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Abstract

Global forced migration rates are the highest since World War II. This article presents an overview of migration and presents an original argument as to the imperatives for social work. First, global trends are presented and forced migration is conceptualised as an international phenomenon. Second, global responses are explored with a focus on legal and protection frameworks. Finally, existing policy, practice and research gaps related to human mobility and forced displacement are examined, and recommendations for social work policy, research and practice are presented. The contextual influence of the Covid-19 pandemic is considered in this article.

Keywords

Covid-19 and refugees forced migration internally displaced persons international social work practice and research refugee protection framework refugees and asylum seekers social work policy

Introduction

According to the International Organisation for Migration (IOM), global forced migration has reached levels not seen in more than five decades (IOM, 2016). The Global Trends Report from the United Nations High Commissioner for Refugees (UNHCR, 2018) noted that the global population of forcibly displaced people in 2017 exceeded the population of the United Kingdom. ‘Forced migrants’, in the context of this article, refer to asylum seekers, refugees and other internally displaced persons, who have been involuntarily displaced due to war, conflict, poverty, political instability, human rights violations and environmental factors and find themselves living as forcibly displaced people.

Although the Syrian crisis has given an unprecedented momentum to global forced displacement issues, the current refugee crisis is not just a European or Middle Eastern concern. Furthermore, the situation burdens more than international aid organisations and challenges nations in terms of politics, economics, human rights and development. The call is now to maximise the expertise and knowledge of organisations ranging from government agencies to human rights advocacy groups to Non-Governmental Organisations (NGOs), and urges multilateral engagement among them. With its focus on person in environment, and underpinned by radical social work and critical race theory, social work should play an integral part in this coordinated response.

This article overviews forced migration and identifies imperatives for social work, considering simultaneously refugees, asylum seekers, internally displaced population (IDP), stateless persons, stranded migrants, development-induced forced displaced persons and environmental migrants. The first section of the article presents a global picture of forced migration and examines why this is an international phenomenon. The second section lays out the current landscape of global responses, focusing on existing legal and protection frameworks. The third section raises various questions about existing policy, practice and research gaps related to human mobility and host communities. The final section provides recommendations for policy, practice and research, arguing for collaborative work that leads to a properly functioning multidisciplinary global network, including social work.

The development of this article draws on Arksey and O’Malley’s (2005) framework for scoping reviews. We conducted a rigorous search for relevant literature using terms such as ‘forced migrants’, ‘asylum seekers’, ‘refugees’, ‘internally displaced persons’, ‘refugee protection framework, ‘social work with refugees and asylum seekers’, ‘researching refugees’ and ‘refugee policy and practice’, covering a range of disciplines including social work, law, policy, human rights, psychology, politics, international development and sociology. The critical interpretive synthesis model (Dixon-Woods et al., 2006) helped organise and structure the literature, allowing us to create a synthesis that forms the key arguments of this article.

At the time this article was first conceptualised, the Covid-19 pandemic had not yet occurred but the gravity and impact necessitated we consider its influence on forced migration at a global level. Thus, our work and observations that follow ought to be read in the light of the fact that as in every other disaster (man-made, natural or otherwise), forced migrants, because of their already precarious circumstances, will always suffer more than anyone else, precisely because of the conditions in which they strive to survive. We have only been able to briefly address the existence and impact of the pandemic but future research will undoubtedly follow.

The global picture of forced migration

The UNHCR Report (2018) on global trends indicates that in 2017, about 44,000 people per day were displaced from their homes, an increase of nearly 30 percent above the number in 2015 and an increase of 500 percent above the number in 2005. Displacement levels have increased dramatically every year since 2011, when the United Nations (UN) agency announced a new record of 42.5 million forcibly displaced people globally. By the end of 2017, 68.5 million people worldwide found themselves displaced by a combination of oppression, war, generalised violence and human rights abuses, amounting to an increase of over 75 percent in two decades (UNHCR, 2018). The latest data from UNHCR (June 2020) indicate a staggering 79.5 million forcibly displaced people worldwide at the end of 2019. Of these, 25 million were refugees, 45.7 million were members of a designated IDP and 4.2 million were asylum seekers. These figures do not include potentially millions of forcibly displaced people who have not registered claims for protection or who have travelled through irregular channels. The statistics also discount stranded migrants, consisting of labour migrants residing in regions of conflict, and others forced to flee their homes who have not sought refugee status (Zetter, 2015), as they fall outside the existing protection instruments.

More than two-thirds of refugees worldwide (68%) come from five countries: the Syrian Arab Republic (6.6 million), Afghanistan (2.7 million), South Sudan (2.2 million), Myanmar (1.1 million) and Somalia (1 million) (UNHCR, 2020). In all these cases, at least 25,000 refugees from a common nationality have lived in exile for more than 5 years in a given asylum-offering country. Approximately 6.7 million refugees (41% of those under UNHCR’s mandate) were in such prolonged refugee status in 27 host countries at the end of 2015. The numbers of refugees and IDP have further increased as a result of the ascent of the Islamic State, with more than 2 million people fleeing areas controlled by the regime (Internal Displacement Monitoring Centre [IDMC] and Norwegian Refugee Council [NRC], 2015). The situation is further aggravated by the fewest refugee voluntary repatriations in 30 years (European Commission, 2016; UNHCR, 2016).

