Asylum hotels and mental health

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Hi there, I'm Claudia Hammond. You're listening to an episode of All In The Mind. Episodes are released weekly wherever you get your podcasts. But if you're in the UK, you can listen to the latest episodes a whole week earlier than anywhere else. First on BBC. Sounds. How would it feel to live in a hotel? There are more than 32,000 asylum seekers housed in hotels here in the UK. And there's been intense political debate in recent months focused on the cost, both financially...

for the government and for local communities. But what about the cost to the mental health of those living in the hotels? Today on All In The Mind, we want to explore the evidence. And here we are in early November and for some of us the lighter lengthening days of spring feel a long way off. Do you struggle with winter? A clinical psychologist shares with us her radical idea on how we might mentally reframe our whole relationship with the season.

And here with me in the studio is Dr. Peter Olushaga, Senior Lecturer in Psychology at Sheffield Hallam University, and here to help unpick some of the latest science on mental health and psychology. What have you got for us today, Pete? So I've got two studies. One is... on the possibility of using an acne drug to cut the risk of schizophrenia and the other is a study on the psychology of losing.

Yeah, and these both sound fascinating, but since you also happen to be the brother of one of the faithfuls in The Celebrity Traitors, can I ask you about that later on as well? Absolutely. Great, I look forward to that.

First, to asylum seekers. When people arrive in Britain in search of asylum, the government is bound by law to provide accommodation. And when other options aren't available, hotels are used as what is intended to be temporary accommodation. But the number of asylum claims has led to a situation where tens of thousands of people are effectively living in hotels for weeks or even months, or in the case of the asylum seeker we're about to hear from, more than a year.

There have been protests outside some of these hotels with campaigners on both sides of the debate. Meanwhile, the government has announced some asylum seekers will soon be housed on military sites. But for the moment, people are still living in hotels. So what kind of impact does that have on them mentally? In a moment, we'll hear from a clinical psychologist about her research on this. But before that, I want to understand what life is like at an asylum hotel.

I've been speaking to a former political activist who was placed in a hotel in London after fleeing his home country in fear for his life. For the sake of his safety, he's asked us to call him Stev and just to say that he's from West Africa. I started by asking Stev how long he was at the hotel. I stayed there for 14 months. 14 months in the hotel? Yeah. Wow.

What do you remember about arriving in that hotel the first day? Was it welcoming? What was it like? To be honest, it was not, because the atmosphere was toxic. Did you know how long you would be staying in the hotel? Get there and you don't know when you're going to be out on this toxic place. Can you imagine that someone would be in prison? And then you don't know where to get out. It's very traumatized.

So it was reminding you of your time before. And I guess you're left in a kind of limbo, really, waiting. Yeah, it was. You know, many of us hear the word hotel and associate it with holidays and luxury, but what was it actually like? Ten people in a room, did you say? Yeah. And you don't have your privacy because you cannot close the door. And I start pistoling twice.

So you can't keep your stuff safe either? No, not at all. And what did you do all day? What were the daytimes like? It's so boring. You don't have any, some place to take away your stress. So you get out of your room, the corridor, and if you have a chance to have a place to watch the TV, and that's it. And so then at night, everyone is trying to go to sleep in this room together. And what is that like?

So sometimes I have to get out of that room, go down to a city room to sleep on the sofa. So I see the horrible flashback, come back right now. And... You'd already had very difficult experiences and had to flee your country. Did being in the hotel then add to the problems with your mental health? Or were they separate? It's worse in my mental life and lack of safety, lack of autonomy, lack of social, community social. And so what kind of support did you get with your mental health?

How did you manage to stay hopeful during that time? To be honest with you, first thing, this was my fate. Because I'm Christian, I'm Catholic, so I keep praying for God to help me get out of this toxic environment. Were you able to find a local Catholic church to go to? Yeah. It's not far from the hotel accommodation. So I walk in and then I start to get involved on the daily Sunday Mass over there.

And that must have been a relief to find a community. And you now have refugee status and you're at university studying finance. What are your hopes for the future? Well, very best of luck for the future. Best of luck with your university course. Thank you so much. Stev, who was given psychological support to recover from the experiences he had in West Africa by the Helen Bamber Foundation.

