The speed of the fall of Kabul took everyone by surprise. Thousands rushed to Kabul airport to try to get on hastily arranged international relief flights. There were chaotic scenes. National governments and relief agencies struggled to meet and process evacuees when they arrived at short notice. Many Afghans fled by land into neighbouring countries, some making their way west, many remaining where they fled.

Flights from Kabul arrived at many UK airports, particularly Heathrow. CAST staff were involved in the initial response at Heathrow Airport alongside staff from a range of organisations. The evacuation took place during the COVID-19 pandemic and many Afghans were initially placed in quarantine hotels for a time-limited period, although some required emergency treatment on arrival and were taken to hospital.

Following quarantine, a very large number of displaced Afghans, over 1200, were placed in hotels across two central London councils – the Royal Borough of Kensington and Chelsea and Westminster City Council. CAST received funding from North West Thames NHS ICS to assess their mental health needs and to try to find ways of helping them. CAST formed a close partnership with the two councils and with local voluntary sector partners.

The programme was delivered within a tight timescale, with new migrants arriving and existing migrants being moved at short notice to other parts of the country in a context of uncertainty. Given the pressures of the pandemic, the National Health Service (NHS) was struggling with long waiting lists for mental health support and there was a general shortage of trained staff with trauma experience able to deliver treatment, especially in the first language of Afghans.

CAST adopted a screening approach to reach out to the newly arrived Afghans in their hotels, going door to door, to understand their health and wellbeing needs. Screening questions focused on trauma and other mental health difficulties but also sought to establish their other needs. The project was was delivered by a range of staff including Assistant Psychologists, people with lived experience, interpreters that had experience working with traumatised people and other NHS staff who worked on an overtime basis. Staff worked in pairs so that there was always someone that could speak the first language present during interactions. The project was focused on reaching residents during the evenings and weekends as this was the best time to find people in their rooms. The team carried out screening conversations, assessments and offered psychological stabilisation and signposting support to the residents. Training and supervision and supervision was provided to all staff throughout the project.

The proactive outreach approach was low cost, avoided many referrals to already overwhelmed services, made the best use of available human resources, could be planned and delivered quickly and ensured that many people who would otherwise have been missed received the services they needed. The partnership with local councils and voluntary sector organisations showed the efficiencies that could be achieved with cross-agency working and how needs including but not restricted to mental health could effectively be addressed in a vulnerable population.

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