The mental health of detained asylum seekers in Australia

 Definition of asylum seekers 

The terms asylum seeker and refugee are often confused. An asylum seeker is someone who says they are a refugee, whose claims have not yet been definitively evaluated.  A refugee is a person who has been assessed as meeting the criteria set out in the 1951 Convention relating to the status of refugee. A refugee is defined by this convention as a person who has a well-founded fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to return to their country of origin[1].

Historical situation 

Mandatory detention was introduced in Australia for all ‘unauthorised’ arrivals in 1992. Over the past two decades in Australia, detention of two years or more has not been uncommon[2]. The most recent figures show that the average time spent in detention has grown from 25 days in 2008 to 183 days in 2010[3].

Current situation 

  Recently, the average length of detention has been significantly reduced. However, as at November 2008, 42 persons were still in detention after more than 2 years. Notwithstanding the recent shifts in government policy (and a pledge to have all children out of detention by June 2011) the legislative environment that supports mandatory detention and off-shore processing remains in place.

The detention environment and detainee health 

The health of people in immigration detention has attracted considerable attention, both in the popular press and in academic publications. There is almost universal criticism of the policy of detaining asylum seekers, particularly in terms of the mental health implications, with studies reporting a link between detention and mental illness. 

Currently, there are 15 detention centres operating in Australia and one detention centre offshore (Christmas Island).  In the last decade, the most populated detention centres have been in isolated, remote locations however in recent years there has been some movement of people to ‘alternative places of detention’ and ‘residential housing facilities’, some of which are in metropolitan settings.

Qualitative reports gained from refugees after they have been released from detention describe the tedium and restrictive routine in the detention environment as well as significant exposure to disturbing events. One study conducted by Coffey et al. in 2010 referred to detainees witnessing mass riots, beatings of detainees by detention officers, fighting between detainees, acts of self-harm, suicide attempts and hunger strikes[2].

Common mental health problems faced by asylum seekers 

There is a large body of research indicating that immigration detention causes asylum seekers psychological harm. Post traumatic stress disorder, depression and anxiety are highly prevalent amongst failed asylum seekers and refugees who have previously been detained, with the extent of their mental ill health linked to the length of time they have spent in detention [4]. Time spent in immigration detention has been found to contribute to the severity of symptoms relating to PTSD, depression, anxiety and suicidality [2].

The experiences of fleeing, seeking asylum and resettlement are likely to leave asylum seekers at high risk of mental health problems and they are likely to need significant social, psychological and psychiatric support [5]. The types of support required are not adequately accessible in immigration detention.  Additionally, high levels of stress caused by uncertainty about the future is hypothesised to further negatively impact the health of asylum seekers[6].

Resources for asylum seekers and refugees in Australia 

All detention centres, and the health services provided by them, are managed by private organisations under contract. General practitioners, medical specialists, and nursing and allied health staff, who performed routine screening on arrival and departure, are available to detainees during their stay for primary health care.

There are a number of services that specifically focus on the needs and requirements of asylum seekers and refugees.  The Asylum Seeker Resource Centre and Foundation House (formally the Victorian Foundation for Survivors of Torture) are two such organisations based in Melbourne, Victoria.

 1.            Final act of the United Nations Conference of Plenipotentiaries on the status of refugees and stateless persons and Text of the 1951 Convention relating to                 the status of refugees - Resolution 2198 (XXI) adopted by the United Nations General Assembly and Text of the 1967 protol relating to the status of                 refugees ; with an introductory note by the Office of the United Nations High Commissioner for Refugees. 1968. 

2.             Coffey, G.J., et al., The meaning and mental health consequences of long-term immigration detention for people seeking asylum. Social Science and     Medicine, 2010(70). 

3.             Wright, J., Time spent in packed detention centres leaps to six months, in The Age. 2011, Fairfax: Melbourne. 

4.             Green, J.P., The health of people in Australian immigration detention centres. Medical journal of Australia, 2010. 192(2): p. 1. 

5.             Asylum Seeker Resource Centre, Destitute and uncertain; The reality of seeking asylum in Australia. 2010: Melbourne. 

6.             Mueller, J., et al., Mental health of failed asylum seekers as compared with pending and temporarily accepted asylum seekers. European Journal of Public     Health, 2011. 21(2): p. 184.