Follow on support
It is essential that anyone arriving from Ukraine has equal access to mental health assessment and support. This will enable people to have access to the right services at the right level and at the right time. Consideration will be given to advocacy services, where required.
Escaping war will contribute to psychological stress and mental health issues (e.g. post-traumatic stress disorder (PTSD) which may not manifest until weeks after displacement.
It is important that those working with people who have arrived from Ukraine are mindful of any indications of this occurrence (conservative estimates indicate at least 30% of all refugees will develop PTSD at some point, other estimates go as high as >70%). It is crucial to:
- consider individuals’ mental health and wellbeing as those affected by war and conflict are at higher risk of mental disorders and, where appropriate, refer to mental health services
- use trauma-informed approaches to care provision
The above steps are recommended to be offered to every refugee fleeing violence.
The legislative framework for mental health in Scotland is primarily contained in the Mental Health (Care and Treatment) (Scotland) Act 2003 for which there is a code of practice issued by Scottish Ministers. However, it should be noted that there are many strands to mental health legislative practice in Scotland and these can be complex to navigate in the way that they interact. Anyone requiring care and treatment under legislative processes will be treated with dignity, respect and humility, with rights afforded in line with the principles of the legislation.
Should anyone require inpatient admission, hospital staff will provide support and advice to the individual and adopt a sensitive approach to their cultural needs and beliefs.
It is important any carers of someone in hospital and/or community team care are supported to understand the mental health care and treatment process and options in Scotland. Importantly, they should be supported to understand that as carers in Scotland they have access to a carers rights framework and a carers assessment.
Psychological Wellbeing Packs are currently in development for arrivals from Ukraine. These will be made available as soon as possible.
It is likely that arrivals from Ukraine, including children and adults, have had lengthy journeys and may have suffered trauma and loss. Early arrivals have been described as exhausted, suspicious of authority and uncertain about their destinations. In turn, this has meant that early identification of need, discussions around what support they may require, and any signs there may be risk have been limited, relying on the assessment skill of the Welcome Hub staff.
With this in mind, with consent, it is recommended that a visit is undertaken after the matching process to revisit the questions on the welcome checklist (under supporting documents). Local authorities should consider who is best placed to undertake this visit, however it is recommended that it is someone with relevant experience in resettlement, family support or social care.
It is essential that these visits have a clear referral route to child and adult protection services, and local procedures around risk and protection are followed.
It may also be the case that further assessment of need is required for a child or for an adult. The Getting it right for every child (GIRFEC) national practice model should be applied when assessing the needs of children. Again, such referrals should be made to the local social work department without delay. Assessments of need are local authority duties under Section 23-24 of the Children (Scotland) Act 1995, and Section 12 of the Social Work (Scotland) Act 1968 respectively. The Rights of People with disabilities are protected by the UN Convention on the Rights of Persons with Disabilities (UNCRPD). Additionally, “Disability” is a “Protected Characteristic” under the Equalities Act 2010.
In line with current statutory duties, the local authority has a duty to carry out an assessment of the child, or of any other person in his or her family, in order to ascertain the child's needs in so far as they are attributable to his or her disability or that of the other person, if asked to do so by the child's parent or guardian - Section 23 (3) of Children Scotland Act 1995. This duty extends to all children arriving from Ukraine who require such an assessment.
These visits are an opportunity to enquire with people who have arrived from Ukraine that they feel safe and supported. They should also serve as an opportunity for any support needs of the host to be considered, identifying any particular challenges that could contribute to future breakdown of the hosting arrangement.
The Super Sponsor Scheme and Homes for Ukraine: guidance for local authorities outlines that sponsors are required to;
- all sponsors, and adults (aged of 16 years) in the household, must agree to an enhanced Disclosure Scotland check, this includes an ID check
- all sponsors must agree to a home visit undertaken by a local authority officer/contractor in order to assess the suitability of the accommodation offered
- check their mortgage lenders website for further guidance or seek the agreement of their landlord if they are a tenant
- notify their insurer that they will be hosting guests prior to their arrival
- all sponsors are required to provide suitable accommodation for a minimum of 6 months
- sponsors should support and help guests to adapt to life in the UK, initially checking if they have enough food and supplies such as toiletries, along with checking if they have access to a mobile phone and internet to stay with family members
- sponsors should help direct their guests to public services, for example, registering with a GP or NHS dentist
It is essential that sponsors understand and are clear to people travelling from Ukraine about their role and that they are also provided with offers of support. This will be an essential part of ensuring positive relationships and preventing breakdown.
It is possible that cultural differences, including parenting styles and lifestyles become apparent, perhaps placing strain on living arrangements. It is therefore important that both people arriving from Ukraine and their host families are informed of support and advise to manage any difficulties, with the aim of avoiding breakdown. In circumstances where the arrangement is no longer sustainable, support should be sought directly from the local authority.
It is recognised that breakdown in living arrangements may also occur within the family visa scheme. In such cases, the local authority should be contacted to support pursuit of alternative accommodation.
The local protocols for sharing information and raising child and/or adult protection concerns have not changed. Where any person becomes aware of the risk of harm to a child or an adult, then Police Scotland (if the danger is imminent) or Health and Social Care Partnership/Social Work should be alerted immediately. These responsibilities should be particularly highlighted to redeployed, retired or volunteer staff.
As people arriving from Ukraine are moving between local authority areas it is especially important that relevant safeguarding information be shared efficiently between authorities where it is necessary, lawful and proportionate to do so, to ensure effective, efficient transitions to minimise and mitigate risks.
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