As Stev explained there, he felt he was re-traumatised by his stay in a hotel because it reminded him of being in prison in his home country where he was a political activist.

So how typical is his experience in a hotel? We're going to hear next from Dr Janelle Spira from the University of Hertfordshire, a clinical psychologist who works with people with trauma, including asylum seekers. and she researches the impact of accommodation type on their mental health. Before we get to the evidence Janelle has gathered, I wanted to ask her whether the people she sees in clinic mention the protests outside these hotels.

I've had many clients come to sessions and they've described that they're absolutely terrified. They've told me that they're scared to leave the hotel. And what I'm seeing in my clinical practice is these protests and the resulting feelings of unsafety. is having an impact on people's mental health treatment as well. I work with people who've experienced trauma including torture and trafficking and it's much harder to treat someone's PTSD when they're living in a constant state of threat.

and insecurity. So you're trying to gather some scientific evidence on the impact that hotel accommodation can have on asylum seekers. And actually, Steph, who we just heard from, took part in a study you carried out. What did you do and what did you find? So we analyzed data from asylum seekers' mental health questionnaires, and we also conducted interviews with asylum seekers who lived in hotels. And we found that hotels negatively impact asylum seekers' mental health.

with asylum seekers living in hotels experiencing higher levels of psychological distress and depression compared to asylum seekers living in alternative accommodation. So it sounds as though not only is accommodating asylum seekers in hotels... unpopular with some living near the hotels but it sounds as though it's not good for asylum seekers themselves either what is it about

Being in a hotel that is so difficult compared with living in other accommodation? Our research derived three themes to explain why hotels negatively impact asylum seekers' mental health. So the first theme was lack of safety. The second was lack of autonomy. And the third was social isolation. And this exactly fits in with what Steph said, because he said that he didn't feel safe.

He very much didn't have autonomy and felt he wasn't in control of things. And even though there were other people around him, lots of people, you know, he was sharing a room at some points with nine other people, that he felt isolated. Absolutely and it's really understandable how then this is going to have a negative impact on people's mental health and the recovery. And in your research if you're looking at say the impact of being in a hotel on rates of depression or thoughts about suicide.

How do you separate the impact of being in the hotel and waiting and feeling unsafe maybe from the trauma that someone has already experienced? I ask people. I've found that asylum seekers are very clear about what mental health symptoms relate.

their pre-migration trauma compared to the mental health symptoms that relate to their post-migration trauma. Might they have different symptoms from each? Yeah, so I'll give you an example. So one of my research participants said that she previously struggled with PTSD related to traumas in her home country, but she'd never experienced depression and suicidal ideation until she came to the UK, lived in an asylum hotel, and faced very poor living conditions and also social isolation.

to the extent that she contemplated taking her own life. What are the alternatives? What would be a better place for people to live in than a hotel? I did a separate piece of research, which was a systematic review on the relationship between housing and asylum seekers' mental health that included 21 studies from all over the world. And in this study, we identified the types of housing. that are the most harmful for mental health and also the types of housing which are better alternatives.

First, the housing that was most harmful for mental health was detention and collective housing. So hotel accommodation would fit under that category of collective housing. And then on the other hand, the better alternative, so better forms of housing is private. and community housing. These were identified as being able to actually improve mental health. There were studies that demonstrated that moving an asylum seeker from collective housing to private and community housing actually

alleviated symptoms of depression. Now, the government has pledged to end the use of hotels for asylum seekers by 2029. But of course, we know there is a housing crisis. So if housing in the community isn't available, what else could work? These kind of alternatives that are being proposed, say, for example, military barracks, would have some of the same problems that hotels have if asylum seekers were housed in military barracks.

they would probably still feel unsafe because they might still be threatened by far-right protesters. They might still be sharing rooms with strangers. So it would have many of the same problems that hotels have. But what else could be done if there isn't enough housing in the community? to house the numbers of people coming.

So HMOs could potentially be a better alternative. So that's homes of multiple occupancy. Yes. So it could be a better alternative than hotels. And I've worked with asylum seekers who said that they did have a much better experience when they lived. in an HMO, but it really would depend on the implementation. So if the government was to create HMOs and turn an entire neighborhood into...

housing for asylum seekers, then that would contribute to social isolation rather than integration. It would be much better to have HMOs that are integrated throughout the community, so on different streets, in different neighbourhoods. Now lastly, I just wanted to talk to you about a part of the research paper that I was really moved by, which is where the participants talk about the survival strategies that they used while living in a hotel and how they did cope.

