Safeguarding
Children
Seeking
Asylum
Sarah Nathaniel
Background
• Cardiff Medical School final year project
• Safeguarding issues presenting at initial assessment in
a Cardiff Asylum Clinic
• Children seeking asylum (2009):
• Accompanied: 4,391
• Unaccompanied: 3,175
• Vulnerable group with significant health needs
• Safeguarding involves protecting children from harm and
the promotion of their health and wellbeing
Methodology
• Case series
• Specialist paediatric clinic in St David’s Hospital
• Clinic letter sent to the GP between January 2008
and December 2010
• Qualitative analysis of cases with safeguarding
concerns
• Systematically categorising findings into key
themes
Findings
• 204 appointments:
• 64 did not attend
• 7 clinic letters not located
• 140 clinic letters analysed
• 64 cases safeguarding concerns raised
• 61% male 39% female
• Age: 5 months – 18 years
• Most prevalent country of origin: Pakistan
• “[He] is not recognised as a child within the care system
although tells me that he is coming up to 15 years of age.
He was withdrawn and distressed following 10 days at
a detention centre.”
• “[There are] safeguarding concerns about safety of these
children and the isolated and unsupported situation
this very vulnerable woman is in. She is not appropriately
emotionally available for these children because of her
own vulnerability and her inability to control their
behaviour makes them vulnerable to accidents.”
• “Child’s experiences pre-flight, during flight and postflight (including detention in the UK) have been traumatic
and he has shown serious attempts at self harm and
suicide in the past.”
• Four themes:
1. The asylum process: unaccompanied children, agedisputed cases, accommodation, isolation, education,
immunisations
2. Socio-cultural factors: female genital mutilation,
trafficking
3. The parent/guardian: mental health, abuse
4. The child: physical health, mental health, abuse
• Interplay between these factors
Safeguarding Web: Progression Prevention Protection Provision
Education and
Immunisations
Trafficking
Sociocultural
Asylum
Process
Age
Dispute
Unaccompanied
Children
Accommodation
Vulnerability
Unsuitable
Unsafe
Inappropriate
Parent/s
FGM
Isolation
Abuse
Stress
Anxiety
Depression
Trauma
Physical
Verbal
Emotional
Sexual
Child
Health: Physical,
Mental, Emotional,
Relational and
Spiritual
Discussion
• The indigenous child and the child seeking asylum
• Most at risk:
• Unaccompanied children seeking asylum
• Age-disputed children
• The asylum process both causes and exacerbate
safeguarding issues
• Maslow’s Hierarchy of Needs
• Basic physical needs
• Security
• Social
Limitations
• Dynamic nature of safeguarding issues
• Purpose of the clinic
• Time restrictions
• Drawbacks of qualitative analysis
• Need for a prospective study
Recommendations
• Multi-agency service provision
• Health surveillance that, using the Multidisciplinary Team
and relevant Non Government Organisations, is:
• Accessible
• Consistent
• Specific
• Specific mental health services: parent and child
• Abuse
• Maternal mental health
Summary
• Significant safeguarding concerns
• Multi-factorial
• Mental health of family unit
• Multi-agency service provision
• Further research needed
Thank you for listening
Contact:
sarahnathaniel@doctors.org.uk