Holt, Leah; (2023) Exploring Professionals’ Perspectives on the Impact of Statelessness on Mental Health. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Part 1 - Literature review The Mental Health Impact of Working in Asylum Law: A Systematic Review Abstract: Aims: Legal professionals work closely with asylum seekers at many points during an asylum claim. Whilst there is an increasing literature examining the mental health impact of working with traumatised populations, there has been limited evidence focusing on the field of asylum law. This review aims to synthesise the current qualitative and quantitative literature on the mental impacts of working in asylum law. Method: A systematic search across eight databases retrieved 11 studies (six qualitative; three quantitative; and two mixed methods). A thematic synthesis was completed for the qualitative research and a narrative synthesis was completed for the quantitative research, before the findings were integrated into a combined synthesis. Results: Four main themes and 13 subthemes were generated by the qualitative research. The main themes were: Emotional labour; Working in a broken system; Emotions do not mix with law; and Detachment. The quantitative synthesis found a variety of measures used in the literature, indicating relatively high levels of distress in this population, and some preliminary findings relating to possible predictors of poor mental health. Conclusions: Despite limited evidence and methodological flaws in the literature, this review indicates that legal professionals are exposed to traumatised clients and difficult working conditions, both of which can negatively impact mental health. It also highlights a number of factors which may predict or perpetuate difficulties. Clinical implications, limitations and suggestions for future research are discussed. Part 2 - Empirical Paper Exploring Professionals’ Perspectives on the Impact of Statelessness on Mental Health Abstract: Aims: ‘Stateless’ is a term used to describe a person who is not recognised as a national of any state. Although there is some emerging evidence suggesting poor mental health outcomes amongst stateless people around the world, to date there has been no research conducted in the UK which specifically focuses on mental health. The aim of this project is to begin to address this gap in the literature by exploring UK based professionals’ perspectives on the mental health impact of statelessness. Method: Semi-structured interviews were conducted with 14 professionals working with people affected by statelessness. Transcripts were analysed using reflexive thematic analysis. Results: The analysis generated six themes and 19 subthemes. The six main themes were: Bureaucratic torture; “Stuck in limbo”; Identity and belonging; Understandable reactions; Inadequate support; and Finding “ways to thrive in adversity” Conclusions: The findings show that professionals witness high levels of psychological distress in people impacted by statelessness, which they attribute to the cumulative effects of their lack of legal status. The results particularly highlight the impact of the bureaucratic processes and living conditions in the UK. The findings also indicate that there are a number of barriers for accessing support and outline how people affected by statelessness draw on other resources to support their mental health. Implications for clinical practice and future research are discussed. Part 3 - Critical appraisal Part three comprises a critical appraisal of the research process. It reflects on methodological challenges, conceptual considerations and key decisions made whilst conducting the systematic review and the empirical research.

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