Yes. So we found that asylum seekers utilized three survival strategies for living in asylum hotels. The first was family. The second was faith. and the third was seeking support. Mental health professionals are not the only ones who can support asylum seekers' mental health. Many people spoke about the positive impact that ordinary people in the community had on their mental health by befriending...

them, inviting them to share a meal and helping them feel part of the community like they belonged. Dr Janelle Spira. To schizophrenia now. Currently there is no preventative treatment.

But what if a commonly used antibiotic could help reduce the risk of some young people developing schizophrenia? Now, Pete, you've been looking at a new study that raises this possibility with the caveat that randomised control trials would be needed.

So it is very early days, but it has been in the press and we wanted to take a look at what the study can and can't tell us. It's a study from Finland and it focuses on doxycycline, an antibiotic often prescribed for acne. What do the researchers do here? So they carried out what's called an emulated trial. So they used some real world data from everyone who was born in Finland over a 10 year period from 1987 to 1997, who had also attended psychiatry.

services as an adolescent and who had been prescribed some sort of antibiotics. So in total they ended up with around about 52,000 people. So they have these teenagers and they follow them up over time. And what did they find? Well, so they looked at two different groups. One group had been prescribed doxycycline and the other group had been prescribed... different types of antibiotics and the risk of schizophrenia in the group who had been prescribed doxycycline

was around 1.4% compared to about 2.1% in those who had been prescribed other types of antibiotics. And so what does that mean to us in real numbers? In terms of real actual numbers, that means the difference of about two or three people.

So in the group that had been prescribed other types of antibiotics, around five people in 100 would go on to develop schizophrenia, whereas in the doxycycline group, that number would be about two or three. So it's only the difference of a couple of people, but that's still a couple of people who...

don't go on to develop schizophrenia yes that's a couple of people every hundred who don't so it'd be worth having now this isn't a randomized controlled trial as we said it's observational data but it does seem extraordinary that one kind of antibiotic could have this effect

What possible mechanisms are they suggesting? Well, there's a couple of different possible mechanisms. One is to do with the anti-inflammation properties of the antibiotics, and the other is to do with something called synaptic pruning. So synaptic pruning is where weaker neural connections in the brain are eliminated. And this happens naturally in childhood and adolescence. It's a way of improving brain efficiency and brain function.

evidence to suggest that these antibiotic drugs might reduce excessive synaptic pruning. And that's interesting because excessive pruning is associated with the development of schizophrenia. So presumably you'd need much more research before people could start being prescribed doxycycline as some kind of preventative if they were thought to be at risk.

Absolutely. Like you say, a randomised control trial is needed. There are so many participants that the two groups might have differed in lots of different ways apart from just the antibiotics that they were prescribed as adolescents. But what might this mean for the future?

Well, I think the idea that there might be some sort of preventative treatment for schizophrenia is a really exciting one because it's a condition that has so many costs associated with it. But there's a long way to go just yet. So there's not an idea that, I don't know, you'd have the whole country, every teenager, taking antibiotics? No, no, no. If you look at the study, they...

just specifically looked at people who had attended adolescent psychiatric services. So potentially for those who are displaying early signs of psychosis, it's a potential preventative treatment. After trials in the future. Thank you for that.

Now, let me ask you something, Pete. Are you a fan of winter? I love the winter. I grew up in the northeast. It's basically Narnia up there, so I'm very much used to it. Well, I don't like it at all, and I don't think I'm alone in feeling that way. An Ipsos poll found that just 8% of Britons describe winter as their favourite season, with the majority...

65% preferring spring and summer. But what if we could mentally reframe winter so that we can enjoy it? Dr Stephanie Fitzgerald is a clinical psychologist who's been giving us some thought for her new book, The Gifts. of winter. And when she came to the All in the Mind studio, I asked her why it is that some of us seem to struggle to enjoy the winter.

