Health, trauma, medical support and treatment

Torture often leaves both physical and psychological scars. Some of these may heal quickly, others may persist over time. If you have suffered torture or ill-treatment, your family and friends may find it hard to truly understand what you have endured which can make you feel isolated. Each survivor experiences torture differently, and each survivor deals with its impacts in their own, unique way.

Some common impacts include: bodily pain, recurring thoughts, shaking or sweating, insomnia and nightmares, difficulties with memory and concentration, irritability, depression and panic attacks.

Crisis support

Sometimes the impacts of the torture can be overwhelming. If you feel like you might attempt suicide, may have seriously harmed yourself, or you need urgent medical help. Please:

  • call 999 and ask for an ambulance to A&E
  • go straight to A&E

If you need help, ask someone. Mental health emergencies are serious. You are not wasting anyone’s time. If you are currently safe but still need urgent advice:

  • contact 111 if you live in England or NHS Direct 0845 46 47 if you live in Wales
  • call your local doctor (GP) and ask for an emergency appointment

Other organisations that can help in a crisis include the following:

Organisation Description Contact details

Samaritans

 

Crisis and emotional support helpline (24/7)

116 123

[email protected]

Suicide Prevention UK Helpline for those struggling with thoughts of suicide (24/7) 0800 689 5652
Give us a shout Free 24/7 text support for mental health Text Shout to 85258
CALM Helpline for men 0800 58 58 58
HOPElineUK Suicide prevention and non-judgemental support for people below age of 35

0800 068 4141

07860039967

[email protected]

For more emergency resources, click here.

General medical care

Torture is inflicted on the body and the mind and can have lasting impacts on both. It is therefore important that you discuss any health problems with your local doctor, also known as a General Practitioner (GP). They can assist you in obtaining specialist support and help you cope with the psychological and physical effects of torture. Everyone, regardless of immigration status, is entitled to free primary healthcare from a GP. You can register at a GP surgery in your local area and should do this as soon as possible. You can find your local GP on NHS Choices.

What medical care is free to everyone?

The following treatments are free to everyone, regardless of immigration status:

  • Accident and emergency services, such as those provided at an A&E department, walk-in centre, minor injuries unit or urgent care centre
  • services for treating a physical or mental condition caused by torture, female genital mutilation, domestic violence, or sexual violence
  • services provided for the diagnosis and treatment of some communicable diseases, including HIV, TB and Middle East Respiratory Syndrome (MERS)
  • NHS services provided for COVID-19 investigation, diagnosis and treatment
  • services provided for diagnosing and treating sexually transmitted infections
  • family planning services (does not include termination of pregnancy or infertility treatment)
  • palliative care services provided by a registered palliative care charity or a community interest company
  • services that are provided as part of the NHS 111 telephone advice line

What medical care might you have to pay for? (depending on immigration status)

Depending on the treatment that you need (for example, physiotherapy, surgery, counselling), your GP may need to refer you to specialist treatment which is known as “secondary care”. Specialists in hospitals may recommend tests or treatment and provide more complex services, compared with those provided at GP surgeries.

Access to secondary health care is residence-based. This means that you need to be living lawfully in the UK to be entitled to free specialist treatments. All refugees and asylum seekers with an active application or appeal can access the full range of secondary care services free of charge in the UK. In Northern IrelandScotland and Wales, any person who has previously made a formal application for asylum, regardless of the outcome, is entitled to access secondary care free of charge.

If you do not fall within these categories of people entitled to free secondary care services, you may be expected to pay a fee to access these services. However, the following groups are exempt from charges for secondary care which would normally apply to overseas visitors:

  • people with indefinite leave to remain
  • refugees and their dependents
  • asylum seekers and their dependents
  • some refused asylum seekers that are supported by the Home Office
  • children looked after by a local council
  • victim or suspected victim of modern slavery or human trafficking
  • prisoners and immigration detainees

For more information on what you are entitled to, click here.

If a hospital doctor believes that you need treatment for a life-threatening disease or injury, or for an injury or illness that may become critical if left untreated, they should not wait for payment before treating you. If you are not a resident of the UK or do not fall into one of the categories above, you may still receive a bill after your treatment. The NHS can also pass information on your treatment and any outstanding debt to the Home Office. Owing money to the NHS may impact any application to remain in the UK, therefore, you should consult an immigration advisor to discuss this further.