While most of the recent focus has been on refugees arriving to Europe’s shores from the Middle East, other unresolved and new crises and conflicts have added to the increase in global forced displacement (Norris and Malknecht, 2015; UNHCR, 2016). New or renewed conflicts in Burundi, Iraq, Libya, Niger and Nigeria, together with ongoing crises in Afghanistan, the Central African Republic, Central America, the Democratic Republic of the Congo (DRC), South Sudan and Yemen exacerbated the global refugee crisis further. In particular, the deteriorating situation in Yemen has led to widespread internal displacement; by the end of 2015, nearly 170,000 individuals had fled to nearby countries and about 2.5 million people had been displaced within Yemen’s borders. In 2015, mounting violence in Central America forced thousands of Hondurans, Guatemalans and Salvadorans to leave their homes, principally to North America, a trend that continues to cause political tension across the US border (BBC, 2018, 2019). Pending refugee and asylum cases from Honduras, Guatemala and El Salvador increased from 20,900 people in 2012 to 109,800 in 2015 (UNHCR, 2016). Although lower than the refugee numbers reported from Africa and the Middle East, Latin American refugee populations increased by more than 500 percent between 2012 and 2015 (UNHCR, 2016). Notably, new policies and practices in the United States have resulted in increased confinement of asylum seekers in detention facilities and federal prisons (Gilman and Romero, 2018; Human Rights First, 2018).

Approximately 95 percent of displacement occurs in the global South (Zetter, 2015). While most people (up to 95%) will stay in their own country or nearby, forced migrants are demonstrating increased mobility, settling at greater distances both regionally and globally in attempts to access safety and livelihoods (Zetter, 2015). In 2014, developing countries hosted 86 percent of the global refugee population, with the Least Developed Countries providing asylum to more than 4 million or just over a quarter of the total (Guterres, 2015; UNHCR, 2014). In 2020, 85 percent of the world’s refugees were hosted in developing countries (UNHCR, 2020); a trend that continues to feature in forced migration discourse, with only 15 percent of them hosted in the global North.

These data indicate that a small number of countries receive disproportionate numbers of forced migrants. While these countries make significant efforts to provide relief (Guterres, 2015; World Bank, 2016), the large numbers arriving often overburdens them. This impacts negatively on public education, waste management, housing, electricity, water supplies, food prices and wages (European Commission, 2016; World Bank, 2010; Zetter, 2012), and strains the tolerance of host populations, potentially increasing the risks of civil unrest and political instability.

Natural disasters, climate change and environmental stress further contribute to forced migration. Floods, windstorms, earthquakes, droughts and other disasters displace millions of people each year worldwide, and because of climate change, these migrations are likely to increase (Bakshi, 2016; The Nansen Initiative, n.d.). The multiple effects of increased conflict, violence and climate change will force even more people to flee and multiply sources of potential trauma.

In 2015, almost 1 million migrants arrived in Europe, and over 2 million Syrians were forced into exile (UNHCR, 2016). It is clear from this vast migration that attention must no longer focus entirely on low-income ‘fragile states’, nations susceptible to crisis in their economic, social or political systems (Crisis States Research Centre [CSRC], 2006). At the Fragility, Conflict and Violence Forum 2016, World Bank President Jim Yong Kim called for new frameworks and paradigms to guide international perspectives on fragility and conflict, as traditional measures have been made obsolete by the fact that fragility is no longer limited only to low-income states. Kim contends it is time to explore how to operate more effectively in middle-income countries experiencing conflict and violence (Yong Kim, 2016).

Moreover, the coronavirus pandemic that has so far claimed over 3.27 million deaths (World Health Organization [WHO], 2021) has exacerbated the pre-existing vulnerabilities of displaced people living in fragile settings. With lack of documentation and limited access to protection levers, housing, food, water and sanitation, health, and education, forced migrants are disproportionately affected by the Covid-19 crisis. Furthermore, forced migrants in conflict-affected contexts are housed in hard-to-reach places, making the provision of humanitarian assistance a great challenge. A recent Organisation for Economic Co-operation and Development (OECD) report (2020) pointed out that the weaker health care and social protection systems afforded to refugees, the majority of whom live in the global South, will experience disproportionate impact of the pandemic.

Global responses to forced migration

Legal framework

The 1951 Convention Relating to the Status of Refugees established international legal parameters for refugees (UNHCR, n.d.). The document states, ‘To be recognized legally as a refugee, an individual must be fleeing persecution on the basis of religion, race, political opinion, nationality, or membership in a particular social group, and must be outside the country of nationality’ (UN General Assembly, 1951). In the aftermath of World War II, the original framework covered only people fleeing persecution, but the 1967 Protocol Relating to the Status of Refugees eliminated the geographical constraints to make the Convention ‘truly global’ (UN General Assembly, 1967; Zetter, 2015). By 2015, there were 142 states signed on to both documents, with five additional states having agreed to one or the other. Several regional instruments, covering Africa (the Kampala Convention; IDMC, n.d.) and Latin America (Cartagena Declaration on Refugees; Esthimer, 2016), have built on the designations of the Refugee Convention. Before 1998, people forced to relocate within national boundaries by violence or environmental hazards seldom enjoyed any protections. The UN General Assembly therefore adopted the 1998 Guiding Principles on Internal Displacement, which bolster the principles of protection and humanitarian assistance, and the responsibility of national authorities to protect the rights of refugees (Brookings-Bern, 2008).