I think one of the challenges that people face is that we make no seasonal adjustments at all and then we wonder why it feels so difficult. It is a season that we need to adjust to and for. Now I love summer but I must confess that I do dread winter and I know people will say things like you know get outside and get the light or light candles and try and embrace feeling cosy for me I still find those aren't enough in a way I still long for spring so what can I do to shift that

mindset what can any of us do can we change the way we think about the seasons yes so i think there are some very practical things you can do to change how your mindset is as you approach the season. And one of the things which may not be what you're expecting is that a tax year can make you happier.

Often on the 1st of January, we set ourselves up with new ambitions, goals, you know, ready to go. And it's just not the season. So what tends to happen is we start them, we fail, then it feels even more miserable. Yes, a lot of people have New Year's resolutions and there's loads of research showing how hard it is.

is to do that because it's just not a good time to do it. So in your rewriting of the year, we'd have spring is April to June, July to September is summer, October to December is autumn. And just January to March is winter. It's really important to not sort of combine autumn and winter in one homogenous blob. Oh yeah, I think of it as one great long thing, basically. And that until April, May, you know, we're doomed, really. Yeah, absolutely. And that won't be serving you well.

winter doesn't arrive until around the 22nd of december and when you think about that then the mindset shift that comes with that is that every day in winter brings a little bit more light so i think it's really important to separate them out otherwise six months of the year just Yeah, I do like the idea of pushing back winter to January. But then what about New Year's Eve parties? Are we missing out on those? You'd have those in April, would you?

I use that period from January to the end of March to prep and plan and sort of lay the foundations of whatever it is that I'm hoping to start. There's a sort of New Year's celebration that happens at 1st of April, but it is that finding a way... to embrace the idea of delaying the action but not confusing that stillness with stagnancy. Yes, so you're not talking about hibernating in sort of January, February, March and hardly doing anything.

I think of it as a restful time, but I also think it's worth reframing because we often think of winter as a dead season where nothing happens, nothing grows, nothing develops. And that couldn't be further from the truth. And when we look at our gardens... for example, we always credit spring with, you know, the beautiful flowers of spring. All that growth happens in winter. Yeah, we can't see it though, can we? So it doesn't count, does it? You can. It's just remembering to look for it.

Would it help if society moved on to this year plan as well? I mean, you could have the school year start in April. You could have everything start in April. I would love to see a radical societal overhaul where we live much more in alignment with seasons. I do think there's something about... adapting more broadly to the seasons, it would support us all to just be more aligned with the nature around us rather than battling against it all the time.

And if people are trying to change their mindset and kind of mentally reframe winter, I wonder where language fits in. Can we use different language that helps us to do that? So if we think about some of our favourite carols, for example, they start in the blue.

bleak midwinter. I mean, that is quite depressing. And if you just Google winter, what will come up is cold, dark, miserable, depressing, you know, and actually that's not the winter I experience. And so I think it's really important that we... revisit the language we're using but also those types of statements from a brain health perspective are not going to serve you if you go into winter thinking i hate this it's miserable it's dark it's depressing your brain will support you to

Find evidence for those thoughts and it will absolutely make sure that you have quite a depressing, dark and miserable winter. So have there been any studies where people try to mentally reframe winter to see if they can do that? Not necessarily where they've tried to reframe it, but certainly trying different activities, trying new things, trying new hobbies, for example. And again, this is where a lot of the research about New Year's resolutions potentially failing.

comes from because we see actually it just doesn't quite fit with that sort of rhythm of the season what we know is that winter is a good season to support us for the planning and plotting of doing new things almost putting the systems in place ready to go, rather than just jumping straight in. Do you love this time of year now, which of course we can't call winter now, because this isn't winter in your book, is it? This is the autumn.

When I was researching for the book, I discovered so much more than a survival guide. You know, I really did genuinely discover all these beautiful gifts that lie in the season. Some are still better though, isn't it? What people won't be able to see is I'm half English, half Irish. very pale. So summer is not my friend necessarily. Thank you, Dr. Stephanie Fitzgerald for that idea. Lots to think about there.

Now, Dr. Pete Olishaga is still with me and it's time for your pick of the latest psychological science. And you have a new study for us on something called the opposer's loss effect. What is that? Are you a sports fan, Claudia? I'm a fan of some sports, like tennis in particular. The easiest way I can think of to describe it is, let's say we're watching a football match. I support Newcastle because I really like Newcastle.

