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Br J Gen Pract. 2008 July 1; 58(552): 510.
PMCID: PMC2441518

‘Home Office syndrome’

Gervase Vernon, GP and Medico-legal Report Writer
Medical Foundation for the Care of Victims of Torture, London, N7 7JW
Dave Ridley, Practice Nurse
Cape Hill Medical Centre, Smethwick, West Midlands
Dineo Lesetedi, Practice Nurse

We wish to offer a name for a syndrome which will be familiar to those working with refugees and asylum seekers. While asylum seekers are awaiting a Home Office decision on their asylum claim, they often give no attention to their other needs; in particular, their health needs. This is because they often fear that they will be killed or tortured if they are returned to the countries from which they came.

The health and health behaviours of asylum seekers are strongly influenced by their social circumstances — starting with the events that have happened in the countries they have come from, the stress of separation from their family and everything that is familiar, and the difficulties they face here. Once in the UK, taking care of their health, or bothering to take tablets for conditions, such as high blood pressure or diabetes, seems unimportant compared to the immediate problems of survival. Health problems take second place to the progress of their asylum case — people will miss important appointments with their GP or hospital specialist to see their solicitor.

The ‘Home Office syndrome’ is perhaps a specific example of Maslow's hierarchy of needs. While the individual is dealing with what he perceives to be a threat to his life, all other matters, including health care, are put on hold.

The delays in deciding asylum status have been long and may still last months. As a result, the ‘Home Office syndrome’ is bad for the health of asylum seekers who may wait long periods before they seek appropriate help for their health needs. Other examples of policies that damage the health of asylum seekers are those that prevent legal employment,1 and the refusal of secondary health care for ‘failed’ asylum seekers. The last policy has recently been judged illegal in the High Court.2

REFERENCES

1. Vernon G, Feldman R. Refugees in primary care: from looking after to working together. http://www.networks.nhs.uk/uploads/06/06/refugees_in_primary_care.doc (accessed 12 Jul 2008)
2. Department of Health. Failed asylum seekers and ordinary residence. http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_084479. (accessed 12 Jul 2008)

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners