Fifteen Eighty Four

Academic perspectives from Cambridge University Press


Out of the fire … into the frying pan…

Chris Maloney, Julia Nelki, Alison Summers

silhouette in front of a fire

Often ‘refugees’ and ‘asylum seekers’ are spoken of together, as if they are almost the same. But they aren’t.

If you’re a ‘refugee’, it has been accepted that you can’t go back to the country that you fled, that you need safety, protection, and a chance to build a life somewhere else, at least for the time being. You can then set about that rebuilding.

If you are an ‘asylum seeker’, your needs have not yet been recognised – and they may never be. You live with minimal resources, on the margins of a strange society, subject to hostile scrutiny from both those around you and the asylum process itself.

People seeking asylum are at increased risk of mental ill-health compared to refugees and other migrants (Jannesari et al., 2020), which is one of the reasons we have written our book ‘Seeking Asylum and Mental Health’. They are also in a very particular predicament, which is not always recognised – another reason for the book.

They are in limbo, needing to move across borders. No longer physical borders – they have arrived here, after all – but legal, social, and cultural ones. Once you’re a refugee, you’ve reached the safer side of these borders and are trying to take stock. You may share some needs, experiences, and ongoing difficulties with those still seeking asylum, or ‘status’, but your position is fundamentally different.

Seeking asylum, you need to move on, but you may never be able to. Like other refugees, much – if not all – that gave meaning to your life has been lost. You may feel relief at having arrived safely but at the same time despair at what has gone. You are likely to be facing all the challenges of adjusting to life in an unfamiliar country where you don’t speak the language and don’t know anyone.  But unlike those who have been recognised to be refugees, as someone seeking asylum, you don’t yet know whether or not you are really safe.  Except in rare circumstances, you can’t work, and you can’t choose where you live. You may be moved suddenly, disrupting any fragile new connections you have made, or you might spend months in a hotel. You need to live on around £6 a day.  The process of having your asylum claim considered moves slowly. Very slowly. Often inexplicably so. You may manage to tell your painful story, and find you are not believed. At any time, you may find your application to stay in the UK refused; any contact from the Home Office may feel terrifying. Often, to turn the well-known saying ‘out of the frying pan into the fire’ on its head, it may feel as though you’ve escaped the fire but only for the frying pan.

Further developments often occur by chance or circumstance. It can be a surprise to those who first encounter the court system to discover how much weight experienced legal teams give to who is the judge on the day.  Chance equally determines your Home Office decision maker and to how you fare with other aspects of the asylum process, and with mental health care too.   You may have a decision on your asylum claim within months – or you may wait years.  You may have a decent flat provided as part of your asylum support package, or not.  If you are struggling with your mental health, you may find yourself in the 50% who reach some form of health care (Balas and Caggiano, 2022), or you may not. You might find an empathic worker who understands your practical needs and manages to be helpful.  Or not.  And all this comes on top of the many twists of fate that have led you to the United Kingdom in the first place.


Jannesari, S., Hatch, S., Prina, M. et al. (2020). Post-migration social–environmental factors associated with mental health problems among asylum seekers: A systematic review. J Immigrant Minority Health, 22: 1055–64. https://doi.org/10.1007/s10903-020-01025-2.

Balas, K., Caggiano, T.  (2022) Going full circle: The primary needs and experiences of refugees and people seeking asylum living in London. London: London Refugee Advocacy Forum.

About The Authors

Chris Maloney

Chris Maloney is a psychiatrist, psychotherapist and General Practitioner. He worked as a GP with people seeking asylum for many years, and has been an expert witness in asylum cas...

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Julia Nelki

Julia Nelki is a child psychiatrist and family therapist. She has set up services for families and unaccompanied children seeking asylum in Liverpool, is a trustee of a Refugee cha...

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Alison Summers

Alison Summers is a general psychiatrist and psychodynamic psychotherapist. She has worked with people seeking asylum since 2008 as a psychotherapist and more recently a medico-leg...

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