Despite these policy efforts, there remains a major protection gap for people displaced across international borders by environmental factors. Environmentally displaced persons are not covered by the Convention or the Protocol, and legal rulings have supported their claims only in rare cases (Buchanan, 2015; Zetter, 2014). As yet, no formal action has been taken to adopt an international convention on refugees from environmental hazards, and debate continues (Mayer, 2016). In virtually all destination countries, Zetter (2014) reports that existing laws do not offer relief for migrants displaced by environmental factors. Worth noting, policies in Finland and Sweden propel the issue onto the international agenda (Zetter, 2015). First, both countries have slightly more generous temporary protection allowances, potentially allowing refugee applications on the basis of environmental displacement. The Finnish Aliens Act (1991), for example, allows aliens to receive residence permits if ‘. . . they cannot return [to their countries of origin] because of an armed conflict or environmental disaster’. In addition, the Nansen Initiative, led by the governments of Switzerland and Norway, is a broad consultative process that examines ways to offer legal protections to people forced to migrate internationally as a result of natural disasters, particularly in relation to climate change.

As with other international instruments, the Guiding Principles on their own lack international legal stature. However, the challenge of protection is less one of law and norms, and more one of finding the resources to implement status protections into national development and climate change agendas. For example, a study conducted in Kenya, Ethiopia, Ghana, Bangladesh and Vietnam, identified as countries at risk from climate change but without vigorous political structures to address national environmental risks, revealed insufficient governmental capacity, instruments and resources to respond adequately. In each country, the study further found a weak civil society incapable of pursuing the right to protection from environmental degradation (Zetter, 2011; Zetter and Morrissey, 2014).

Protection framework

Conflicts and crises have non-linear trajectories, and forcibly displaced populations both contribute to and suffer from conflict (Newman and Van Selm, 2003). However, there is general agreement on the current drivers of global forced migration beyond traditionally defined persecution (Zetter, 2015), including poor governance and political instability, intra-state conflict, and environmental change and resource scarcity. Iraq and Syria offer vivid examples of the first characteristic, particularly in the sudden, violent mass displacement of people. The second characteristic is exemplified in Kenya where post-election violence in 2007 forced some 600,000 people to relocate within national borders. The Arab Spring of 2010, too, resulted in dramatic forced migration, particularly in Libya. Lack of resources drives global forced migration by means of water shortages, unreliable food supplies, pollution, famine and climate change. These factors may not directly displace populations, but when combined with other elements, including generalised poverty, they do. The continual crisis in Somalia is a clear example: three decades of clan conflict and government failure have led to insecure food supplies and fragile livelihoods (Zetter, 2015).

Given the complex and multi-causal nature of contemporary drivers of displacement, protection focused primarily on persecution has become problematic and challenging to implement. Forced and unforced migrations are not clearly distinguishable, resulting in what have been designated as ‘mixed’ migration patterns. These, when combined with entirely new migration patterns in some regions, result in increasing numbers of migrants who fall into the ‘protection gaps’ between defined ‘protection spaces’ (Zetter, 2015). Although without official definitions, these terms describe two central elements of the current international refugee protection scheme (UNHCR, 2006). ‘Protection space’ refers to the locations where forced migrants reside and to the agents and agencies that offer them protection. ‘Protection gaps’ occur where limits on or a complete lack of protection exists, either due to poor practice or lack of status (Zetter, 2015).

Historically, various forms of relief for forced migrants have been available, including return, resettlement and establishing formal local residence. In 2015, for instance, the DRC, the Islamic Republic of Iran, Pakistan, Tanzania and Uganda simultaneously carried out programmes offering both voluntary return and resettlement (UNHCR, 2016). Nevertheless, only a fraction of displaced people resolve their residence status annually. This results in an ever-growing population of migrants in protracted distressing situations for years, even decades (Crawford et al., 2015; Crisp, 2003). Clearly this results from a global inability to resolve the ongoing challenges that confront both the forcibly displaced and the countries to which they migrate (European Commission, 2016; Vibes, 2015). Host countries have approached forced migrants through humanitarian assistance (e.g. legal and physical protection, food and shelter). This practice, however, has maintained displaced populations ‘in limbo’ leaving them to rely on ongoing, even permanent, material assistance (European Commission, 2016; World Bank, 2016).

Newman and Van Selm (2003) argue that humanitarian measures alone are insufficient, and that it is time to consider a wide range of actions, or what they call ‘an intervention continuum’ (p. 17) to prevent a massive refugee crisis, including ongoing political and diplomatic efforts, resources for development, third-party monitoring and the reinforcement of social norms by building democratic institutions. Nonetheless, more than a decade later, with the failure of global parties to end violent conflicts and establish secure territories, the sheer overwhelming number of forced migrants reflects a continued state of crisis around the globe (Norris and Malknecht, 2015).

