A comparison of the mental health of refugees with temporary versus permanent protection visas

Abstract

Objectives: To determine the impact of the Australian provisions for temporary rather than permanent protection for asylum seekers found to be genuine refugees. Design and setting: A comparison of the mental health of Persian‐speaking refugees with temporary (n = 49) versus permanent (n = 67) protection visas attending an early intervention program in Sydney, New South Wales, 2002–03. Measures: Standard measures were used to assess past trauma, detention experiences, postmigration stresses, symptoms of post‐traumatic stress disorder (PTSD), anxiety, depression and functional impairment. Results: The two groups had experienced similar levels of past trauma and persecution. Nevertheless, holders of temporary protection visas (TPVs) returned higher scores on three psychiatric symptom measures (P < 0.001). Multivariate analyses showed that TPV status was the strongest predictor of anxiety, depression and particularly PTSD. Further analyses suggested that, for TPV holders, experience of past stresses in detention in Australia and ongoing living difficulties after release contributed to adverse psychiatric outcomes. Conclusions: The sequence of postmigration stresses experienced by TPV holders appears to impact adversely on their mental health.

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

“…The same study showed that people with post-migratory living difficulties were more likely to have PTSD compared with people without difficulties. Likewise, Swedish and Australian cross-sectional studies showed that individuals with PMLDs were more likely to suffer from MH diagnoses that also included depression and anxiety [2, 36, 37]. Some Dutch studies associated long asylum procedures, lack of work and family issues with significant impacts on anxiety, depressive and somatoform disorders [4, 38].…”

Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study

“…exposure to acts of violence, not receiving adequate medical attention etc.) that contributed to PTSD (but not depression) [47]. This suggests that more research may be required to elucidate further the association of length of time in detention and long-term mental illness in this population.…”

Global Protection and the Health Impact of Migration Interception

“…In general, the use of temporary protection appears to be a viable solution only when there is a clear commitment by recipient countries to return evacuees once safety has been fully restored to the source country. The use of temporary protection provisions for populations who remain at risk of persecution, as occurred with refugees arriving through irregular migration channels in Australia [22], appears to be a highly counterproductive approach that leads to adverse mental health outcomes that persist until permanent protection is granted [23],[24].…”

“…Mental health research indicates that rates of mental disorder amongst populations held in detention are substantially higher than compatriots held in community settings [22],[37]–[40]. Children in particular show evidence of severe mental health impairment [41]–[44].…”

“…Immigration detention provides a clear example of the intrinsic link between the denial of basic human rights and deterioration in health, and mental health in particular [26]. Confinement, isolation, lack of freedom, perceptions of being arbitrarily punished, uncertainty about the future, and fear of being returned to situations of danger all converge to create a pattern of deteriorating mental health [49],[50] that does not appear to be evident in community-based alternatives [22],[37],[57]. The mental health cost to clinicians working within detention facilities has also been substantial, with documentation of high levels of secondary traumatisation [54],[58],[59].…”