title: Two year psychosocial and mental health outcomes for refugees subjected to restrictive or supportive immigration policies.
abstract: Australia has been at the forefront of implementing immigration policies that aim to limit the flow of asylum seekers over recent decades. Two controversial polices have been the use of immigration detention for unauthorized arrivals and the issuing of temporary protection visas (TPVs) for refugees who arrived without valid visas. We conducted a longitudinal survey over 2 years commencing in 2003 of 104 consecutive refugees from Iran and Afghanistan attending a state-wide early intervention program in New South Wales. The sample included those released from immigration detention on TPVs (n = 47) and others granted permanent protection visas prior to entering Australia (PPVs, n = 57). Psychological symptoms were assessed at baseline and follow-up by the Harvard Trauma Questionnaire (HTQ), the Hopkins symptom checklist-25 (HSCL), the GHQ-30 and the Penn State Worry Questionnaires (PSWQ). English language competency, daily living difficulties and coping-related activities were also assessed. The results indicated that TPVs had higher baseline scores than PPVs on the HTQ PTSD scale, the HSCL scales, and the GHQ. ANCOVA models adjusting for baseline symptom scores indicated an increase in anxiety, depression and overall distress for TPVs whereas PPVs showed improvement over time. PTSD remained high at follow-up for TPVs and low amongst PPVs with no significant change over time. The TPVs showed a significant increase in worry at follow-up. TPVs showed no improvement in their English language skills and became increasingly socially withdrawn whereas PPVs exhibited substantial language improvements and became more socially engaged. TPV holders also reported persistently higher levels of distress in relation to a wide range of post-migration living difficulties whereas PPVs reported few problems in meeting these resettlement challenges. The data suggest a pattern of growing mental distress, ongoing resettlement difficulties, social isolation, and difficulty in the acculturation process amongst refugees subject to restrictive immigration policies.
authors.affiliation: Centre for Population Mental Health Research, The Liverpool Hospital, NSW 2170, Australia. z.steel@unsw.edu.au
authors.forename: Zachary
authors.initials: Z
authors.lastname: Steel
authors.forename: Shakeh
authors.initials: S
authors.lastname: Momartin
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.forename: Marianio
authors.initials: M
authors.lastname: Coello
authors.forename: Jorge
authors.initials: J
authors.lastname: Aroche
authors.forename: Kuo Wei
authors.initials: KW
authors.lastname: Tay
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D001007:Anxiety / Q000208:ethnology; D015331:Cohort Studies; D003863:Depression / Q000208:ethnology; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D007492:Iran / Q000208:ethnology; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012036:Refugees / Q000523:psychology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology