Immigration detention and temporary protection is damaging the mental health of refugees in Australia, writes Zachary Steel, senior lecturer at the Centre for Population Mental Health Research, University of New South Wales.

Two studies undertaken by researchers from the University of New South Wales in Australia, link immigration detention and temporary protection, to persisting and wide-ranging mental health problems and associated disability among refugees.

Refugees on temporary visas were more likely to be unemployed, experience poor work conditions, to have insufficient money to buy food and pay rent, to experience communication difficulties and to have problems accessing health care.

They were also more likely to be separated from immediate family members, and to be fearful of being forcibly repatriated to their home countries where they had experienced persecution.

The stresses caused by their temporary visa status were found to contribute substantially to persisting symptoms of post-traumatic stress disorder, anxiety, depression and psychological distress.

Persisting mental illness

The first study was published in the British Journal of Psychiatry earlier this year, and involved 241 Arabic-speaking Sabaean - Mandaean refugees living in Sydney.

It found that past detention continued to be associated with persisting mental illness, especially among refugees held in detention for six months or longer. About half the long-term detainees continued to have depression and post-traumatic stress disorder three years after release, compared to a quarter of those held for less than six months, and lower rates still for those not detained at all.

More than 70 percent of detainees held for six months or longer, said they were regularly disturbed by memories of their time in detention and feelings of depression and hopelessness, even though, on average, three years had passed since their release.

The Mandaeans are a small pre-Christian sect originating mainly from Iran and Iraq who have suffered long-term discrimination in their home countries.

Those surveyed fell into two categories: those who arrived in Australia without entry documents who were held in detention, many of whom were released on temporary protection visas (TPVs); and those who arrived with valid entry documents or as part of the off-shore humanitarian program, who were granted permanent residency.

The study was undertaken an average of three years after the refugees had been released from detention, and of the 241 surveyed, 150 had been held in detention (57 for up to six months and 93 for six months or longer).

Of the refugees who had been on TPVs, 58 per cent displayed impaired mental health, with rates of post-traumatic stress disorder (44 per cent) and depression (50 per cent) considerably higher than among those with permanent residency (8 per cent and 19 per cent respectively).

Analysis of the combined impact of detention and ongoing temporary protection, showed that both post-migration stresses remained powerful determinants of mental health, even after levels of pre-migration torture and trauma and other demographic factors were taken into account.

Detention caused stress

The second study, published in the Medical Journal of Australia in October, reported similar findings.

It involved 116 Afghan and Iranian refugees presenting to an early intervention screening service in Sydney. They included 49 former detainees (average time in detention 13 months) on TPVs and a group of 67 refugees resettled through Australias off-shore humanitarian program, who had not been detained and had permanent visas.

Both groups had been living in the community for an average of three months, and the two groups had experienced similar levels of pre-migration trauma.

Those who had been detained had poorer scores on all mental health indices, including depression, anxiety, post-traumatic stress disorder and psychological disability. Those who had been placed on TPVs had high rates of depression and post-traumatic stress.

While there have been some important and commendable humanitarian changes to the policy of mandatory detention made by the Australian Government in recent years, many people continue to experience prolonged periods of immigration detention, and the TPV provisions remain in force.