The response to this complex phenomenon has been complicated by a purported link to terrorism. Since the terrorist attacks of 11 September 2001 in the United States, refugees have increasingly been portrayed as somehow dangerous (Loescher, 2003; Newman and Van Selm, 2003), with some political leaders describing them as murderers and rapists (Chouhy and Madero-Hernandez, 2019). Forced migrants are not necessarily viewed as persons in need so much as sources of threats to society. These conceptions challenge the established concepts of state membership and citizenship and, in this context, institutions such as asylum. In some communities, hosting even small groups of refugees has also led to ‘an ugly tendency of xenophobia’ (Bloomberg View, 2015; Meiritz and Taub, 2015), public anxiety about immigration (Papademetriou and Banulescu-Bogdan, 2016) and outsized fears of terrorism (Norris and Malknecht, 2015). In the midst of these assumptions, evidence of the economic benefits that host nations receive from refugee communities has largely remained lost in the discussion (Betts et al., 2014; Zetter, 2012). Similarly, while the refugee hosting countries in the global South grapple with increased pressure on their already strained resources and services, the anti-immigrant sentiments fanned by right-wing rhetoric in some of the Western countries bolster racism and xenophobia by stereotyping refugees as a burden on their services.

Despite ongoing reassessment of historical concepts of security and sovereignty, there is also a need for an international plan to cover the humanitarian, political and developmental agendas all at once. As outlined above, forced displacement not only challenges social and humanitarian norms, but also subsumes politics, economic development and the broader phenomenon of migration in countries around the world.

The current state of policy and practice

Policy

Two main discussions preoccupy the policy debate on forced migration: status and protection. In the first case, refugee is a catch-all term used to describe all involuntarily displaced migrants. Yet the limited legal definition of the term exposes forced migrants not officially recognised as refugees or asylum seekers to mounting risks. The label has become increasingly problematic and inadequate in characterising the complex, multivariate factors that prompt migration, beyond persecution. The term forced migrants more accurately describes the broader population of people whose circumstances misalign with traditional definitions and formal designations (Zetter, 2015). Better comprehension of the global migrant crisis requires a new vocabulary and meticulous re-evaluation (Newman, 2003).

Asylum-offering countries have adopted a variety of designations to identify non-traditional migrant populations (‘temporary protected status’ in the United States, ‘subsidiary protection’ in the European Union [EU]); however, these designations do not necessarily provide adequate protections or harm reduction to those seeking security. The Transatlantic Council on Migration (2014) asserts that the EU has made some progress in reducing such deficits, particularly by means of its local regional development and protection programmes. For example, the European Commission (2016) has put forward a comprehensive plan for a ‘strategic reflection’ on how best to maximise the benefits of the EU’s programmes that address the scale and complicated causes of forced displacement both regionally and locally.

The need now is to fully respect the international and human rights law and design interventions where actual vulnerabilities prevail over legal status. Forcibly displaced populations require formal protections from threats based on a wide variety of characteristics including sex, age and disability as well as political, ethnic, linguistic and religious affiliations: ‘A “one-size-fits-all” approach is not workable anymore’ (European Commission, 2016: 4).

Protection occupies a second field of debate. Several authors (Hurwitz, 2009; Zetter, 2015) claim that at the international level, notions such as the ‘responsibility to protect’ are insufficient to result in collective, community-based protection schemes. For example, the 2015 European refugee crisis saw asylum and reception systems fail to promote a comprehensive response. Existing frameworks were mostly insufficient, neither managing the crisis nor providing adequate protection space. A variety of countries in Europe responded by simply adding border restrictions (UNHCR, 2016), such as increasing border controls and erecting fences along borders, as in the case of Poland, Hungary and the Czech Republic (BBC, 2017).

A study commissioned by the Swiss Federal Commission on Migration investigated whether conventional ‘status-based protection’ was the singular or sufficient approach, exploring whether the means to reduce vulnerability and exposure to vulnerability is an equal imperative. Zetter (2014, p. 13) promotes the concept of ‘displacement vulnerability’ to accommodate ‘needs-based’ or ‘rights-based’ protections, which better frames the challenges and the deficiencies of protection schemes. He (Zetter, 2015) further contends that the fundamental challenge confronting the global protection system so far remains unaddressed and calls for the development of a coherent protection policy that conceives forced migration as a part of a migration continuum. In addition, he suggests that policies to address displacement are best viewed within a broader spectrum, one that accounts for organisational and developmental practices that comprise traditional asylum protocols. This implies a shift in emphasis from status to needs – to address vulnerabilities, irrespective of the status of individuals – thus providing consistent protection along the displacement continuum and addressing the increased management requirements and politicisation of protection.

