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Journal Article

Citation

Amarasena L, Samir N, Sealy L, Hu N, Rostami MR, Isaacs D, Gunasekera H, Young H, Agrawal R, Levitt D, Francis JR, Coleman J, Mares S, Larcombe P, Cherian S, Raman S, Lingam R, Zwi K. Arch. Dis. Child. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, BMJ Publishing Group)

DOI

10.1136/archdischild-2022-324442

PMID

36549868

Abstract

OBJECTIVE: To describe the health and well-being of children and young people (CYP) seeking asylum subjected to Australia's immigration policy of indefinite mandatory detention on Nauru.

DESIGN: Cross-sectional analysis of a cohort of CYP seeking asylum.

SETTING: Australian paediatric clinicians from 10 health services completed detailed health assessments around the time of transfer from Nauru, mostly to Australia.

PARTICIPANTS: Sixty-two CYP who were ≤18 years on entry into offshore immigration detention on Nauru between 2013 and 2019. Mean age at health assessment was 9 years.

MAIN MEASURES: Health outcomes were categorised as physical, mental or neurodevelopmental concerns/conditions. Risk and protective factor data were collected using the adverse childhood experiences and refugee-specific adverse childhood experiences tools.

RESULTS: Over half of the CYP (n=32, 52%) were held on Nauru for ≥4 years. The vast majority of CYP had physical health (n=55, 89%) and mental health (n=49, 79%) concerns including self-harm or suicidal ideation/attempt (n=28, 45%). Mental health concerns were more likely in CYP who were school-aged (p=0.001), had been held on Nauru for ≥1 year (p=0.01); originated from the Eastern Mediterranean region (p<0.05); witnessed trauma (p<0.05) or had exposure to ≥4 refugee-specific adverse childhood experiences (p<0.05). Neurodevelopmental concerns were seen in eight children (13%).

CONCLUSIONS: This study highlights the almost universal physical and mental health difficulties in a sample of CYP who experienced forced migration and were subjected to Australia's offshore immigration detention policy. Immigration detention in recipient countries, a known adverse childhood experience, may contribute to or exacerbate harmful outcomes in CYP seeking asylum.


Language: en

Keywords

child welfare; mental health; adolescent health; global health; child health

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