Lone child asylum seekers are at risk of poor mental health. Credit: Geert Vanden Wijngaert / AP/PA Images. All rights reserved.

A freezing cold November night in Calais. A terrified boy with burns on his face hid in a refrigerated lorry, exhausted and desperate. His only desire was to make it to England alive.

Twelve months earlier, in his homeland of Afghanistan, Gulwali Passarlay’s father, grandfather, and three other family members were killed by US soldiers, who suspected arms were stored in the family home. His uncle had a senior role in the Taliban, but his father was a well-respected doctor and his grandfather a shepherd.

In the weeks that followed, the Taliban tried to recruit Gulwali, then aged 11, and his older brother, to avenge their father’s death; ‘Be martyred or die’ read one handwritten threat*.

Fearing for her grieving sons’ lives, his mother paid traffickers to smuggle them out of Afghanistan and after being almost immediately separated from his brother, he travelled by bus, foot, plane, horse, train, ferry, and in the back of various vans and trucks, blindly and helplessly following the instructions of exploitative smugglers.

He slept on countless floors, flea-ridden mattresses and at a low-point, in an overcrowded chicken coop alongside fifteen men, travelling across Iran, Turkey, and Europe, to arrive in Britain alone, deeply traumatised and physically scarred. He was aged just 13.

“I felt less than human,” Gulwali* has said of his journey to the UK. In the eyes of the British government he was an ‘unaccompanied child asylum seeker’.

READ MORE: An Afghan experience of the UK asylum system

Home Office figures show that last year, 3,034 unaccompanied children, like Gulwali, arrived in the UK to claim asylum. These children were forced to make terrifying journeys, navigating traffickers and strange lands in search of safety from unthinkable brutality.

In Europe as a whole, this figure is almost 90,000, according to the statistical office Eurostat. Over 90% were male, and the majority were adolescents, in contrast with the infants commonly pictured in the mainstream media.

These deeply traumatised adolescent boys are at the forefront of undoubtedly the greatest humanitarian crisis since World War II.

Critics say the UK government has been slow to react, and has not done enough to date to ease suffering. In May 2016, David Cameron announced that unaccompanied child asylum seekers in Europe could be brought to the UK, as part of an amendment to the Immigration Bill proposed by the Labour peer Lord Dubs. However, no tangible numbers were specified and no long-term funding established to support children once here. 

The mental health implications for these young survivors are grave. They are subject to a poorly funded, ill-planned system, which arguably exacerbates the needs of the most vulnerable and is failing to acknowledge a looming mental health crisis.

"When you get to your final destination, it is not the end. It is just the beginning, another struggle, another battle"

Enduring psychological problems

When Gulwali first arrived in the UK, he recalls that he was deeply traumatised, depressed, and struggling to cope. His experiences echo the statistics. Unaccompanied child asylum seekers are at high risk of psychological problems as they cope with the trauma of their past and learn to navigate the UK asylum system.

Between a fifth and a half of these children are estimated to show signs of post-traumatic stress disorder (PTSD), with a higher rate of psychological problems in unaccompanied children, compared to those arriving with families.

And it appears there is no quick fix; psychological problems are often chronic, lasting more than 12 months. Nine years after arriving in the UK, Gulwali still experiences nightmares, depression and mental health issues related to trauma.

Worryingly, given that many children are fleeing war and violence, the number of traumatic life events a child experiences before migration is strongly related to the severity of psychological distress experienced.

Understanding how the UK system impacts on mental health is critical, as the risk for trauma does not end when a child arrives in the UK.

Today, Gulwali is a 21-year-old articulate and passionate university graduate living in Bolton. He speaks openly about his ongoing struggles with mental health, the failures of the UK asylum system, and his desire to improve the lives of child migrants and asylum seekers. Gulwali Passarlay today. Credit: Gulwali Passarlay. All rights reserved.

“The journey itself is hard, but the biggest depression is when you are here, dealing with officials,“ Gulwali told me. “I want to tell people when you get to your final destination, it is not the end. It is just the beginning, another struggle, another battle.”

UK asylum process: exacerbating mental health?

Local councils are legally bound by the Children Act to care for unaccompanied children who arrive in their area. However the type, and quality of care — both key to a child’s mental health — are not legislated.