Practice

One of the main symbols of the current forced migration crisis is refugee camps, built and run by governments, NGOs or international organisations such as the Red Cross or the UN: temporary settlements where refugees and ‘people in refugee-like’ circumstances (stateless or denied the protection of the government) are received. Over 100,000 people per camp is common, and the average time spent in them per refugee is 17 years (Vibes, 2015). Such overcrowding and long-term adverse living conditions not only stretch humanitarian resources but also exacerbate problems for individuals and families. For example, Keller et al. (2017) reported that among those fleeing violence in Central America, many (32%) met diagnostic criteria for Post-Traumatic Stress Disorder (PTSD), depression (24%) and 17 percent for both problems. Yet, while the pre-migration experience affects forced migrants’ well-being, the post-migration experience also has significant impact and can determine how migrants recover from pre-migration trauma (Hynie, 2018). Detention adds a further burden. Filges et al.’s (2018) systematic review of the mental health of asylum seekers reported that persons in detention in the countries investigated (Australia, Canada, United Kingdom and Japan) had disproportionate levels of PTSD, depression and anxiety symptoms after detention compared to those who were not detained in immigration holding centres, camps or provincial jails. A qualitative study (Palattiyil and Sidhva, 2015) of HIV-positive asylum seekers in Scotland revealed that all respondents had substantial traumatic experiences, including physical and sexual assault and forced human trafficking, with many fulfilling the Diagnostic and Statistical Manual of Mental Disorders (5th edn., DSM-5) criteria for PTSD (American Psychiatric Association, 2013). In addition, in their study, Palattiyil and Sidhva (2015) noted that these symptoms impacted asylum seekers’ ability to tell their stories effectively, thus reducing the likelihood of successfully applying for asylum.

Refugee camps highlight the complexity of the practice needs, which require attention at different levels of service delivery and which occur over time. Focusing only on the individual by relying on diagnostic labels ‘presents the risk of pathologizing and/or oversimplifying human responses to traumatic events without examining or considering the social context that encompasses those experiences and responses’ (Suarez, 2016: 142). Labelling not only reduces the problem to the individual but also pathologises the presenting distress, which may be a functional coping response to very difficult circumstances (Suarez, 2016). Furthermore, the forced migration experience occurs over time and locations, impacting people in different ways across the experience. Therefore, it is essential to learn about the unique experience of individuals and the contexts in which the individual has lived and travelled.

To understand and help forced migrants, a multi-layered response is needed. Social work practice is commonly described as occurring at the macro-, meso- and micro-levels (Hepworth et al., 2013; Sheafor and Horejsi, 2015). Such a framework applied over the migration experience is helpful in identifying opportunities for service with forced migrants, within a culturally competent, rights-based perspective (Cemlyn and Briskman, 2003; Joseph, 2017; Palattiyil and Sidhva, 2015; Valtonen, 2008). A commitment to human rights and social justice is an embedded value of global social work (International Federation of Social Workers, 2018), a ‘supranational’ framework for practice with refugees (Valtonen, 2008: 21).

The macro-level includes policy practice, social planning and community organisation (Hepworth et al., 2013). At this level, social workers working with forced migrants attend to the conditions that create and perpetuate the trauma over time, the ‘social determinants’ (Joseph, 2017: 237). Policy practice works to create and enhance laws, policies and resources for forcibly displaced people. In the examples noted above, social workers would seek to improve the quality of the refugee camps. Laws and policies would provide access and equity in service provision, and advocate for the right to maintain valued aspects of culture of origin including language (Valtonen, 2008). Oppressive policies would be challenged. Social workers in community practice would help establish and work with and across community groups and organisations to identify or develop affordable housing, employment and employment training, translation and interpretation services, legal counsel, and educational opportunities. They would also work to develop receptive communities through education, as suggested by Segal (2012): ‘Community social workers can minimize xenophobia and enhance integration efforts by educating both the new and long term residents about each other and by facilitating dialogue’ (p. 10). In short, the focus of macro-practice is to change communities, institutions and societies to ensure they are committed to the rights of the forcibly displaced, in a socially just and culturally competent manner.

Work at the meso-level includes changing systems that more directly impact the service user, when compared with the macro-level, such as groups and the classroom (Sheafor and Horejsi, 2015). Group work with forcibly displaced populations that aims to relieve the immediate trauma associated with the forced migration experience has been effective (Macgowan et al., 2021; Rafieifar and Macgowan, in press). However, group work that focuses only on reducing the trauma symptoms is incomplete. Rather, group work that focuses on the transition process and provides mutual support is also needed and helpful (Joseph, 2017; López and Vargas, 2011), particularly one that has a social justice perspective. Socially just practice in groups encourages members and the group as a whole to ask if the group’s purpose addresses relevant issues of diversity for the particular members and groups’ embedded contexts. Additional consideration includes the degree to which the group’s goals relate to the unique experiences of oppression encountered by each member and as expressed by these members, themselves (Ortega and Garvin, 2019). Group work focusing on social support is valuable as it can also help reduce distressing symptoms. In a study of Iraqi refugees, the level of affective social support was important in determining the severity of PTSD and depression (Gorst-Unsworth and Goldenberg, 1998).

Micro-level services are delivered directly to the service user. In a model aligned with the culturally competent, rights-based perspective utilised by a voluntary agency supporting asylum seekers in the United Kingdom, Fell and Fell (2013) described a non-linear, five-part, reflective process model of helping asylum seekers, which is relevant for all forcibly displaced people. The first two elements ‘welcome’ and ‘accompaniment’ involve a person-centred process that is welcoming and gives a posture that services are available but not imposed. Establishing rapport, developing trust, and understanding and working through the potential cultural barriers that might create a reluctance to engage are important in the initial encounters (Segal, 2012). The barriers to work through include cultural factors (e.g. stigma around seeking help, norms and beliefs about mental illness, preferences for alternative practitioners) and structural factors (e.g. language barriers, high cost, lack of insurance) (Derr, 2016).

The result of this engagement is that service users know ‘that a particular kind of care and expertise are available’ (Fell and Fell, 2013: 1330). The engagement includes broad-based assessment and a plan of service that is collaborative and tailored. Betancourt et al.’s (2017) study in the United States examined differences in trauma exposure among three groups of children and adolescents: refugee-origin, immigrant and US born. The study reported higher levels of types of trauma exposure among refugee youth than in the other two groups, and greater rates of community violence exposure and traumatic loss than the other groups (Betancourt et al., 2017). Thus, the trauma experiences of migrants and refugees are not necessarily the same, and all need careful assessment to understand and more effectively manage the concerns they face. Assessment includes collecting information not only about challenges and immediate problems such as distress and discrimination, but also strengths and resources to tailor services to the individual. It is important to remember that thoughts and behaviours that may be classified as troubling according to Western diagnostic labels may be normal reactions to adverse events (Fennig and Denov, 2019). A broad-based assessment identifies resource needs such as translation services, housing and employment, and ‘oppressive systems and policies’ that need attention (Fennig and Denov, 2019: 13). Therefore, in addition to working on individualised concerns such as disturbing thoughts or memories, practitioners would also address unjust systems and policies that contribute to or perpetuate the trauma.

The third element of the Fell and Fells’ (2013) model, ‘mediation’, is linking the individual to needed care. There are different ways social workers may intervene at the micro-level. Social workers may provide a brokering role, educating and connecting individuals with existing resources, and supports is part of an individualised approach (Joseph, 2017). It may also include the fourth element, professional ‘befriending’: that is, provision of services a social worker thinks may enhance the individual’s existence, but which the individual is not yet able to obtain, likely due to the unfriendly process they have been through (Fell and Fell, 2013).

In cases where there is a clear need to address the presenting symptoms of trauma, the social worker may use specialised therapies that have been shown to be helpful. A number of reviews have shown the benefits of interventions in reducing PTSD and trauma symptoms among forcibly displaced persons. For example, Nickerson et al. (2011) noted that helping approaches that focused on trauma (e.g. Cognitive-Behaviour Therapy, CBT) were promising in reducing PTSD among refugees, but the designs needed strengthening and the treatment components needed to be better examined in such studies in order to understand the mechanisms of change. Slobodin and de Jong (2015) conducted a literature review of quantitative studies of a range of interventions for traumatised refugees and asylum seekers and concluded that CBT and Narrative Exposure Therapy (NET) were effective. In their meta-analysis of 12 randomised controlled trials of trauma-focused interventions for refugees, Lambert and Alhassoon (2015) found large effect sizes among those receiving help when compared with those in control conditions. In a meta-analysis of 12 studies involving refugees and asylum seekers in high-income countries, Nosè et al. (2017) concluded that psychosocial interventions, particularly NET, were effective in reducing PTSD symptoms when compared with controls. Naseh et al. (2019) reviewed the findings of studies for PTSD treatment among refugees. Their study reported the best results for Eye Movement Desensitisation and Reprocessing (EMDR) and concluded that culturally adapted EMDR could be used by social workers as a useful intervention for PTSD among refugees. The consistent message from these reviews is that refugees and asylum seekers with heightened distress can benefit from culturally appropriate psychosocial interventions.

The fifth element of Fell and Fells’ (2013) model is ‘advocacy’. In micro-practice, advocacy may take on a different nature than at the macro-level as ‘the granting of asylum is not in the power of the individual advocate’ (Fell and Fell, 2013: 1334). Therefore, social workers need to advocate within the scope of practice, presenting a realistic vision of what can be accomplished. For example, social workers can advocate for resources or be another voice for the forced migrant at hearings.

Social work practice with forcibly displaced populations requires work at the macro-, meso- and micro-levels within a culturally competent, rights-based perspective. While the effects of forced migration are felt at the individual level, the concerns migrants bring to practice are not rooted in the individual but are a product of the experiences, over time, from all three levels. Effective practice with forced migrants includes attention to all areas.

Imperatives for social work policy, practice and research

With its emphasis on the person in environment and critical race theory, social work should address the spectrum of issues facing forcibly displaced persons whose individual challenges intertwine with other broader systems that need attention (Ostrander et al., 2017). There is a need to go beyond traditional humanitarian approaches to find durable and comprehensive solutions in policy, practice and research.

Policy recommendations

As highlighted in this article, broad-scope policy development and change is needed. What follows are recommendations for policies that (a) allow refugees to contribute to the economy, (b) recognise the interconnectivity of regular and forced migration, (c) extend beyond focusing on root causes of forced migration and (d) include critical examination of existing priorities and values.