If a healthcare professional has refused you access to healthcare, not provided interpreting services, or you think you have been incorrectly charged, you can seek advice from your immigration advisor or from one of the following organisations:

Organisation Description Contact details
Doctors of the World International organisation that empowers excluded people to access healthcare

0808 1647 686 [email protected]

Website

Refugee Council Nationwide organisation supporting refugees and asylum seekers

0808 196 7272 [email protected]

Website

Medication

Some treatments may require medication. This can include painkillers, anti-depressants, or medication to manage chronic conditions. Medication must be taken only in the way prescribed by your doctor. There are usually charges for prescriptions, but there also exemptions. These exemptions are based on your age, whether you are pregnant or had a baby in the last 12 months, in receipt of certain benefits or have a continuing physical disability. For the full list, see here.

If you have a low income, the NHS Low Income Scheme [insert link] could help pay for NHS prescription charges. You will need to complete a HC1 Form that can be found online.

For more information click here.

Dental treatment for migrants

Not all dentists offer NHS services. You can find your nearest NHS dentist here.

As with prescriptions, most patients are charged for dental treatment. There are a few dental services that are free for everyone:

  • stopping bleeding in the mouth
  • removing stitches
  • repairing dentures

In addition, some groups are exempt from dental charges, such as:

  • anyone under the age of 18, or under 19 in full time education
  • people receiving certain benefits
  • women who are pregnant or had a baby in the last 12 months

If you are not in one of these categories, you may have to pay. A person with low income or no recourse to public funds can apply for the NHS Low-Income Scheme mentioned above, to cover full or partial costs. For more information on dental charges, see here.

Medical evidence of your torture

You may be worried about how you will be able to prove that you have been tortured. In the UK, medical evidence is often required for asylum, immigration, and accountability claims. This type of medical evidence can include a statement from a doctor confirming your injuries and the impact of torture on your state of health, or the evidence could take the form of an official “medico-legal report” (MLR).

The MLR will involve a detailed analysis by medical doctors, psychologists or psychiatrists of any injuries or scars you may have as well as your mental health. It normally means explaining details of the torture, describing psychological symptoms, and having a physical examination of the parts of the body affected by the torture. Usually, such a report can provide important evidence, and if your legal advisor does not mention getting one, you should raise the issue with them.

The cost of an MLR may be covered by Legal Aid if you have an ongoing asylum case. If the MLR is not obtained during the asylum process, or if you did not seek asylum (because you are a British national, for example) NGOs working with you on your case may be able to help you obtain an MLR and possibly cover the cost of the report.

If you are struggling to obtain independent evidence of torture or are unhappy with a report that has been made about you, you should contact your legal advisor.

Psychological support

You may decide that you are ready to speak to a professional therapist or counsellor to process your past experiences. Seeking this help is not a sign of weakness or a source of shame. Talking through your experiences may help to provide you with a sense of healing.

There are different types of counselling and having a good relationship with your individual counsellor is important. If you are not getting on well with them, it might be helpful to change counsellors or to seek a different therapeutic approach.

Getting therapy on the NHS through your GP is possible, but there are often long waiting lists as counselling services in the UK can take a long time to access. Specialist services are sometimes available for those that have suffered severe torture and trauma, but even if they are available in your area, there may be a long wait for an appointment.

If you are a survivor of torture, there are several organisations outside of the NHS that can provide you with health, medical support, treatment and support obtaining medical evidence of torture:

Organisation Description Contact
Freedom from Torture Holistic support to survivors of torture across the UK including medico-legal reports and psychological support

020 7697 7777

[email protected]

Website

Helen Bamber Foundation Supporting survivors of torture and trafficking who do not have status in the UK with legal support, therapy, medical advice, housing and welfare

call 0203 058 2020 or email [email protected]

Website

Forrest Medico-Legal Services Provides medico-legal reports for survivors of torture and human rights abuses.

07930 363425

Website

Room to Heal Provides individual therapy as well as psychological support groups including gardening for people who have fled persecution

07515 461745

[email protected]

Website

Refugee Therapy Centre Counselling for refugee families, couples and individuals

02075610402 [email protected]

Website

Baobab Centre for Young Survivors in Exile Psychotherapy, group activities and casework available for young asylum seekers and refugees

0207 263 1301

[email protected]

If you are a survivor, there are several organisations in the UK that can support you in rebuilding your life. Find out more in the pages below: