Mental health experts call for urgent action on asylum seekers

The Black Dog Institute, as well as other leading mental health organisations, have co-signed an open statement with the National Health and Medical Research Council (NHMRC), calling on the government to act immediately to guarantee the health of asylum seekers on Nauru.

The open statement - co-signed by the Centre of Research Excellence in Mental Health and Substance Use, Orygen National Centre of Excellence in Youth Mental Health, the Black Dog Institute and the Brain and Mind Centre - calls for the provision of appropriate health care and access to independent and well-trained health professionals, which is "a basic yet vital human right" for families currently detained on Nauru, the organisations posit.

Prolonged immigration detention has adverse mental health impacts on detainees, both during and after detention, according to the organisations. St John of God Hospital chair and UNSW professor Zachary Steel, who is based at the Black Dog Institute and the School of Psychiatry UNSW, undertook research in 2006 into Mandaean refugees from Iraq and Iran, which found:

• 68 per cent of those detained for more than six months had witnessed a suicide attempt
• 65 per cent reported seeing other detainees engage in self-harm
• 61 per cent witnessed physical assault
• 48 per cent reported that they weren't getting treatment for health problems

In addition, the research showed the impact of detention still caused mental health issues three years following release from detention, revealing:

• 74 per cent felt sad and hopeless when thinking about detention
• 73 per cent experienced sudden and upsetting memories of their time in detention
• 58 per cent avoided talking about detention because it caused them distress

According to the research, trauma experienced by asylum seekers in detention serves to layer upon existing traumatic events experienced prior to detainment. The research revealed that 75 per cent of temporary protection visa holders and 61 per cent of permanent protection visa holders experienced the murder of family or a friend.

Similar research conducted in 2001 by detained Iraqi medical practitioner and psychologist at Villawood Detention Centre found 58 per cent of detainees experienced pre-migration trauma, including physical torture and 85 per cent manifested chronic depressive symptoms.

"However, instead of providing specialist care for already traumatised individuals, research shows that trauma is exacerbated by indefinite periods of detainment, in often isolated centres. According to the evidence, this is believed to compound existing mental health issues that have the potential to continue years following release from detention."

More concerning, the organisations continued, is that children in detention as young as five months have been found to be depressed, with behavioural problems, incontinence, anxiety and suicidal ideation common amongst detained children (Silove et al 2007). Moreover, studies have shown that all children assessed suffered post-traumatic stress disorder (PTSD), with children as young as seven attempting suicide.

Professional bodies, including the Australian Medical Association (AMA), the Royal Australian College of Physicians (RACP) and the Australian Psychological Society (APS), have previously issued statements recognising the vulnerability of asylum seekers and highlighting the adverse effects of detention on their mental health since the early 2000s.

"The evidence base is clear: long-term detention of asylum seekers is corrosive on the mental health and wellbeing of these individuals," said Black Dog Institute's Professor Steel, who has undertaken significant research on mental health and immigration detention.

"The policy to continue holding those on Nauru will be with the full understanding of the overwhelming medical evidence that shows how the policy would produce enormous emotional harm to those affected."

Abundant research conducted into the welfare of asylum seekers highlights the urgent need for trained and independent health professionals to have adequate access to asylum seekers to provide appropriate care, the organisations agreed.

"It is this need for basic human rights to be recognised that is seeing leading mental health organisations come together to ensure this need is delivered to the vulnerable population of detained asylum seekers on Nauru." 

The open statement reads as follows: 

"Central to our work at the Centre of Research Excellence in Mental Health and Substance Use, Orygen National Centre of Excellence in Youth Mental Health, the Black Dog Institute and the Brain and Mind Centre is respect for the human rights of all people, regardless of their background and circumstance. We strive to uphold the principles of dignity, equality and respect.  

"We are hugely concerned about the violation of basic human rights within the Nauru detention centre, and the lack of care being provided for those currently detained at Nauru.

"As mental health researchers, we are well aware of the impact that such conditions are likely to have on asylum seekers. These are vulnerable children and adults in great need of care. Consequently, we call on the government to act immediately to guarantee the health and wellbeing of all asylum seekers on Nauru, particularly the children and their families.  

"We urge for the provision of appropriate health care for all those detained on Nauru. We believe that independent and well-trained health professionals should be allowed to have ongoing access to the asylum seekers on Nauru, in order to provide adequate care for their physical and mental wellbeing. If this is not possible within the confines of Nauru, the asylum seekers and their family members should be treated onshore in Australia, for as long as is necessary for their recovery."