Sleepless nights because of ethical dilemmas in mental health care for asylum seekers

The number of asylum requests in the Netherlands in 2015 was relatively high but comparable to 20 years ago. This article compares the social, political and cultural factors in mental health professionals’ ethical dilemmas and reflections in both periods. The data consists of papers from an expert meeting in 1995 on Medical Ethical Standards in Mental Health Care for Refugees, and interviews and focus groups with health professionals on ethical dilemmas in mental health care for asylum seekers in 2015. Using a discursive approach to analyse the data, we found that, in 1995, as well as in 2015, the deliberations of mental health professionals reveal medical, social, cultural and judicial paradigms. In 2015, political factors tend to weigh more heavily than in 1995. We conclude that, in both periods, mental health professionals experience conflicts of values but the context of care for asylum seekers changed.