Impact of immigration detention and temporary protection on the mental health of refugees.
BACKGROUND
Over the past decade, developed Western countries have supplied increasingly stringent measures to discourage those seeking asylum.


OBJECTIVE
To investigate the longer-term mental health effects of mandatory detention and subsequent temporary protection on refugees.


METHODS
Lists of names provided by community leaders were supplemented by snowball sampling to recruit 241 Arabic-speaking Mandaean refugees in Sydney (60% of the total adult Mandaean population). Interviews assessed post-traumatic stress disorder (PTSD), major depressive episodes, and indices of stress related to past trauma, detention and temporary protection.


RESULTS
A multilevel model which included age, gender, family clustering, pre-migration trauma and length of residency revealed that past immigration detention and ongoing temporary protection each contributed independently to risk of ongoing PTSD, depression and mental health-related disability. Longer detention was associated with more severe mental disturbance, an effect that persisted for an average of 3 years after release.


CONCLUSIONS
Policies of detention and temporary protection appear to be detrimental to the longer-term mental health of refugees.
Steel
Zachary
Z
Psychiatry Research and Teaching Unit, Level 4, Health Services Building, Liverpool Hospital, Liverpool, NSW 2170, Australia. z.steel@unsw.edu.au
Silove
Derrick
D
Brooks
Robert
R
Momartin
Shakeh
S
Alzuhairi
Bushra
B
Susljik
Ina
I
D000328:Adult; D001315:Australia / Q000453:epidemiology; D004641:Emigration and Immigration / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D007492:Iran / Q000208:ethnology; D007493:Iraq / Q000208:ethnology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012036:Refugees / Q000331:legislation & jurisprudence / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000208:ethnology; D013997:Time Factors