A descriptive, prospective cohort study of the somatic and psychological health impacts of immigration detention on asylum seekers and refugees

Abstract

Background It is estimated that there are over 130 million forcibly displaced people worldwide, including refugees and asylum seekers. Some countries, such as Australia, have attempted to contain unplanned humanitarian flows using immigration detention. Globally, studies have consistently demonstrated the deleterious somatic and mental health impacts of immigration detention, with high levels of distress documented among detained refugees and asylum seekers. However, the cumulative and persistent effects of indeterminate immigration detention on the prospective somatic and mental health of refugees and asylum seekers are unclear and poorly quantified. Method This prospective, mixed-methods cohort study will recurrently assess the somatic and mental health of adult asylum seekers and refugees (ASR) with an experience of Australian Government-sponsored immigration detention greater than 28 days. ASR ≥ 18 years old released from immigration detention will be assessed at 0, 3, 6, and 12 months and annually thereafter for up to 10 years. Five self-report scales (HSCL-25, HTQ, WHODAS 2.0, BPI-SF, and PHQ-15) and the MINI Structured psychiatric interview will measure symptoms of depression, anxiety, post-traumatic stress, pain intensity and severity, somatic symptoms, and functional impairment. This study will describe the health profiles of individuals who were subjected to an indeterminate period of immigration detention. It will also identify emergent psychological disorders associated with detention, engagement in treatment, and the functional status of this cohort. Additionally, pre-existing health records will be accessed to identify current and previous health status and assess changes in these health indices. Discussion This is a cohort study with no comparable population described previously in the literature. As such, the data will provide invaluable information regarding the temporal health impacts of immigration detention associated with insecure visa status. These data may be used to inform health service planning and future policy formulation in national and international contexts with the potential to improve health outcomes for asylum seekers and refugees in host countries.