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Background: The number of people fleeing persecution and regional conflicts is rising. Western countries have applied increasingly stringent measures to discourage those seeking asylum from entering their country, amongst them, to confine asylum seekers in detention facilities. Clinicians have expressed concerns over the mental health impact of detention on asylum seekers, a population already burdened with trauma, advocating against such practices. Objectives: The 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 methods: Relevant literature was identified through electronic searches of bibliographic databases, internet search engines, hand searching of core journals and citation tracking of included studies and relevant reviews. Searches were performed up to November 2023. Selection criteria: Studies comparing detained asylum‐seekers with non‐detained asylum seekers were included. Qualitative approaches were excluded. Data collection and analysis: Of 22,226 potential studies, 14 met the inclusion criteria. These studies, from 4 countries, involving a total of 13 asylum‐seeker populations. Six studies were used in the data synthesis, all of which reported only mental health outcomes. Eight studies had a critical risk of bias. Meta‐analyses, inverse variance weighted using random effects statistical models, were conducted on post‐traumatic stress disorder (PTSD), depression, and anxiety. Main results: A total of 27,797 asylum seekers were analysed. Four studies provided data while the detained asylum seekers were still detained, and two studies after release. All outcomes are reported such that a positive effect size favours better outcomes for the non‐detained asylum seekers. The weighted average SMD while detained is 0.45 [95% CI 0.19, 0.71] for PTSD and after release 0.91 [95% CI 0.24, 1.57]; for anxiety 0.42 [95% CI 0.18, 0.66] and for depression 0.68 [95% CI 0.10, 1.26] both while detained. Based on single‐study data, the SMD was 0.60 [95% CI 0.02, 1.17] for depression and 0.76 [95% CI 0.17, 1.34] for anxiety, both after release. Three studies (one study each) reported outcomes related to psychological distress, self‐harm and social well being. Psychological distress favoured the detained but was not significant; whereas both effect sizes on self‐harm and social wellbeing indicated highly negative impacts of detention; in particular, the impact on self‐harm was extremely high. The OR of self‐harm was reported separately for asylum seekers detained in three types of detention: Manus Island, Nauru and onshore detention. The ORs were in the range 12.18 to 74.44; all were significant. Authors' conclusions: Despite similar post‐migration adversities amongst comparison groups, findings suggest an independent adverse impact of detention on asylum seekers' mental health, with the magnitude of the effect sizes lying in an important clinical range. These effects persisted beyond release into the community. While based on limited evidence, this review supports concerns regarding the detrimental impact of detention on the mental health of already traumatised asylum seekers. Further research is warranted to comprehensively explore these effects. Detention of asylum seekers, already grappling with significant trauma, appears to exacerbate mental health challenges. Policymakers and practitioners should consider these findings in shaping immigration and asylum policies, with a focus on minimising harm to vulnerable populations. [ABSTRACT FROM AUTHOR]

Objectives: This review assesses the evidence about the effects of detention on the mental and physical health and social functioning of asylum seekers. Method and Analysis: We followed Campbell Collaboration guidelines to conduct a systematic review. Meta-analytic methods were used to quantitatively synthesize the study results. Results: Primary study effect sizes for post-traumatic stress disorder, depression, and anxiety, while the asylum seekers were still detained lies in the range 0.35-0.99, all favoring the nondetained asylum group. Author's Conclusions: There is some evidence to suggest an independent adverse effect of detention on the mental health of asylum seekers. The conclusions should however be interpreted with caution as they are based on few studies. More research is needed in order to fully investigate the effect of detention on mental health.

Research Findings: The United Nations Convention on the Rights of the Child was ratified by Denmark in 1991 but never incorporated into Danish legislation; instead the State party has chosen a stepwise implementation in legal and social praxis. However, this process mirrors a remarkable reluctance to approve the Convention as a legitimate part of Danish legislation, as it is argued that the Danish welfare state embodies a social and legislative framework that in general terms ensures children's rights. But the role of the Convention in Denmark is weak and relatively invisible and does not ensure an adherence in local municipalities to either the national legislation or the demands of the Convention. Practice or Policy: A critical examination reveals that for vulnerable groups of children this lack of legitimacy of the Convention has serious consequences. Therefore, the Convention occupies a paradoxical status as ratified but not fully integrated into Danish legal and social praxis. (Contains 1 footnote.)

Objective: The aim was to examine how traumatic and stressful events, responses to violence, child characteristics, and mothering quality, as measured in middle childhood predict psychological distress and positive resources in adolescence. Method: The participants were 65 Palestinian adolescents (17 [plus or minus] 0.85 years; 52% girls), who had been studied during the First Intifada (T1), during the Palestinian Authority rule (T2) and before the Second Al Aqsa Intifada (T3) in Gaza. Psychological distress was indicated by PTSD, and depressive symptoms and positive resources by resilient attitudes and satisfaction with quality of life, all measured at T3. The predictors that were measured at T1 were exposure to military violence, active coping with violence and children's intelligence, cognitive capacity, and neuroticism. Mothering quality and stressful life-events were measured at T2, the former reported by both the mother and the child, and the latter by the mother. Results: Adolescents' PTSD symptoms were most likely if they had been exposed to high levels of traumatic and stressful experiences and had poor cognitive capacity and high neuroticism in middle childhood. Only high levels of childhood military violence and stressful life-events predicted high depressive symptoms and low satisfaction with quality of life in adolescence. Conclusions: Military violence in childhood forms risks for both increased psychological distress and decreased positive resources. However, child characteristics such as cognitive capacity and personality are important determinants of psychological vulnerability in military trauma.