Asylum-hosting countries need a legal framework that allows refugees to contribute to the economy rather than remaining outside the mainstream (Yong Kim, 2016). Hosting states commonly limit refugees’ access to labour markets, movement and sanctioned residency. Furthermore, prohibitions against making improvements to settlements further complicate attempts to obtain long-term secure legal status (European Commission, 2016). Refugees and IDP have assets and skills to contribute to host country economies and societies (De Haas, 2006; Jacobsen, 2006). Without opportunities, the predominant dependence model of ‘care and maintenance’ undermines displaced peoples’ opportunities to become more self-reliant (Jacobsen, 2002; Zeus, 2011).

Zetter (2014) argues that it is time to recognise the interconnectivity of regular and forced migration, which will represent a significant step in formulating complementary and coherent national and international policies. Nyberg-Sørensen et al. (2002) identified the links between regular migration and development, specifically the occupational and basic living strategies adopted by individuals, households and communities. These include (a) significant and targeted funding; (b) financial support and activism among migrants, refugees, Diasporas and their multinational communities; and (c) the transnational movement frequently associated with global integration, inequality and insecurity.

However, such a message has not yet fully reached the operational level. Assistance agents are constrained by a mixture of institutional restrictions, organisational structures, and funding phases and procedures that fail to reflect the actual needs of displaced people and host communities (European Commission, 2016). While humanitarian assistance provides initial immediate relief and protection to forcibly displaced people, development assistance operates under long multi-annual planning and funding cycles. Beyond physical and legal protections and emergency food and shelter, forcibly displaced people require ongoing access to employment, medical care and shelter.

The German Institute for International and Security Affairs warns that despite growing interest in using development cooperation as a tool to deal with the causes of displacement, such an approach will prove insufficient without corresponding changes in security, foreign, economic and trade policies (Angenendt et al., 2016). As policy is formulated, a critical examination of existing priorities and values is needed, such that debates around the root causes of displacement reflect a shared responsibility and commitment. The ethical and normative frameworks have focused extensively on refugee cases at the expense of main reflections around the causes of forced displacement (Betts, 2014; Cohen and Deng, 2012; Laker, 2013). Even such historically accepted pillars of governance, law and international cooperation may require fundamental reappraisal (Newman, 2003) with a focus on more rigorous science, both theoretical and methodological, to have a beneficial impact on policy (Jacobsen and Landau, 2003).

The coronavirus pandemic has upended humanitarian responses of governments, the UN and other NGOs globally. With pre-existing vulnerabilities, the medium to long-term impact of the pandemic on forcibly displaced people is likely to be greater than any other group of people, when governments are challenged by competing priorities (OECD, 2020). Key recommendations to safeguard the rights of forced migrants and to protect them from the precarity of the Covid-19 pandemic call for integrating them into national response plans to address risks of violence, discrimination and xenophobia and for their inclusion into health sector response plans and social protection schemes (OHCHR, IOM, UNHCR and WHO, 2020).

Practice recommendations

Two primary practice recommendations are intended to ensure the availability of direct services and to involve forcibly displaced persons in the delivery of direct services.

As noted above, many forcibly displaced persons may need a range of psychosocial services at different levels of service. All points of contact (e.g. camps, clinics, interview stations) should have sufficiently trained personnel to administer culturally appropriate (Palattiyil and Sidhva, 2015) broad-based assessments that include challenges, strengths and resources, and deliver tailored efficacious helping approaches to those who need them. Culturally appropriate, coordinated services should be available along the continuum from first to last contact with service providers. If indicated, therapies such as CBT, NET and EMDR are recommended. In addition, there is a noted shortage of trained social workers in regions affected by forced migration and a critical need for building social welfare infrastructure in those areas (Harding and Libal, 2012).

In conjunction with the policy recommendation noted earlier to permit refugees to contribute to the local economies, refugees should be included in service design and delivery if they are to be empowered. Easton-Calabria (2016) described such an initiative in Kampala, Uganda, in which refugee-run organisations developed programmes to promote refugee self-reliance and support community integration and development. These groups direct a range of vocational training, literacy programmes, and community-based micro-savings and lending, which help meet long-neglected financial needs in the refugee community (Easton-Calabria, 2016). Young African Refugees for Integral Development (YARID), which empowers refugees and builds community through vocational education, English classes, access to sports and computer literacy skills (personal communication between its co-founder and the article’s lead author, 16 April 2019) is a perfect example of such innovative practice. Other examples include refugees helping with tuberculosis control in Northern India (Wares et al., 2000), refugee-led schools both in Indonesia (The Conversation, 2016) and Egypt (Magdy and Kennedy, 2015), and helping with economic development in Ecuador (Piñeiro and Saavedra, 2016).

Research recommendations

Forced migration research and refugee studies primarily focus on gathering testimonials and voices of forcibly displaced persons, as well as attempts to connect the on-the-ground reality with local and global policies in the context of existing agencies, vocabularies and processes. Solutions to the international refugee crisis will require investigators to re-examine existing assumptions, treating the rights of forcibly displaced individuals on par with all other citizens, and placing them centrally within international security policy (Newman, 2003). As described below, coordinated, collaborative research that is both local and global and brings together multiple stakeholders is the primary need.

