Snakes and Ladders

FormulationGame

Roll the dice!

Do you know what a HC2 Form is? Luckily, someone at the local church Habib visits knows, and so Habib can fill it in and get medication for free.

You feel low in mood, and upset. You don't go out. You are also not sleeping well due to the nightmares.

Your experiences of travelling are shaping who you feel you're becoming.

You find that you could potentially feel better if you could access some counselling or something.

Lack of Specialist Services

An official job

Looking for work

Your OT helped you by referring to Shaw Trust. They support you in looking for a job that is appropriate to your skill base. You might quit FastGrubThe job means you could start saving money towards renting a room in a shared accommodation. Q - Does your job contribute to your identity?

49.18 is not very much to live on. You find it hard to prioritise what to get. It's not really enough to eat well.The cost of living has gone up

Survive

Your family misses you, the children don't understand. You want to provide for them. Your wife can't work anymore under the Taliban

Save/Send

Or

Your calls are missed....

Kabul time zone..

Kabul is 3 hours ahead. You try and contact Zahra often but because of Fast Grub, you often can only call later in the evening and she is not answering. Your anxiety increases. Q - Could you do long long distance?How does being a partner form your identity?

You're usually clean and well dressed but your interest is waning

Normal situation Interrupted

You're not caring as much anymore

Are they free?

Get anti-depressants

Your GP recommends an anti-depressant. It is not in your nature to take medication, but you agree. You will have to pay. You have to prioritise again. You can get the medication free by applying for a HC2 to show you have low income. Your internet is patchy at the hotel. Move back 2 spaces - maybe you'll find the form?

Have to prioritise

Finances

£49.18 a week from the UK government is not stretching as far as you need it to. You have to choose between yourself and your family. It is an important role for you to be the 'breadwinner' and send money to Afghanistan. Go back four spaces

Pattern of occupation, volition, choices, values, identity, Habits, Roles, Routines, Responsibilities, Structure - Environment, Socioeconomics, policital issues

What changed

How many of these factors impact each other, what are the 'pinch points' restricting a persons full participation?

Why's that

What interventions might help?What's most achievable?What are the person's strengths?What can you remove to help structurally?

What next

You've made connections and a friend has invited you to play 5-aside football on Monday evenings. You hope you can go. You don't like evenings much and feel anxious about going out.

5-aside football

Maybe

You could work

You've heard from a hostel acquaintence that a local fast food place FastGrub may be taking people on cash in hand. You used to work in publishing and printing books for children in English. and were proud of this work. But any work is good at this point. Q - Do you feel proud when you say you work in your current role? How do others react?

Support Group

Socialising

You meet with your OT and discuss goalsYou're not sure what you can achieve before you get asylum. You don't know when you willYour OT finds you a local and safe social space with people from a similar background to you.

In Kabul you were never without something to read, whether it be a newspaper, book or magazine.While your English is good, you always think you can improve! Q - What newspaper do you read? Does it say anything about you

Reading

You can connect with others

Find groups on FB

You find other like-minded people online who share similar stories to you, and you also meet a drummer who you tell about the kit you played with. Q - Are you in a facebook group, or follow a page? Does it align with an interest you have?

You get your decision

Decision

You finally get your decision after 2 years. The Home Office gives you 14 days to move out of the accommodation. You have nowhere to go. Luckily an acquaintance lets you stay with them but it's very small, and when he has friends over you sleep on the sofa. You consider quitting FastGrub

After a long journey, you arrive on the shores at Dover. It is disorientating and upsetting, but you are finally here. Move forward one space

You arrive in the UK

Money is good

After weeks with no money, this amount of money really makes you feel independent. You can buy chocolate and drinks that you've never tried before.

You miss them

Your 2nd Born Child

You have only seen pictures of your second born child, Roya. You want to be part of their life, have an active role

A local charity has given you a phone and SIM card which you can use to call your family, friends and goverment agenciesQ - Do you know anyone without a phone?

Mobile Phone and SIM

You apply to bring them

Wife and kids

Your wife and children remain in Kabul. Zahra is finding it more difficult to leave the country. You haven't been able to get them overYou may continue to feel low in mood, and be challenged by living in the UK without them.

In England, Scotland and Wales, immigration and residency status have no bearing on a patient’s entitlement to register with a GP. You are allowed to register, but you don't know this..

You encounter difficulty in registering with a GP, as many other Asylum Seekers are, and so you can't access basic healthcare or medication.Q - How would this make you feel about your identity, your role in this society?

GP Registration

Both Asylum Seekers and healthcare staff may lack the knowledge of the rights and entitlements to Mental Health ServicesA lot of the interventions that can be provided need to be practical, and therefore require good understanding of the system.

What are my rights?

Lack of Awareness

Zahra tells you that she's started attending a secret underground fitness group in Kabul. You're very pleased for her but you're also concerned about her getting caught. You worry about her You would normally discuss it with her Move back two spaces

Underground fitness

You've lost weight

You've lost weight since moving to the UKYou didn't notice so much, but your clothes appear bigger and you have moved up a notch on your belt. Go back two squares

Digital Exclusion?

You find that while you have your phone, dongle and connectivity via 4G (if you go to town), connectivity is patchy, and the Home Office have no obligation to provide wifi in the hostels. You want to apply for jobs, or book medical appointments but it is hard. You would love to face-time your family, but it's often too late and you get best connection in public but can't do it there.

