Policies of Deterrence and the Mental Health of Asylum Seekers

Abstract

In the past, most refugees who permanently resettled in the traditional recipient countries of North America, Europe, and Australasia were screened prior to arrival in a host country. In the last decade, increasing numbers of unauthorized refugees or asylum seekers, those who formally lodge application for refugee status in the country in which they are residing, have applied for protection after crossing the borders of these countries. Concerns about uncontrolled migration have encouraged host countries to adopt policies of deterrence in which increasingly restrictive measures are being imposed on persons seeking asylum. These measures include, variously, confinement in detention centers, enforced dispersal within the community, the implementation of more stringent refugee determination procedures, and temporary forms of asylum. In several countries, asylum seekers living in the community face restricted access to work, education, housing, welfare, and, in some situations, to basic health care services. Allegations of abuse, untreated medical and psychiatric illnesses, suicidal behavior, hunger strikes, and outbreaks of violence among asylum seekers in detention centers have been reported. Although systematic research into the mental health of asylum seekers is in its infancy, and methods are limited by sampling difficulties, there is growing evidence that salient postmigration stress facing asylum seekers adds to the effect of previous trauma in creating risk of ongoing posttraumatic stress disorder and other psychiatric symptoms. The medical profession has a role in educating governments and the public about the potential risks of imposing excessively harsh policies of deterrence on the mental health of asylum seekers. JAMA. 2000;284:604-611

Mental health and the asylum process

“…42 Risk factors for PTSD that are particular to asylum-seekers include insecure accommodation, denial of the right to work, excessively stringent asylum processes, and difficulties dealing with immigration officials. 6,42 Mental distress is exacerbated by a mix of distress, demoralisation, and loss of autonomy.…”

“…42 Risk factors for PTSD that are particular to asylum-seekers include insecure accommodation, denial of the right to work, excessively stringent asylum processes, and difficulties dealing with immigration officials. 6,42 Mental distress is exacerbated by a mix of distress, demoralisation, and loss of autonomy. 43 Some authors have gone as far as to describe the asylum policies of western governments as "excessively harsh policies of deterrence", which aim to discourage forcibly displaced people from seeking refuge in their jurisdictions, rather than to live up to the standards of the UN Convention Relating to the Status of Refugees.…”

“…43 Some authors have gone as far as to describe the asylum policies of western governments as "excessively harsh policies of deterrence", which aim to discourage forcibly displaced people from seeking refuge in their jurisdictions, rather than to live up to the standards of the UN Convention Relating to the Status of Refugees. 42 …”

Mental health and human rights: challenges for a new millennium

“…3 In Central America, there is substantial evidence of considerable difficulties with the delivery of effective mental health care. In Africa, Ethiopia has a population of 55 million and is served by one psychiatric hospital, and 11 psychiatrists.…”

“…On arrival in a new country, they may well go on to face confinement in detention centres, enforced dispersal and ongoing discrimination. 3 Clearly, the delivery of appropriate, acceptable mental health care to this population is a critical and complex task, requiring strategic planning and flexible resourcing.…”