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What does the evidence tell us about the impact of immigration detention on children?

Croakey is compiling submissions to the Australian Human Rights Commission inquiry into the impact of immigration detention on the health, well-being and development of children.

***

Jaelea Skehan and Gavin Hazel from the Hunter Institute of Mental Health write:

On 3 February 2014 the President of the Australian Human Rights Commission, Professor Gillian Triggs, launched an inquiry into children in closed immigration detention.

The purpose of this inquiry is to investigate the ways in which life in immigration detention affects the health, well-being and development of children.

In mental health, we are often trying to find answers to things we don’t know. But there are some things we do know.

We know that a healthy start to life is important for a child’s health and wellbeing and their health and wellbeing into adult life. We know that a focus on the determinants of health and mental health can foster safer and healthier families and communities.

While many of us working in mental health may not have been directly exposed to facilities where children are detained, the evidence about what enhances, and what puts at risk, the mental health and wellbeing of children is important to consider in light of this review.

What do we know about early childhood development?

The quality of an individual’s life in childhood and adolescence has a significant impact on emotional, social and psychological development and lays the foundations for further development in these areas.

A number of early life conditions are associated with social and emotional wellbeing later in life, including:

  • Health factors: Good maternal health during pregnancy, safe childbirth, freedom from chronic or severe illness in infancy and early childhood;
  • A positive family environment – one that is safe and free from violence, one that promotes secure attachment to parents and/or caregivers;
  • Access to high quality family support and childcare when this is needed; and Achievement of age-appropriate social and emotional competencies.

Other key social determinants of health and social and emotional wellbeing include basic freedoms of speech, religion, and residence; social inclusion; a peaceful living environment; economic and housing security; access to adequate health services; social support; and education.

Evidence suggests that happy and healthy children are more likely to develop into healthy and resilient adults in later life. Children who experience a poorer start in life are more likely to develop behavioural, learning or mental health problems in childhood or adolescence and these can remain with them throughout their lives (Council of Australian Governments, 2009).

What do we know about child and adolescent social and emotional wellbeing within the context of detention?  

The presence of a stable and supportive environment within the home is a protective factor for the social and emotional wellbeing of young people. When families are separated across detention facilities in Australia, the fundamental dynamics of the family are disrupted, which has an unavoidable impact on the child’s wellbeing.

Attachment theory holds that a consistent and loving relationship with a primary caregiver is essential to optimal development during the younger years, and that the absence of or disruption to such a relationship can cause significant developmental issues in later life (Bowlby 1969; 1973; 1980). These issues are further compounded for unaccompanied minors seeking asylum, who experience the loss of a parental/caregiving figure for emotional and psychological support.

A number of studies identify a strong relationship between the experience and/or exacerbation of mental and physical health issues among children and adolescents in immigration detention; in particular, post-traumatic stress disorder, self-harm, suicidal ideation, depression and anxiety (Bull et al., 2012; Dudley, 2003; Dudley et al., 2012; Mares & Jureidini, 2004; Silove et al., 2007; Steel et al., 2004); and a link between the length of detention and severity/comorbidity of psychiatric disorders (Bull et al., 2012; Green & Eagar, 2010; Mares and Jureidini, 2004; Procter, De Leo & Newman, 2012; Steel et al., 2004).

Some final considerations

The evidence reviewed would suggest that at a minimum, the immigration detention system is unable to support the promotion of protective factors that are important for the wellbeing of all children.

This includes, but is not limited to, access to education, health, recreation, and supportive relationships. The evidence, although limited, would also suggest that there are concerning rates of severe mental illness, as well as self-harm and suicidal ideation among children and young people in these settings.

While policies around those seeking asylum and detention are not straightforward and as a nation we may not know the best way forward to address all competing objectives, paramount to our collective thinking and response must be consideration of the impact policies and approaches have on children. Specifically, the mental health and wellbeing of children.

• This summary was written by Jaelea Skehan (Director) and Gavin Hazel (Program Manager, Child and Youth) at the Hunter Institute of Mental Health. 

 ****

References

Beitchman, J. H., Inglis, A., & Schachter, D. (1992a). Child psychiatry and early intervention II: The internalising disorders. Canadian Journal of Psychiatry, 37(May), 234-239.

Beitchman, J. H., Inglis, A., & Schachter, D. (1992). Child Psychiatry and Early Intervention IV: The Externalising Disorders. Canadian Journal of Psychiatry, 37, 245-249.

Bernstein, G. A., Borchardt, C. M. & Perwien, A. R. (1996). Anxiety Disorders in Children and Adolescents: A Review of the Past Ten Years. Journal of the American Academy of Child and Adolescent Psychiatry, 35(9), 1110-1119.