Fast Grub, Slow Rewards

You work as a courier, which is risky for you and causes stress, but you want to send money back home to your family. You feel less likely to engage with healthcare in case they find out about your work and send you home

The UK Government gives you an amount to live on a week. You do not need to pay rent or bills as you are staying in a hostel, hotel or other accommodation. This goes on your ASPEN card, which is like a debit card. Some places won't take this, though, and it isn't to be used for internet shopping.

Weekly Finances

Local walks

Your finding you enjoy the evening walks in your current local area, Folkestone. The harbour is nice, and when it gets quieter you feel more comfortable.

You liked drumming

Music

You enjoy drumming, and in your teens you found a kit to play with. You haven't mentioned it to anyone but recently it crossed your mind as you feel the possibilities are more available in England. Move forward 3 spaces

You are bored, no money and you don't know anybody. Go back one space and hope to find someone to talk to

Bored

Do we know which strengths, skills or abilities Habib has that he is not currently using? And Why?

You call home as often as you can. You love hearing your children. Your eldest doesn't understand why you suddenly disappeared. She is often upset with you, especially as your wife is so restricted and has no rights in Kabul now. Your daughter thinks they are linked. You are concerned as she gets older, she is nearing sixth grade and school will stop.

Your children

Final Question!

x

Fast grub, quick chat

Little connections

You have a few regulars you deliver to while you work, the small moments of interaction make you feel good. Not good money, but you value the chats - you are a social creature.

Still no services at this time

Counselling

Sadly there are not currently specific services for asylum seekers You feel invalidatedGo back 10 spaces

You value how you look as a person, it is part of your identity. You made an effort to impress your family, and to reflect who you are. But your mood, finances, and reduced interest (plus less people to impress!) have impacted this.

Your appearance

You can stay somewhere but...It's a noisy house, an uncomfortable sofa and your mind will not shhhhhhhhYou feel grateful to be here, but you are tiredYou have job interviews and you want to come across as the best version of YOU Go back 3 spaces

It's not a nice sofa

You finally register with a GP!! She is understanding and makes time for you. She recommends seeing the Primary Care Mental Health Nurse. Q - is it important to you to have a healthcare professional understand you?

GP Registration

Maintaining interests

Patchy WIFI

The Wifi in the hotel is patchy again. You are keen on keeping up with the sport in the UK and Afghanistan but the pages won't load. You feel bored. Sport is important to you and your sense of self. Q - What interest is important to who you are?

Conceptualising

What has changed for Habib?Why has it changed?What challenges does he face?

You have always experienced anxiety and low mood, and your situation has exacerbated this further. It feels like your roles and purpose have been taken away Discuss - have you ever lost a role, and how had it impacted your mood?

Anxiety and Low mood

Send money home

Cash in hand work

You've managed to save enough that you can afford to send your family some money. You have felt more useful to them, and your spirits are lifted a little. Roll again

You're making connections

Socialising

In your local area you are feeling positive because the people in the local shop are kind to you. This is a boost, despite other people feeling hostile to youYou have always been a sociable person. Your English is good because you learnt at school and produced books in English

You join the local library with your friend's address. Reading and self-education is a passion. You can access their books and the internet cafe! Q - Do you read? What genre? Does it form part of your identity? Also - go forward 3 spaces....

You join the local library

The journey you made to the UK was dangerous. Sometimes you didn’t eat for 3 or 4 days, just eating leaves from trees. You travelled by foot or by car – everything in the hands of the smugglers. You did what they said. They hurt you. The journey took 4-5 months, you felt the risk of being hurt or killed. You travelled to the UK by a boat made for 8 but carried 30.

Your Journey

After staying with a friend, you find a room in a shared house, which leaves you some money to send home. You really feel like it's you and you can start to personalise it a littleQ - Is there anything in your home that tells a story of who you are, or an aspect of the core YOU?

Stable Accommodation

Locality shift manager, Petrov, meets you collecting a delivery and questions why you are covering Agit's shifts. He threatens to report you. You strike a deal, and rent from Petrov instead. He pays you £40 for 20 hours work.

Petrov, Questions

You are not sleeping very well. The hostel is in a neighbourhood where it is loud at night, plus you have infrequent nightmares.

Not sleeping well

You decide to visit the PCMH NurseHe helps you understand C-PTSD He also refers you to an Occupational Therapist!

PCMH Nurse

Zahra and the kids

Your wife and children are safe in Kabul, albeit under the regime of the Taliban, the restrictions are getting more concerning for them, and you.

2nd Child

Zahra has your second child She is safe and well, you hope to see her soon.

Internet Access

You make a friend who has wi-fi at their flat. You can use their laptop infrequently. Q - Do you have an internet persona? A social media version of yourself?

A charity helps you find the local food bank! You attend and sign up

Food Bank

You wish you are home. You are lonely and isolated.

Lonely

Facebook helps you connect. You tend to use it on a friends computer or if you get signal in town. The accommodation has little to no wifi.

Facebook

High anxiety

Your anxiety is very bad today: you feel low. You have poor sleep as you woke up having had nightmares. You tried to contact Zahra but the wifi is bad: it's very early there. You feel bad about yourself. Go forward a square

Your anxiety is still bad: you feel low. You have poor sleep as you woke up having had nightmares. You tried to contact Zahra but she didn't answer: it's very early there. You must pull yourself together. Roll again

Anxiety, still

You read newspapers and worry about the UK's attitude towards asylum seekers This makes you feel low, worried and demotivated to go out.

Concerns

You meet Agit at the latest hostel. He works as a cycle courier for Fast Grub (your grub, fast!) Agit rents out his bike and his unwanted shift slots to you for 50% of your earnings

Fast Grub,