Azad*, an asylum seeker from Iran, recounts his story in a gentle and mild manner, seated in the stillness of a therapy room at a trauma clinic in Birmingham. The centre, which opened its doors in July last year to address the “unmet mental healthcare needs of those seeking sanctuary”, is run by Médecins Sans Frontières (MSF), or Doctors Without Borders. It provides specialised trauma-focused psychological care for refugees and asylum seekers in the city and surrounding areas.
It has so far received more than 350 referrals from the NHS and refugee organisations, and held 521 consultations for patients – many of whom have survived conflict, persecution, torture and other forms of violence and exploitation in their home countries or on their migration journey. Data MSF shared with the Guardian by MSF shows that of 150 case files reviewed by MSF, 88% documented experiences of violence and one in three detailed suicidal thoughts at the moment they came to MSF. Azad, who arrived in the UK on a small boat , was approached by MSF at the hotel he was being accommodated in Birmingham.
He had known for a long time that he needed help, he said, but had nowhere to turn. Azad’s journey to the UK had begun several years earlier, when the Iranian authorities cracked down on protests that had swept across the country in late 2022 against the death of 22-year-old Mahsa Amini in police custody. She had been arrested for allegedly violating rules requiring women to wear the headscarf.
Azad, a Kurdish-Iranian civil engineer, took part in the demonstrations and said he had witnessed people being shot and others blinded. After authorities spotted him spraying graffiti, his father urged him to flee the country, fearing for his safety. The authorities later ransacked his family home, he said.
Azad travelled to Germany, where he applied for asylum but was rejected – a decision he said was driven by a “racist” interviewer and delays that prevented an appeal hearing. The decision left him feeling hopeless. The UK was his last and only option, he said.
When he arrived, he alleged border officials had sworn at him. MSF staff said the mental health struggles of their patients had been further compounded by the rise in “hostility and anti-migrant sentiment in the UK”. Some of their clients had to be moved from hotels far-right protesters routinely targeted.
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