It is vital that agencies working in the field of forced migration need to coordinate better with each other and share capacities to evaluate best practices and policies that need improvement. Turton (2006) avers that practical and scientific knowledge should be combined, while encouraging empirical research to understand the situation of displaced people at the local level, without ruling out the consideration of the global. Moreover, such research inevitably questions the usefulness and adequacy of existing assumptions, categories and generalisations; thus, academic research plays an effective and beneficial part in the general improvement of human welfare (Turton, 2006).

Multiple players must collectively react to face the challenge, with contributions from professionals and relevant actors on the ground (intergovernmental organisations, donors, humanitarian actors, researchers and forcibly displaced people/refugees themselves). This multidisciplinary and collaborative work ought to draw on research, risk assessment and management tools to establish an evidence base from which to allow analyses of the causes of long-term refugee displacement. Unified efforts among regional authorities, aid agencies and displaced communities, combined with broader investment will prove vital in promoting local ownership and the sustainability of the response (European Commission, 2016). The most original approaches are organised in this manner, for example, cooperative inter-city efforts to promote local economic development, urban planning and service delivery.

While we know that the coronavirus pandemic has had profound impact on forced migrants, including access to healthcare, PPE, infection control measures, livelihoods, counselling, to name a few, we just don’t know definitively what the disproportionate impact will actually be yet, just that it is impacting forced migrants disproportionately. We can and should advocate for more resources and research to be put towards gaining this understanding, including the longer term effects of Covid-19 on forced migrants and measures to mitigate them. We need a ‘build-back better’ agenda for forced migrants to genuinely improve their situation from what they were pre-Covid-19.

In concluding, these recommendations for policy, practice and research collectively argue for an appropriately functioning multidisciplinary global network with social work embedded within that context. These will have to include legal, economic, cultural, political and civil dimensions, so a forced migrant may enjoy the same benefits in services and rights as any national. Comprehensive solutions require collective commitment to address displacement and a willingness to utilise and deploy a wide range of appropriate options and opportunities.

With a shift in the current paradigm on forced migration and an increased sense of citizenship of those displaced, forced migrants will be better placed to lead a more productive life, contributing to the development of the host countries.

There is a moral imperative to respect their expertise of their ‘own’ lived experiences. Moreover, their generosity in sharing their expertise, often invoking painful memories, needs to be underpinned by a collective commitment to truly hearing the voices of forced migrants in service design and delivery, such that they feel ownership of decisions made about themselves, where they have a real sense of participation. Across policy, practice and research contexts, forced migrants are not only well-placed to contribute, but truly the experts on their lives. The real call now is for us as researchers, policy makers and practitioners to embody the values of coproduction and empowerment. The current Covid-19 pandemic both focuses and requires us to redouble our efforts to focus on our shared humanity and remove the second-class citizenship status that is often conferred on forced migrants.

Footnotes

Acknowledgements

Acknowledgements are due to Dr John Devaney, Centenary Professor of Social Work, and Dr Gary Clapton, Senior Lecturer in Social Work, School of Social and Political Science, University of Edinburgh, and Dr Monica Barry, University of Strathclyde, for critically commenting on the drafts; and Nathalia Salamanca-Sarmiento, PhD student, for support with bibliographic referencing.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship and/or publication of this article.

ORCID iDs

George Palattiyil

Dina Sidhva

Amelia Seraphia Derr

Mark Macgowan

Author biographies

George Palattiyil is a senior lecturer in social work at the University of Edinburgh and researches on forced migration, health, human rights, HIV/AIDS, international social work and social work with older people and coedited Social Work in a Global Context – Issues and Challenges (Routledge, 2016). Drawing on his cross-national research on refugees in Bangladesh, Jordan and Uganda, he recently set up an interdisciplinary ‘Global Refugee Health Research Network’ with eight other partners.

Dina Sidhva is a lecturer in social work at the University of the West of Scotland. She has a passion for researching and giving voice to marginalised, vulnerable people in areas such as HIV, human rights, gender-based violence, asylum seekers and refugees and coedited Social Work in a Global Context – Issues and Challenges (Routledge, 2016).

Amelia Seraphia Derr is an associate professor of social work at Seattle University. Her research examines the nexus between social and health service systems and the migration experience; specifically, barriers to social, mental health and health services for migrants; factors that promote service access and parity; and the role of local sectors in promoting socially just contexts of reception for migrants.

Mark Macgowan is a professor of social work and Associate Dean of Academic Affairs, Robert Stempel College of Public Health & Social Work, Florida International University, Miami. As a therapist and scholar, his research focuses on effective helping approaches for persons impacted by natural disasters and human-made events, such as forced migration.

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Global trends in forced migration: Policy,practice and research imperatives for social work

Abstract

Keywords

Introduction

The global picture of forced migration

Global responses to forced migration

Legal framework

Protection framework

The current state of policy and practice

Policy

Practice

Imperatives for social work policy, practice and research

Policy recommendations

Practice recommendations

Research recommendations

Footnotes

Acknowledgements

Declaration of conflicting interests

Funding

ORCID iDs

Author biographies

References