UK asylum crisis: Birmingham and Sandwell project
Médecins Sans Frontières / Doctors Without Borders (MSF) is delivering specialised trauma-focused psychological care to people seeking sanctuary in the UK.
This includes people seeking asylum and refugees living with difficulties associated with post-traumatic stress disorder (PTSD) and complex PTSD.
Our service users have usually survived conflict, torture and persecution, and have endured violence and exploitation during their migration journey. As a result, they are often affected by uncertainty, destitution, and detention, as well as harmful policies, and hostility from border forces and protest groups.
Among those referred to our service, our clinical team sees a high prevalence of people struggling with trauma symptoms such as flashbacks, nightmares, and hypervigilance, as well as depression, anxiety, separation, loss, and grief.
Our clinical team provide group therapy work and individual therapy sessions. This trauma service is part of a broader holistic approach where we also provide case work support to people in hotel accommodation, signposting them to other support services and raising concerns with relevant authorities where required.
Explained: MSF's response in the UK
MSF responds to refugee and displacement crises around the world. We have vast experience in providing mental health support for people seeking sanctuary, as well as documenting and bearing witness to the harms compounded and created by restrictive policies and practices.
In July 2025, we established this specialist project in Birmingham and Sandwell to address the unmet mental health needs of people seeking sanctuary who have often experienced multiple traumatic events and who are being increasingly marginalised and harmed by hostile policies.
We previously ran a similar project at the Wethersfield mass containment site in Essex, between late 2023 and late 2024
Our service in Birmingham and Sandwell provides an evidence-based, multi-step, multi-disciplinary model that focuses on ensuring people can access the level of care they need at the time they need it. Patients are referred to us by local refugee and migrant support organisations and the NHS (including GPs and NHS mental health services).
While specialised trauma therapy is vital for supporting individuals, we know it’s not enough. That’s why we also advocate for structural reforms that will reduce barriers for those seeking sanctuary, to avoid re-traumatisation and support them to heal.
Questions about MSF's work in the UK
In line with the MSF Charter, we provide medical humanitarian care to people affected by conflict, epidemics, disasters, or exclusion from healthcare. Guided by the principles of independence, neutrality and impartiality, we do not take government funding. We treat people regardless of who they are, and we believe everyone deserves care.
While the majority of our work continues to be focused on treating people caught in complex crises and healthcare emergencies around the world, these guidelines also inform our decision to provide healthcare to people seeking asylum and refugees in the UK. MSF has a long history of supporting refugees and displaced people around the world, including in Africa, the Americas, and Europe. We provide care to people based on medical needs, not migration status.
In the UK, our programme is motivated by the fact that while people in the asylum system suffering with health issues are entitled to free NHS care, they are usually unable to access the type of specialised mental health care they need.
Most of the referrals to our UK project come from NHS services, reflecting the lack of specialist care for this patient group and the barriers to accessing services. Our work both supports and relieves pressure on an already overstretched system.
MSF UK has worked with people seeking asylum since 2023. Between late 2023 and the end of 2024, Doctors of the World UK and Médecins Sans Frontières UK provided medical and humanitarian aid to men seeking asylum accommodated at the Wethersfield mass containment site in Essex.
There, we witnessed a mental health crisis unfolding at the site. Reports published in May 2024 and May 2025, based on data collected by the DOTW-MSF medical teams, documented the profound impact of the UK Government’s mass containment site policy on the health, wellbeing, and dignity of individuals seeking safety.
Our teams observed prison-like conditions at the site that exacerbated mental health issues. We documented a range of protection failures by the Home Office and the private contractor Clearsprings Ready Homes. To date, Wethersfield remains open, and another ex-military barracks, Crowborough in East Sussex, was opened in 2025, with the Government pledging to increase the use of military sites as accommodation.
We established our trauma care service after a comprehensive needs assessment across the UK. This included feedback from refugee support organisations that we have worked with, and was informed by our own clinical experience in the UK and elsewhere. The finding was that people seeking asylum and refugees consistently lack access to tailored and specialised mental health support.
While there are many brilliant organisations working on social and legal support, there are comparatively fewer working on providing clinical services. This is where MSF's experience lies.
We selected Birmingham and Sandwell for the location of our service based on identified needs, gaps and the size of the refugee and asylum-seeking population. Birmingham is the UK’s second largest city and hosts around 4,150 people seeking asylum – the second largest supported asylum seeking population in England after London. However, it has far fewer public and charitable services available to meet these needs compared with the capital.
We have developed a strong network of existing actors in the area, who have supported and fed into the design of the service.
We provide assistance to people seeking asylum and refugees who live in a range of accommodation settings. However, the majority of those referred into our service are accommodated by the Home Office in contingency accommodation, including hotels.
People waiting for their asylum claims to be processed have no choice over where they live and what kind of accommodation they live in. Many of those seeking asylum living in hotels will have experienced significant trauma related to conflict and violence, and can therefore benefit from the assistance that we offer.
MSF and the UK asylum crisis
MSF is responding to the medical consequences of the UK’s harmful asylum system.
Successive governments have continued to implement punitive anti-migration deterrence policies that have caused medical and psychological harm and eroded the protections for people seeking safety.