A large proportion of applicants for asylum in the UK are housed in contingency hotels while awaiting the outcome of their claim. As the prevalence of severe mental illness (SMI) among asylum seekers is estimated to be around 61%, a measurable impact on mental health services local to these hotels might be expected. Aims To evaluate the proportion of asylum seekers on the caseload of a crisis mental health team serving an area with a high concentration of contingency hotels, and to briefly explore the care needs of this population. Method Retrospective cross-sectional analysis of all referrals to the Hounslow Crisis Assessment and Home Treatment Team (HCAHTT) in London, UK, between 1 April and 30 September 2023. Results Of the 718 referrals to HCAHTT, 536 were taken on the caseload, of whom 9 were asylum seekers. No difference was found in the proportion of asylum seekers on the caseload compared with the general population. Asylum seekers were often moved at short notice, over half required an interpreter and all 9 had a history of trauma. Conclusions Asylum seekers housed in Hounslow are not over-represented on the HCAHTT caseload compared with the general population. Given that higher rates of SMI in the asylum seeker population are well-established, this result is more likely to be due to systemic factors than to represent an unusually low rate of asylum seekers experiencing SMI. Asylum seekers tended to require interpretation services and have high rates of reported trauma. Continuity of care is affected by the asylum accommodation process. Better active outreach to vulnerable populations to raise awareness of services might be required.