You want Newcastle to win because you really dislike the opposition. So you hate Liverpool, let's say. And when Liverpool eventually win... you're much more likely to have a negative response than I am because you framed your preference in terms of opposition rather than support.

So this is like sometimes you'll hear people say anyone but England or anyone but Arsenal to win. So what did they do in this new research? So they actually carried out eight studies, but because I'm interested in sport, the one that caught my eye was a study of how this plays out in American football. and American football fans in particular so what they did was they looked at 400 fans of the two teams competing in the Super Bowl this is the championship game in American football

And they asked the fans to rate their preference based on whether they were motivated completely by support for their team or by opposition to the other team. And what did they find? So they... contacted the fans of the losing team a couple of days later, a couple of days after the Super Bowl, to find out how they'd reacted. So they asked them again on a sort of one to seven scale how they'd reacted towards the loss. And results supported exactly what the researchers thought.

Opposers reported much greater negativity when they didn't get the outcome that they wanted. So do they talk about the why in the research? They do, yeah. So there's a couple of mechanisms as to why they think that this occurs. The first one is that framing my preference in terms of the opposition is associated with greater preference certainty. So I'm much more certain about my preferences if I'm focused on the opposition as opposed to who I actually support.

And this leads to greater cognitive inconsistency. So I'm more likely to have much more negative reactions when I don't get the desired outcome. And this can be things like just bad mouthing or even retaliation. And there's a second mechanism as well. There is, yeah. So this is about ambivalence. So the idea that focusing on the opposition just brings to mind much more negative information about the non-preferred option, right? The team that I don't support.

And lowered ambivalence means that I'm just much more entrenched in my own preferences. So I'm less likely to be able to see the silver outcome when my team loses. And so would the same opposer's loss effect play out in politics too? Because I know they did look at presidential elections as well, didn't they? They did, yes, and they found exactly the same thing. They determined voters...

opposition support framing and found that the more people's preferences were based on opposition to one candidate the more negative their response to defeat. Is that something we're seeing more in politics maybe? Well I think it is because I think a lot of political campaigns now are based much more on

opposition rather than support so it's what's wrong with the opposing candidate versus what's good about me and I think that we're seeing that playing out in a lot of political campaigns. So the result of that would then be that if your preferred candidate didn't win

but also the one you really, really didn't like got in, that you'd be particularly unhappy about that result. Yeah, I'm going to react much more negatively to that. Fair enough. And Pete, you know what's coming now? You've chosen to end the game. Why?

Because I've never believed Alan as a traitor. I may be wrong, may not happen, but I did love the idea of the three of us all being faithful and ending the game together. So your brother, David Olushaga, in the Celebrity Traitors, a faithful from the beginning who lost to comedian and traitor Alan Carr. So is everyone asking about the Traitors now, assuming that you must have the inside track since he's your brother?

They are, yeah. My students are obsessed with it, and I'm trying to convince them that I didn't know anything about it at all. Yeah, it's impressive. They have to keep quiet for ages, don't they? They did, yeah. They filmed it back in April, I think. So he's done a good job. That is a long time not to tell you. And what was your assessment, both as a brother and as a psychologist, of how he did, how he got on? I thought he did exceptionally well, to be honest.

I was convinced that he was going to get murdered pretty much every night. banished at the round table every night i'm absolutely amazed that he stayed in it for as long as he did and i was convinced that he would go halfway through after after he was almost voted out and there was a there was a tie and they had to draw lots and i thought surely he'll go the next night no Yeah, I thought he was done for, but the voting just seems to be particularly random and they sort of...

had five or six votes one night, and then the next night just kind of seemed to forget about it. So did he get to stay on through his own skill and cleverness at working out what was going on? Absolutely not, no. Pure luck. I'm absolutely astonished that he made it to the final.

Well, thank you so much for joining us today, Dr. Pete Olushaga. And next week, are we losing our natural ability to navigate? We'll hear about an experiment on the other side of the world that's trying to understand this. Thanks for listening to All In The Mind from BBC Radio 4. And thanks to the producer, Gerry Holt, and our studio engineer today, Tim Heffer. Details of organisations offering support with mental health or feelings of despair are available at bbc.com. slash action line.

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