The controversial practice of age assessments often determines where children are placed. In the absence of documents evidencing a child’s date of birth, age is determined based on an assessment of physical appearance and demeanour.  

The dire consequences of age disputes on asylum-seeking children’s lives – and the culture of disbelief they create -- were highlighted in a report published by the House of Lords European Union Committee last month. The report concedes that mistaken age assessments result in children being placed in unsuitable conditions.

READ MORE: Lost childhoods: age disputes in the UK asylum system   

This was the reality for Gulwali, who aged 13, was mistakenly assessed to be 16, and placed in a semi-independent hostel, with other adolescent children and young adults. The tension surrounding age assessments infiltrated his living environment, creating an atmosphere of surveillance and a sense that everything the residents did was scrutinised.   

“Most of them [the other residents] didn’t feel comfortable, didn’t feel at home because of the issue with the age assessment,” Gulwali recalls.

"The way they dressed, the way they ate, the way they cleaned their room, the way they talked to guys, everything was under watch.  It was like Big Brother.

"Social workers [would] tell you: ‘The way you do your ironing, the way you’re shaving. You’re not 13, you’re 16.’”

Community Action for Refugees and Asylum Seekers, a community outreach charity based in London, provided evidence on this issue to the Lords committee.

“None of the young people we work with have understood why their age is being assessed, why they are being asked to live as an adult, and why they suddenly have no support. This causes significant harm, resulting in young people distrusting adults,” the organisation said.

This distrust will be a key barrier in supporting children with mental health conditions, and in children seeking help from adults.

UK Immigration Officers as they stop check vehicles in Calais, France. Is Britain a welcoming country for lone refugee children? Credit: Gareth Fuller / PA Archive/Press Association Images. All rights reserved.

Only after Gulwali’s age dispute was resolved was he placed with a foster family, aged 16.

 “My foster family was one of the best experiences of my life”, Gulwali told me. “It really affected me, calmed me down, gave me that support, that warmth, that love that I needed for a long, long time”.

Unaccompanied children’s mental health fares better in foster placements rather than semi-independent care arrangements. Yet, there is a consensus that there are a shortage of foster placements for adolescent boys, with many children missing out on the nurturing environment they so desperately need.

UK Fostering, an independent fostering agency, say they are always looking to recruit foster carers for teenagers from all backgrounds. But the process can be lengthy, taking between three to five months for new foster carers to be assessed and presented to an independent fostering panel.

Professor Yule, a Consultant Clinical Psychologist, and Emeritus Professor of Applied Child Psychology at King’s College London, has worked extensively with refugee populations and helped to set up the Foundation for Children and War, a charity supporting children of war through evidence-based coping strategies. He is concerned about the lack of appropriate foster places for unaccompanied child asylum seekers arriving in the UK.

"In my view there needs to be a national programme to identify foster carers to look after these particular children,” said Professor Yule.

“This implies a crash, accelerated identification of [foster] carers, plus training on the additional needs of traumatised adolescents, plus active, ongoing support."

Uncertain futures

For child asylum seekers, arguably the most stressful process is gaining immigration status to remain in the UK.

Without this they risk being deported, undoing all of their efforts during their journey here.  Immigration status is a central source of stress and anxiety for asylum seekers, and whilst waiting for this decision, futures are put on hold.

The age assessment is closely associated with immigration status, as unaccompanied children who are determined to have reached the age of 18 are more likely to have their asylum claim refused.

“Immigration status is one of the biggest concerns” Gulwali told me. “You don’t know what will happen to you tomorrow, the day after, or next year…if you will be able to stay here, or if you will be able to have a future here. We are in a huge limbo”.

The stress surrounding Gulwali’s age dispute, and immigration status almost cost him his life.

Struggling to cope with feelings of loneliness and recurring night terrors, a complaint about his nocturnal screams proved too much and he attempted suicide. This would be the first of two suicide attempts as Gulwali struggled to traverse the asylum system and the generated feelings of helplessness.

READ MORE: UK immigration control: children in extreme distress   

Dr Ala Sirriyeh, a lecturer in Sociology at Keele University and herself the daughter of a refugee, has interviewed unaccompanied young asylum seekers in the UK as part of her research. She agrees that a common source of anxiety among young asylum seekers is uncertainty about what is going to happen to them once they turn 18.

