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ObjectiveTo describe the health and well-being of children and young people (CYP) seeking asylum subjected to Australia’s immigration policy of indefinite mandatory detention on Nauru.DesignCross-sectional analysis of a cohort of CYP seeking asylum.SettingAustralian paediatric clinicians from 10 health services completed detailed health assessments around the time of transfer from Nauru, mostly to Australia.ParticipantsSixty-two CYP who were ≤18 years on entry into offshore immigration detention on Nauru between 2013 and 2019. Mean age at health assessment was 9 years.Main measuresHealth outcomes were categorised as physical, mental or neurodevelopmental concerns/conditions. Risk and protective factor data were collected using the adverse childhood experiences and refugee-specific adverse childhood experiences tools.ResultsOver half of the CYP (n=32, 52%) were held on Nauru for ≥4 years. The vast majority of CYP had physical health (n=55, 89%) and mental health (n=49, 79%) concerns including self-harm or suicidal ideation/attempt (n=28, 45%). Mental health concerns were more likely in CYP who were school-aged (p=0.001), had been held on Nauru for ≥1 year (p=0.01); originated from the Eastern Mediterranean region (p<0.05); witnessed trauma (p<0.05) or had exposure to ≥4 refugee-specific adverse childhood experiences (p<0.05). Neurodevelopmental concerns were seen in eight children (13%).ConclusionsThis study highlights the almost universal physical and mental health difficulties in a sample of CYP who experienced forced migration and were subjected to Australia’s offshore immigration detention policy. Immigration detention in recipient countries, a known adverse childhood experience, may contribute to or exacerbate harmful outcomes in CYP seeking asylum.

Timely access to culturally safe and responsive speech-language pathology (SLP) services for Aboriginal and Torres Strait Islander children, led and implemented by communities, is essential. However, a multitude of barriers relating to accessibility, policy, the impacts of colonisation, awareness of services and expectations, and experiences often prevent this from being a reality. This article describes a “good news” story—the development of a SLP model of care (MoC) for urban Aboriginal children, co-designed by Aboriginal community members and Aboriginal and non-Aboriginal health professionals, where the unique strengths, values, and resilience of Aboriginal families, communities, and culture are incorporated into routine clinical practice. We will describe the clinical redesign process undertaken to develop the MoC, the key elements and activities of the MoC, and outline implications for clinical practice.Within this article, Aboriginal is inclusive of Aboriginal and Torres Strait Islander peoples. We acknowledge the diversity in cultures and identities of all First Nations people.

ABSTRACTRefugees often come from countries with histories of human rights violations and can face multiple challenges in building a new life in Australia. Little is known about the specific experiences of those who also live with a disability, and how this may impact their rights to health. We present an intersectional approach to using arts-based research to bring to light the embodied experiences of these people, who live at the intersection of multiple axes of marginalisation. Bringing together lived experience of displacement and disability, with interdisciplinary researchers and a range of clinicians and service providers, we present an overview of the issues faced by refugees with disabilities in Australia. We then discuss how arts-based research could help to generate academic and policy discourses which are more attentive to the needs, priorities and identities of refugees with disabilities.

AimThis longitudinal study investigated protective factors for social-emotional well-being in refugee children in Australia.MethodsNewly arrived refugee children aged 4–15 years were recruited between 2009 and 2013 and assessments were conducted at two points, at years 2 and 3 postarrival. Social-emotional well-being was assessed using the Strengths and Difficulties Questionnaire (SDQ). Protective factors were assessed by structured interview and the Social Readjustment Rating Scale (SRRS); scores <150 reflect fewer stressful life events in the previous year.ResultsForty-three eligible refugee children were recruited. The SDQ was completed by parents in 90% and protective factor data in 80% at years 2 and 3 of follow-up. Protective factors for normal SDQ scores were: originating from Africa (p=0.01), father present on arrival (p=0.019) and family SRRS scores <150 at year 2 (p=0.045). The median number of protective factors was 4 (range 1–8). Better SDQ scores were associated with ≥4 protective factors (p<0.006). Furthermore, more protective factors increased the child’s likelihood of a stable or improved SDQ score over time (p<0.04). Modifiable protective factors likely to promote social-emotional well-being include stability in the child’s school and residence, parental employment, financial and marital stability, proximity to one’s own ethnic community and external community support.ConclusionsCumulative protective factors, some of which are potentially modifiable, can predict social-emotional well-being in newly arrived refugee children. Children with four or more protective factors are at low risk of poor social-emotional well-being.

Objectives: To evaluate an urban art‐based community health program (Ngala Nanga Mai; We Dream) that seeks to improve health, education, empowerment and connectedness of Aboriginal parents by describing paediatric health service attendance, maternal educational engagement, participant growth and empowerment, and worker and participant experiences. Methods: Mixed methods were used. Qualitative data was collected through interviews and focus groups. Demographics, health service use and child health status were extracted from clinical records. Psycho‐social empowerment and wellbeing was measured using the Growth and Empowerment Measure (GEM). A Critical Effectiveness Factor framework that measures factors necessary for success, effectiveness and sustainability was used to assess program quality. Results: Between 2009 and 2012, 92 Aboriginal parents participated. A total of 93.5% of regular participants engaged their children at least once with paediatric health services and 27.1% undertook further education. Empowerment scores significantly improved, despite little change in psychological distress. The program operationalised all 10 Critical Effectiveness Factors for youth wellbeing. Conclusions: Ngala Nanga Mai creates an environment of social connectedness, strengthened parenting, maternal and child wellbeing and empowerment. It supports increased utilisation of health, education and support services, and early detection of treatable child health issues. Implications: Improving the health of Aboriginal children requires new strategies and learning from innovative programs. Solid baseline data, long‐term follow‐up data and meaningful health outcome data are critical to improving services and health outcomes at the program level. Ultimately, long‐term commitment to adequate resourcing is needed in order to deliver broader improvement of child health outcomes.

To evaluate an urban art‐based community health program (Ngala Nanga Mai; We Dream) that seeks to improve health, education, empowerment and connectedness of Aboriginal parents by describing paediatric health service attendance, maternal educational engagement, participant growth and empowerment, and worker and participant experiences.

Predeparture medical screening and measles-mumps-rubella vaccination are routinely given to refugee children before departure from most transit countries en route to Australia.