Insight Into The Needs of Unaccompanied Asylum Seeking Children: A Day in Review

As part of the Royal College’s series of insight events, I recently attended a day of discussion about the needs of unaccompanied asylum seeking children in the UK. This is an increasingly relevant issue as current estimates suggest that on any one day, there are 5000 looked after asylum seeking children within our UK system and these numbers continue to increase.

The setting; The Institute for Mechanical Engineers, opposite St James’ Park in central London. A beautiful setting for a good long look at our nation’s response to the current refugee ‘crisis’. With a prime minister using terms such as ‘swarms of migrants’, it’s easy to see how the good intentions of many have faltered and a day amongst the positive and proactive leaders in refugee welfare has done a great deal to restore my faith in humanity.


The morning session was led by Baroness Helena Kennedy, a prominent voice in the House of Lords. She touched on the three legal documents that help guide refugee law on a global scale including the Refugee Convention 1951, the United Nations Declaration of Human Rights 1948 and more recently the United Nations Convention on the Rights of the Child. The more astute may notice that the former two documents were created shortly following World War Two, a period when children across Europe were sent on trains miles from home for their own protection by parents who feared they may never see their child again. It is odd how detached our society had become from it’s own past when considering the plights of child migrants.

Maurice Wren the Chief Executive of the UK Refugee council spoke next, denouncing the term ‘Crisis’ in favour of ‘Challenge’ and highlighting the need for the UK to plan for more receiving local authorities for unaccompanied asylum seeking children. He called for independent guardianship for all unaccompanied child asylum seekers and a need to uphold the right of children to reunite with their families.

He was followed by Mr Gulwali Passarly, author of ‘The Lightless Sky’, afghan refugee and politics student who reflected on his experiences of the UK asylum process and being the subject of an age dispute. After the journey from hell, to not be believed on arrival to the UK was devastating and contributed to him contemplating suicide. Health care professionals offered some kind words when all seemed lost but there is a need for us to shout a little louder if we are to influence current immigration practices.

After coffee, the Kent and Surrey community child health teams shared their experiences of providing services for unaccompanied minors. Due to their geographical location, they seem streets ahead in terms of providing for the needs of these children but accept that there is still a lot of ground to make.  The current

system means that all children under 16 go into foster care on arrival in the UK but that boys between 16-18 years are often placed in reception centres or even independent living if felt to be appropriate. The Kent medical assessment system was designed with input from CAMHS, public health, community paediatrics and primary care teams and medical assessments are centred around these reception centres or specialist clinics. However the current system of statutory assessments (within 28 days and at 1 year) prevents a more flexible child friendly approach. There is a huge role for general practitioners in meeting the medical needs of these children but ongoing education of professionals is required.

The benefit of a single multiagency holistic assessment of a child’s needs rather than the current fragmented approach was highlighted as well as the need for child friendly resources to help explain the asylum process to those who’s language skills or education may be poor. The importance of sharing good practice amongst professionals was stressed to help resolve some of the current misunderstandings and misconceptions. Although unaccompanied asylum seeking children are ‘looked after children’ by definition, their needs are different and will not be met by current ‘looked after’ services.

In the workshops, we discussed key pathways in healthcare for these children including screening, immunisation and early treatment for communicable diseases as well as treatment of other medical conditions such as anaemia, vitamin D deficiency, visual and dental problems and helminth infection. I was previously unaware that the risk of reactivation of latent TB is five times higher in vitamin D deficiency. 90% of unaccompanied asylum seeking children have travelled from countries experiencing war and conflict and post traumatic stress disorder and sleep disorders are highly prevalent making mental health and psychosocial support an important priority for young people. The difficulties arising from age disputes were also discussed with a suggestion that doctors may need to stand up and say “Is there any reason to disbelieve this child?’ before entering into intrusive and potentially inaccurate age assessments.

The second workshop focused on the role of lawyers, guardians and police in the protection of these children. Baljeet Sandu from the migrant and refugees children’s legal unit emphasised the legal right to specialist representation that children going through the asylum process have and that when achieved through specialist legal services, 100% of asylum claims were successful. Sadly recent cuts to legal aid in England and Wales have meant this does not always happen and the harsh reality of the rapid immigration assessment processes can be very bewildering for these children. In Scotland however, it’s a different story. The role of special guardianship has been created and each unaccompanied child is allocated a special guardian who can advocate for the child and help them to understand the process of seeking asylum

Following this a detective inspector from the London Metropolitan police spoke about their approach to preventing child trafficking. Europol has identified that 10000 children have gone missing from across Europe this year and it is likely that trafficking played a significant role. Police specialist trafficking and kidnap units work closely with non-government organisations to build up relationships with vulnerable young people and identify the organised criminal networks responsible. However he identified a need to educate the entire police force on these issues as the police are often the first point of contact for young people who have illegally entered the country.

Matthew Read, the chief executive of the Childrens’ Society, brilliant summarised the day highlighting that medical opinions matter in upholding the rights of unaccompanied children and that a strong and united multidisciplinary approach is required. As we’ve previously recognised, it’s child first, migrant second and we must lead the way in promoting this ethos.

Related Article: Child First, Migrant Second

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