“I would say that all the young people I've met have expressed anxiety about this,” Dr Sirriyeh said.

“Some [children] are able to get on with life in the meantime, such as going to school and building social networks, but for others this uncertainty can become overwhelming.

“At a time when their peers are planning what they will be doing in the future it's very hard to make plans when you don't know where you will be and what will happen to you.”

Education promotes mental wellbeing?

For many, the uncertainty surrounding their immigration status is a barrier to accessing education or gaining employment. Instead, adolescents, already suffering from poor mental health, are consumed by loneliness and boredom. It is not surprising that self-medication with drugs and alcohol occurs.

Yet education appears to be a gateway to support children with their mental health needs. In Gulwali’s case, support from his school and teachers was most influential in helping him cope with the trauma he had experienced.

School brought structure and normality to his life, and provided him with opportunities to engage with adults and services in a positive way. He was a model student; in his final year he was a school ambassador, prefect and councillor and surpassed the expectations of his teachers with his GCSE success.

However, for refugee children starting a new school, the experience is often not wholly positive. Hostility and bullying are common experiences, Gulwali told me.

“Children in schools and colleges have very little understanding about the situation of asylum seekers,” he said, “so they just play around with them, bully them, without realising that they are already in enough stress.”

Across all realms of society, the focus on immigration in the lead up to the EU referendum has arguably aggravated public hostility to asylum seekers, with reports of an increase in hate crimes. Dr Sirriyeh suggests that this hostility may be higher in less diverse communities, which may have little prior experience of asylum seekers, other than what they have read in newspapers.

“You just don’t feel welcome, you don’t feel part of it. Getting young people to understand that everything they [asylum seekers] love is not here, the least you could do is just be nice to them”.

Listening to Gulwali’s story of survival, it is evident that resilience is his greatest tool in maintaining mental wellbeing and coping with his traumatic past. Resilience in child asylum seekers is common and understanding and harnessing resilience may be one way to minimise mental health issues.

Resilience is at the heart of Gulwali’s message to child asylum seekers today:

“[The] advice from me would be to persevere, keep being motivated to achieve. Don’t lose hope, there is nothing worse than losing hope”.

Perhaps the government faces an unsurmountable task; it is not clear what the most effective therapeutic intervention looks like, and whether this would be sufficient to heal these children from the horrors of their early years. However, all accounts agree that more could, and should, be done.

“Britain should be leading and in principle, it’s wonderful they [the UK government] have committed and said they will take these children, it’s better than nothing, but we should do more”, Gulwali said.

"Every child is a child, whether they are an asylum seeker or not"The government appears to acknowledge that improvements are required. Last week, councillors from the Local Government Association, which represents most local authorities in England and Wales, visited the ‘Calais Jungle’, the makeshift migrant camp in northern France. The purpose of the councillor’s visit was to attempt to join up efforts to help vulnerable children travelling alone and ensure they receive the appropriate care.

Today, nine years after arriving in the UK, Gulwali has a bright future ahead.

He is committed to making a difference, and he enthusiastically talks about his marriage to his Afghan-Danish wife earlier this summer. He is motivated by political activism, which he concedes helps him to deal with the trauma he has suffered, and is committed to campaigning for mental health and refugee rights.

For the innumerable lone children arriving in the UK this year, it is not known to what degree Gulwali’s enduring resilience and triumph is the exception. The grim statistical reality is a pronounced risk of enduring psychological problems, which may be exacerbated by negative experiences associated with the UK asylum process in the form of hostility, distrust and inadequate care.

At the same time, there is an apparent lack of urgency to implement and fund specific care and support initiatives to ensure these children are protected and do not slip through a very holey net.

Gulwali is the success story and speaks of his ‘luck’ in meeting the friends, teachers and foster carers that he did, but what of the many other thousands of adolescent boys who may not encounter such ‘luck’? Gulwali’s mission, he told me, is to give a “voice to the voiceless”. If only the UK government could do the same.

 *Gulwali’s ordeal is chronicled in “The Lightless Sky” which provides a raw account of the brutality and suffering endured in his journey as a child asylum seeker.