Bowlby, J. (1969). Attachment and Loss, Volume 1: Attachment. London: Hogarth Press and the Institute of Psycho-Analysis.

Bowlby, J. (1973). Attachment and loss, Volume 2: Separation: Anxiety and anger. London: Hogarth Press and the Institute of Psycho-Analysis.

Bowlby, J. (1980). Attachment and loss, Volume 3: Loss: Sadness and depression. London: Hogarth Press and the Institute of Psycho-Analysis.

Bull, M., Schindler, E., Berkman, D., & Ransley, J. (2012). Sickness in the System of Long-Term Immigration Detention. Journal of Refugee Studies, 26(1), 47-68.

Burns, J. M., Andrews, G. & Szabo, M. (2002). Depression in young people: What causes it and can we prevent it? Medical Journal of Australia, 177, Supplement, S93-S96.

Catholic Commission for Justice Development and Peace and the Western Young People’s Independent Network (2001). Submission to the National Inquiry into Children in Immigration Detention. Available at: http://www.hreoc.gov.au/human_rights/children_detention/submissions/cath_justice/html

Centre for Community Child Health (2007). Child Behaviour: Overview of the Literature. Monograph 3 in O’Hanlon, A., Patterson, A., and Parham, J. (Series Eds), Promotion, Prevention and Early Intervention for Mental Health in General Practice. Adelaide: Auseinet.

Council of Australian Governments. (2009). Belonging, being and becoming: The early years learning framework for Australia. Canberra, ACT: Department of Education, Employment and Workplace Relations.

Donovan, C. L. & Spence, S. H. (2000). Prevention of Childhood Anxiety Disorders. Clinical Psychology Review, 20(4), 509-531.

Dudley, M. J. (2003). Contradictory Australian National Policies on Self-Harm and Suicide. Australasian Psychiatry, 11, 103.

Dudley, M., Steel, Z., Mares, S., & Newman, L. (2012). Children and Young People in Immigration Detention. Child and Adolescent Psychiatry, 25(4), 285-292.

Durlak, J., & Wells, A. (1997). Primary prevention mental health programs for children and young people: a meta-analytic review. American Journal of Community Psychology, 25(2), 115-152.

Green, J., & Eagar, K. (2010). The health of people in immigration detention centres. Medical Journal of Australia, 19, 65–70.

Holmes, S. E., Slaughter, J. R., & Kashani, J. (2001). Risk Factors in Childhood that lead to the Development of Conduct Disorder and Antisocial Personality Disorder. Child Psychiatry and Human Development, 31(3), 183-193.

Howard, S. & Johnson, B. (2000). Resilient and Non-Resilient Behaviour in Adolescents. Trends and Issues in Crime and Criminal Justice, Number 183.

Huemer, J., Karnik, N. S., Voelkl-Kernstock, S., Granditsch, E., Dervic, K., Friedrich, M. H., Steiner, H. (2009). Mental health issues in unaccompanied refugee minors. Child and Adolescent Psychiatry and Mental Health.

Lynch, K. B., Geller, S. R., & Schmidt, M. G. (2004). Multi-year evaluation of the effectiveness of a resilience-based prevention program for young children. The Journal of Primary Prevention, 24(3), 335-353.

Mares, S., & Jureidini, J. (2004). Psychiatric Assessment of Children and Families in Immigration Detention: Clinical, Administrative and Ethical Issues. Australian and New Zealand Journal of Public Health, 28, 520-526.

Procter, N., De Leo, D., & Newman, L. (2012). Suicide and self-harm prevention for people in immigration detention. Medical Journal of Australia, 199(11), 730-731.

Silove, D., Austin, P., & Steel, Z. (2007). No Refuge from Terror: the Impact of Detention on the Mental Health of Trauma-affected Refugees Seeking Asylum in Australia. Transcultural Psychiatry, 44(3), 359–393.

Steel, Z., Momartin, S., Bateman, C., Hafshejani, A., Silove, D. M. (2004). Psychiatric status of asylum seeker families held for a protracted period in a remote detention centre in Australia. Australian and New Zealand Journal of Public Health, 28(6), 527-536.

****

Previous Croakey posts in this series

• Professor Alan Rosen: How the Federal Government is grooming us to be complicit in child abuse

To lodge a submission to the Australian Human Rights Commission inquiry: https://www.humanrights.gov.au/our-work/asylum-seekers-and-refugees/submissions-national-inquiry-children-immigration-detention

 

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Australian Palliative Care Conference
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