Stories from unaccompanied children in immigration detention: A composite account

In March 2014 we spent a week on Christmas Island as medical consultants to the Australian Human Rights Commission (AHRC) Inquiry into the Impact of Immigration Detention on Children. The visit involved three Human Rights Commission staff as well as the authors, paediatrician Karen Zwi and child psychiatrist Sarah Mares, representing the Royal Australasian College of Physicians and the Royal Australian and New Zealand College of Psychiatrists respectively. Using interpreters, we spoke to over 40 unaccompanied children and service providers to ascertain processes and policies and to give feedback about detainees of immediate concern. We would like to honour the voices of the detainees; we have used their exact words where possible. In a separate paper, we focus on the families and children detained in immigration acilities on Christmas Island. Unaccompanied children are children under the age of 18 years who are seeking asylum from threatened or experienced danger. They arrive unaccompanied by a parent, legal guardian or adult relative over the age of 21 years. On arrival to Australia, unaccompanied children by law become the legal wards of the Department of Immigration and Border Protection (DIBP). The role of a legal guardian is commonly regarded internationally as one who ‘stands in loco parentis to the child’, which includes making decisions regarding the best interests of the child and providing for the child’s emotional and material needs. In Australia, the Minister’s role tends to be nominal without practical assistance offered to the children, which has been described as leaving them not only unaccompanied but also unrepresented. A DIPB officer is appointed locally as the children’s ‘Delegated Guardian’ as discussed below. Most unaccompanied children leave their homes as a desperate measure in search of protection, education and employ ment, and to contribute to the welfare of their family. They have often embarked on dangerous journeys, experienced war, the death of family members, persecution, violence, sexual abuse, escape from forced recruitment into armed organisations and forced domestic labour. These experiences occur during critical developmental periods, thus placing them at risk of mental health problems. Research is limited to a few cross-sectional or on-arrival studies, which have shown that around 25–50% have emotional and behavioural problems, anxiety, depression and post-traumatic stress disorder (PTSD), at higher rates than in accompanied asylum seeker children. However, consistent with other studies on refugee children, the majority of unaccompanied children score below clinical cut-offs for psychiatric disorder, thus displaying a marked resilience. The severity of psychiatric symptoms is likely to increase with more traumatic events experienced prior to forced migration, demonstrating the cumulative impact on well-being of traumatic exposure. Children exposed to adversity following migration, particularly those placed in prolonged detention, are more severely affected. Studies show increased symptoms for those exposed to rioting, fires, violence and self-harm attempts by parents or others in detention. Rapid resolution of asylum claims reduces the duration of uncertainty and associated distress for children, whereas insecure asylum status is associated with a range of psychological problems that can have long-lasting effects. Prompt access to services catering for physical and psychological health is important, as are long-term stability of residence and socially supportive environments. It is also known that PTSD symptoms are increased in lower-support living arrangements suggesting that foster family living and high support may improve outcomes.