Factors that affect refugees’ perceptions of mental health services in the UK: A systematic review

The UNHCR reported that over 123.2 million people were forcibly displaced worldwide by the end of 2024, with the mental health of refugees emerging as a critical issue. In the UK, asylum seekers and refugees make up around 13% of immigrants and the number is increasing year on year. The Immigration and Asylum Act 1999 aimed to ensure that most cases of asylum seekers would be decided fairly, and within six months. However, it has been argued that long wait times and systemic inequalities and inequities within the asylum system have contributed to heightened mental health problems among refugees even once they gain refugee status. The present study aimed to examine the factors that refugees perceive as limiting their ability and willingness to access mental health services in the UK. A systematic review of 15 relevant articles followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results highlight intersecting perceived limitations to accessing mental health services, such as language difficulties, cultural disconnection regarding mental health including stigma and prejudice, mistrust of services as well as structural barriers including general service limitations and the involuntary transient nature of many refugees’ lives. Policy recommendations emphasize integrating ethnic minority organizations into services, developing culturally adapted services that take into consideration the views of refugees, and ensuring holistic approaches to address socio-economic determinants.