We examined symmetries and asymmetries within family members' psychological distress and resources in general and when exposed to traumatic events in particular. PTSD [Posttraumatic Stress Disorder] and depressive symptoms indicated distress and resilient attitudes, and satisfaction with quality of life indicated resources. We also analysed potential complementary dynamics between family members and identified family types according to their distress and resources. Concerning trauma impact, we hypothesized that exposure to family military violence (FMV) and recent personal trauma (RPT) predict family members' psychological distress and resources differently, indicating asymmetry in family responses. The participants were 65 Palestinian families each consisting of a mother, a father and their 15-, 17- and 19-year-old children. The within-family MANOVA results showed asymmetric in psychological distress and resources in sibling and spousal subsystems, for example older siblings reported a higher level of depressive symptoms than both parents, and mothers reported PTSD more often than fathers. The cluster analysis identified four family types, two with symmetric responses: In the "resilient families" all members showed low distress and high resources, and in the "ordeal families" all showed distress and low resources. In the asymmetric families either the children or the parents showed low distress and high resources, named the "children's strength families" and the "parental strength families", respectively. Partial correlation analysis revealed complementary dynamics between children and their parents: If mothers reported high levels of psychological distress, the 15- and 17-year-olds reported low or vice versa. Spousal complementary dynamics were found in psychosocial resources: If the mother showed highly resilient attitudes, the father showed low or vice versa. As hypothesized, exposure to traumatic events was differently associated with family members' psychological distress and resources. Family military trauma (FMT) predicted depressive symptoms only among the youngest siblings, and recent personal trauma (RPT) was associated with dissatisfaction with quality of life only among the oldest sibling and fathers. (Contains 7 tables and 1 figure.)

Evaluation of 11 children from 5 exile families with at least 1 parent having been subjected to torture found children were anxious, depressive, and regressive with psychosomatic symptoms, sleep disorders, and family and school problems. Coping strategies including isolation and withdrawal, mental flight, eagerness to acclimatize, and strength of will and fighting. (Author/DB)

Abstract Background The ruling parties in Bangladesh have systematically used violence against political opponents and criminals. It is essential to 1) determine the magnitude and burden of organised crime and political violence (OPV) and human rights violations in the affected community, and to 2) identify the risk factors and key indicators for developing effective health intervention and prevention measures. Methods The population-based study consisted of two parts: a household survey and OPV screening at mobile clinics (presented in Part II). A cross-sectional, multistage cluster household survey was conducted in the Meherpur district in February-March 2008; 22 clusters with a sample size of 1,101 households (population of 4,870) were selected. Results Around 83% of households reported being exposed to at least two categories of OPV or human rights violations: 29% reported that the family members had been arrested or detained; 31% reported torture or other cruel, inhuman or degrading treatment or punishment. Crude mortality rate was 17.9/1,000 and under 5 mortality rate was 75/1,000. The annual injury rate was 36%, lifetime experience of violence-related injury was 50%, and pain experience within 2 weeks was reported by 57%. Over 80% of the population over 35 years old complained of pain. High prevalence of injury, lifetime experience of OPV-related injury and pain complaints are related to the level of exposure to OPV and human rights violations. A financial burden was imposed on families with an injured person. A geographical variation was revealed regarding reports of torture and lifetime experience of violence-related injury. A combination of individual, relational, community and societal factors, including variables such as political party affiliation, conflict with other families, household income and residential area, affected the risk of victimisation in the household. The odds ratio for reporting extrajudicial execution of a family member was 9.22 for Awami League supporters, 9.15 for Bangladesh Nationalist Party supporters; and 3.97 for Jamaat-e-Islami Party supporters compared with families with no political involvement. Conclusion The level of violence and human rights violations is high. The affected population suffers from violence-related injuries and traumas, which could be a factor contributing to poverty. Victimisation is not random.

Research suggests that a parental trauma history may increase the risk of family violence and have a negative impact on parent/child dyadic functioning and on children's psychosocial adjustment. This study aimed at exploring mother/child dyadic functioning, and symptom levels in mothers and children's psychosocial adjustment in a sample of refugee families referred for treatment of family violence (N = 21). The study entailed a mixed methods design consisting of a video recorded mother/child interaction using the structured observation method "the Marschak Interaction Method" and questionnaires. Children's psychosocial adjustment was measured using the Strengths and Difficulties Questionnaire. Mothers' symptom levels were measured by the Harvard Trauma Questionnaire and The Hopkins Symptom CheckList-25. Mother/child dyadic functioning was measured by the Marschak Interaction Method Rating System (MIMRS), and potential associations between scores on the MIMRS and mother/child symptom and psychosocial adjustment levels were explored using partial correlations. Results reveal that the majority of dyads showed signs of problematic/clearly dysfunctional behavior in one or more of the four domains: Structure, Engagement, Challenging and Nurture. Qualitative analyses of the material revealed a number of distinct ways in which the dyads' behavior was problematic/clearly dysfunctional. An association between maternal symptom levels and scores on the MIMRS could not be confirmed. An association was confirmed between maternal symptoms of anxiety, depression and post-traumatic stress disorder and children's psychosocial maladjustment. Furthermore, an association was found between scores on the MIMRS and children's health-related quality of life. Findings from the study have clinical implications and emphasize the need for future research. [ABSTRACT FROM AUTHOR]