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The impact of detention on the social–emotional wellbeing of children seeking asylum: a comparison with community-based children

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Abstract

Accumulating literature demonstrates that immigration detention is harmful to children. However, there is a scarcity of scientifically rigorous and reliable data about the health of children held in detention facilities. The aim of the study was to compare a community-based population of recently arrived refugee children flown into Australia, not detained, resettled in a non-urban area, with a population of children who arrived by boat seeking asylum, detained since arrival. The parent-version of the strength and difficulties questionnaire (SDQ) of children aged 4–15 years was compared in children living in the community with those held in detention. We compared 86 children who had a parent-completed SDQ performed, 38 (44%) in the community group and 48 (56%) in the detention group. The community sample had been living in Australia for 325 days, with no time in detention. The detention sample had been living in detention for a mean of 221 days. The mean age was similar for the community and detention sample at 8.4 years (P = 0.18). In the total sample, children in the detention group had significantly higher SDQ total difficulties scores than children in the community group (P < 0.0001). There was no difference between age groups (P = 0.82). The children in the detention group had, on average, an SDQ total difficulties score that was 12 points higher than children in the community group. Four of the five SDQ subscale scores indicated greater disturbance amongst children in detention (< 0.0001) compared to children living in the community. The detention group had significantly higher scores (P < 0.001) for all except Pro-social scores as compared to Australian norms for the 4–6 and 7–15 years age group. This study presents a rare opportunity to compare the wellbeing of displaced children who were detained following arrival in Australia with those settled in the Australian community since arrival. The community children’s scores approximated data from the general Australian childhood population. Children held in detention had significantly more social, emotional and behavioural difficulties than children living in the community, and at levels resembling a clinical cohort. Despite the small sample size, data restrictions and other limitations of the data, statistical significance in differences between the community and detention children is marked and arguably demonstrates the negative impact of post-arrival detention in children who are presumed to have similar levels of pre-arrival adversity. If the objective is to optimise the health and wellbeing of children seeking asylum, removal of post-arrival detention is one of the most powerful interventions available to host countries.

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Acknowledgements

The authors acknowledge participating families and children involved in the community study, Refugee Health Nurses Jenny Lane, Colleen Allen and Lisa Atkins, and Statistician Jenny Peat. The analysis of the detention sample is possible because the Australian Human Rights Commission (AHRC) collected the primary data from families seeking asylum and detained on Christmas Island. This was subsequently released under Freedom of Information legislation (FOI). Any errors or omissions are the sole responsibility of the authors.

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Authors and Affiliations

  1. School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia

    Karen Zwi

  2. Sydney Children’s Hospitals Network, High Street, Randwick, Sydney, Australia

    Karen Zwi & Dania Nathanson

  3. School of Psychiatry, University of New South Wales, Sydney, Australia

    Sarah Mares, Alvin Kuowei Tay & Derrick Silove

  4. Menzies School of Health Research, Darwin, Australia

    Sarah Mares

  5. Psychiatry Research and Teaching Unit, Ingham Applied Medical Institute, Liverpool Hospital, Liverpool, Australia

    Alvin Kuowei Tay

  6. Psychiatry Research and Teaching Unit, South West Sydney Local Health District, Sydney, Australia

    Derrick Silove

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  1. Karen Zwi
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  2. Sarah Mares
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  4. Alvin Kuowei Tay
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Correspondence to Karen Zwi.

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Conflict of interest

The authors received no financial support for the research, authorship, and/or publication of this article and have no conflict of interest.

Funding

The community study was funded by Financial Markets Foundation for Children (AUD$158 000 July 2009–June 2011). The funders had no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Ethics

The research involving the community sample in this study and the comparison with the detention sample was granted by the Human Research Ethics Committee Northern Hospitals Network, South Eastern Sydney (SES) Illawarra Area Health Service/SES Local Health District (HREC Ref No 09/163). The research involving the detention sample in this study was assessed by the South Western Sydney Local Health District Human Research Ethics Committee (HREC/15/LPOOL/556), which was satisfied with provisions to protect the rights of participants. All participants gave their informed consent prior to their inclusion in the study.

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This article is part of the focused issue ‘Mental health issues in refugees’.

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Zwi, K., Mares, S., Nathanson, D. et al. The impact of detention on the social–emotional wellbeing of children seeking asylum: a comparison with community-based children. Eur Child Adolesc Psychiatry 27, 411–422 (2018). https://doi.org/10.1007/s00787-017-1082-z

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