This Campbell systematic review examines the impacts of on health, including mental health (PTSD, anxiety and depression), physical health and social functioning, of confining asylum seekers in detention centres. The review includes nine studies from the UK, Japan, Canada, and Australia.
Detention has a negative impact on the mental health of asylum seekers. Levels of post‐traumatic stress disorder (PTSD), depression, and anxiety both before and after release were found to be higher among asylum seekers who were detained compared to those who were not detained. The size of the effects were clinically important.
All the studies assessed the mental health of the participants but none reported outcomes related to physical or social functioning.
Executive summary/Abstract
BACKGROUNDThe last decades of the twentieth century were accompanied by an upsurge in the number of persons fleeing persecution and regional wars. Western countries have applied increasingly stringent measures to discourage those seeking asylum from entering their country. The most controversial of the measures to discourage people from seeking asylum is the decision by some Western countries to confine asylum seekers in detention facilities. In most countries, the detention of asylum seekers is an administrative procedure that is undertaken to verify the identity of individuals, process asylum claims, and/or ensure that a deportation order is carried out.A number of clinicians have expressed concern that detention increases mental health difficulties in asylum seekers, who is already a highly traumatized population, and have called for an end to such practices. This is clearly in conflict with government policies aimed at reducing the numbers of asylum seekers.
OBJECTIVESThe main objective of this review is to assess evidence about the effects of detention on the mental and physical health and social functioning of asylum seekers.
SEARCH STRATEGYRelevant studies were identified through electronic searches of bibliographic databases, internet search engines and hand searching of core journals. Searches were carried out to November 2013. We searched to identify both published and unpublished literature. The searches were international in scope. Reference lists of included studies and relevant reviews were also searched.
SELECTION CRITERIAAll study designs that used a well‐defined control group were eligible for inclusion. Studies that utilized qualitative approaches were not included.
DATA COLLECTION AND ANALYSISThe total number of potential relevant studies constituted 11,376 hits. A total of nine studies, consisting of 12 papers, met the inclusion criteria and were critically appraised by the review authors. The final selection comprised nine studies from four different countries.Two studies reported on the same sample of asylum seekers in Australia at different time points after release. The nine studies thus analysed eight different asylum populations. Six studies (all analysing asylum seekers in Australia) could not be used in the data synthesis...