Refugees & Asylum needs Mental Health Care

In conjunction with World Mental Health Day, Health Equity Initiatives (HEI) calls for greater attention to the mental health needs of refugees and asylum seekers in Malaysia.

There are some 15.2 million refugees worldwide and some 88,900 refugees and asylum-seekers registered with UNHCR in Malaysia, as of end June 2010, the majority of who are from Burma. Malaysia has not ratified the 1951 Refugee Convention or its 1967 Protocol and does not have a legislative or administrative framework for dealing with refugees.

The World Health Organization recognizes refugees as 'one of the most vulnerable groups of today's world' with special mental health needs. Mental disorders like depression, anxiety and post traumatic stress disorder are high in prevalence among refugees and asylum seekers, because of their forced displacement experiences, including extreme levels of trauma, loss, insecurity, abuse, sexual violence, and torture prior to arriving in Malaysia.

Their mental distress continues even after arrival because of their insecure legal status and inability to engage in paid employment legally. Poor accessibility to health care further compromises the mental health of refugees and asylum seekers. Refugees in Malaysia experience many difficulties in accessing mental health services and health care in general.

Some of the factors that limit accessibility to health care are lack of finance, ongoing security threats of arrest, detention and deportation, lack of recognition of their refugee status and language barriers.

In line with the World Health Organization's position to incorporate the special mental health needs of refugees, and to give due regard for equality and non-discrimination in the development of mental health policy and service provision, Health Equity Initiatives calls on the Malaysian government to provide universal access to mental health care, including for refugees and asylum seekers.

We ask that rates for patient care applicable to Malaysians in state-run health facilities also apply to refugees and asylum seekers because they require treatment and do not have the resources. In addition, it is important that the status of refugees is recognized, and they are allowed to work in order that they can finance their health needs and enjoy access to the determinants of health including food, housing, sanitation, and education for their children.

The writer is director, HEI.