Perspective: ‘The forgotten children: National inquiry into children in immigration detention (2014)’

Paxton, Georgia; Tosif, Shidan; Graham, Hamish; Smith, Andrea; Reveley, Colette; Standish, Jane; McCloskey, Kate; Ferguson, Grant; Isaacs, David; Gunasekera, Hasantha; Marais, Ben J.; Britton, Philip N; Khatami, Ameneh; Zwi, Karen; Raman, Shanti; Elliott, Elizabeth J; Levitt, David; Francis, Joshua; Bauert, Paul; Morris, Peter; Whybourne, Annie; Cherian, Sarah; Mutch, Raewyn; Forbes, David; Rutherford, David; Packer, Suzanne

doi:10.1111/jpc.12873

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…Children in detention are frequently exposed to violence, adults with mental illness and acts of self‐harm and describe unpleasant memories, intrusive images and sadness/hopelessness; parents also describe feeling unable to care for or support their children, compounding the sense of hopelessness and lack of control . The 2014 AHRC Inquiry found the CI detention facility to be unsafe for children, with numerous reports of physical/sexual assaults and self‐harm/suicidality; most of our cohort had lived the CI experience. The impacts of detention are universal and not host country‐specific, for example, high rates of major depressive disorder in Syrian ASs have been described in Greece, particularly women with multiple children …”

Section: Discussionmentioning

confidence: 83%

“…Adverse effects of detention exposure are increasingly pervasive where detention is extended, with higher rates of physical and mental health disorders, including PTSD and long‐term relationship difficulties, or where relocations to other detention sites occur . Children in detention are frequently exposed to violence, adults with mental illness and acts of self‐harm and describe unpleasant memories, intrusive images and sadness/hopelessness; parents also describe feeling unable to care for or support their children, compounding the sense of hopelessness and lack of control . The 2014 AHRC Inquiry found the CI detention facility to be unsafe for children, with numerous reports of physical/sexual assaults and self‐harm/suicidality; most of our cohort had lived the CI experience.…”

Section: Discussionmentioning

confidence: 99%

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Paediatric asylum seekers in Western Australia: Identification of adversity and complex needs through comprehensive refugee health assessment

Hanes

Chee

Mutch

et al. 2019

J Paediatrics Child Health

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Aim: Asylum seekers (ASs) report high rates of trauma and difficulty accessing health and educational services. This study aims to ascertain the needs of paediatric ASs managed by the tertiary Western Australian paediatric Refugee Health Service (RHS), including demographic features, the range of health and psychosocial issues and ongoing management challenges. Methods: An audit of multidisciplinary RHS assessments, health records and hospital admissions for new AS patients (<16 years) between July 2012 and June 2016 was undertaken. Results: Records for 110 ASs were reviewed (mean age 6 years, standard deviation 4.72 years). Multiple issues (medical, psychological, developmental, educational) were identified after the first tertiary assessment (median 4, interquartile range (IQR) 3-6) compared to referral sources (median 1, IQR 0-2, P < 0.001). The median number of issues per child at audit completion was 6 (IQR 4-7, P < 0.001). Multiple refugee adverse childhood experiences were identified, with all experiencing >3 (median 4, IQR 4-5). Most had detention experience (107/110, 97.2%), family separation (91/108, 84%) and interrupted education (41/46, 89.2%). The median duration of detention was 7 months (IQR 3-12.5 months) at time of initial review across multiple sites (median 2, IQR 1-3 locations). High rates of hospital interaction were evident, with 45.4% requiring hospital admission and 36% presenting to the emergency department. The median number of outpatient appointments attended per child was 5 (IQR 2-8). Parental and child mental health concerns were identified in 53.6 and 46.3%, respectively. Conclusions: Paediatric ASs have complex trauma backgrounds with exposure to multiple adverse events within disrupted family units. The majority of Western Australian ASs assessed demonstrated negative health or education sequelae compounded by detention not previously identified prior to comprehensive paediatric review. Our data support the urgent removal of ASs from held detention. Ongoing holistic assessment and management engaging multidisciplinary trauma-informed paediatric refugee services to optimise health and well-being is recommended.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Paediatric asylum seekers in Western Australia: Identification of adversity and complex needs through comprehensive refugee health assessment

Hanes

Chee

Mutch

et al. 2019

J Paediatrics Child Health

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“…Local and international studies confirm the profound negative impact of detention on physical health, mental health and well-being in children, adolescents and adults 3 4 7–10 12–22. The severity of mental distress is shown to increase with the amount of time spent in detention.…”

Section: Introductionmentioning

confidence: 86%

Asylum seeking children and adolescents in Australian immigration detention on Nauru: a longitudinal cohort study

Zwi

Sealy

Samir

et al. 2020

bmjpo

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IntroductionImmigration detention has a profound and negative impact on the physical health, mental health, development and social-emotional well-being of children, adolescents and their families. Australian clinicians will report results from detailed health and well-being assessments of asylum seeking children and adolescents who have experienced prolonged immigration detention.Methods and analysisThis is a national, multicentre study with a longitudinal cohort design that will document health and well-being outcomes of the children and adolescents who have been detained in offshore detention on the remote island of Nauru. Outcome measures will be reported from the time arrival in Australia and repeated over a 5-year follow-up period. Measures include demographics, residency history and refugee status, physical health and well-being outcomes (including mental health, development and social-emotional well-being), clinical service utilisation and psychosocial risk and protective factors for health and well-being (eg, adverse childhood experiences). Longitudinal follow-up will capture outcomes over a 5-year period after arrival in Australia. Analysis will be undertaken to explore baseline risk and protective factors, with regression analyses to assess their impact on health and well-being outcomes. To understand how children’s outcomes change over time, multilevel regression analysis will be utilised. Structural equation modelling will be conducted to explore the correlation between baseline factors, mediational factors and outcomes to assess trajectories over time.Ethics and disseminationThis research project was approved by the Sydney Children’s Hospitals Network Human Research Ethics Committee. Subsequent site-specific approvals have been approved in 5 of the 11 governing bodies where the clinical consultations took place. In order to ensure this research is relevant and sensitive to the needs of the cohort, our research team includes an asylum seeker who has spent time in Australian immigration detention. Results will be presented at conferences and published in peer-reviewed Medline-indexed journals.

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“…This paper, as well as two other recent publications in this journal, were written before the release of the Australian Human Rights Commission (AHRC) report ‘The Forgotten Children’. They add a personal flavour to the AHRC facts and figures and corroborate the AHRC report.…”

Section: Note Added In Proofmentioning

confidence: 99%

Sadness and fear: The experiences of children and families in remote Australian immigration detention

Mares

Zwi

2015

J Paediatrics Child Health

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Perspective: ‘The forgotten children: National inquiry into children in immigration detention (2014)’

Cited by 15 publications

References 7 publications

Paediatric asylum seekers in Western Australia: Identification of adversity and complex needs through comprehensive refugee health assessment

Paediatric asylum seekers in Western Australia: Identification of adversity and complex needs through comprehensive refugee health assessment

Asylum seeking children and adolescents in Australian immigration detention on Nauru: a longitudinal cohort study

Sadness and fear: The experiences of children and families in remote Australian immigration detention

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