Asylum seekers: General health status and problems with access to health care

OBJECTIVE To investigate the general health status of asylum seekers and their access to health services. DESIGN Prospective questionnaire survey. SETTING A community-based asylum seeker centre in Sydney from March to September 1994, before the Limited Health Care Assistance Scheme had taken effect. PARTICIPANTS Forty of 57 eligible asylum seekers from 21 different countries attending English language classes. MAIN OUTCOME MEASURES Results on the traumatic events section of the Harvard Trauma Questionnaire, a postmigratory problem checklist, the COOP Functional Health Assessment charts, the Duke-University of Northern Carolina Health Profile, and a structured interview to assess difficulties in accessing health care in Australia. RESULTS More than 30 of the 40 participants reported exposure to past trauma. Asylum seekers were more impaired in their emotional health than a normative group of patients with minor (P < 0.001) and serious (P < 0.001) medical illnesses, and more impaired in role functioning than those with minor medical illnesses (P < 0.001). Twenty or more reported symptoms of nervousness, headache, and/or depression; 28 reported having pain in the previous four weeks. Twenty-seven reported major difficulties in accessing dental services. The same number reported problems in obtaining general medical care; the most important reason cited was not having a Medicare card. CONCLUSIONS Although a selective sample, the asylum seekers in our study appeared to be suffering substantial levels of emotional and somatic symptoms, yet, for most, access to health care was a major problem. The effectiveness of recent sequential changes to the provisions covering welfare and health care for asylum seekers needs to be closely monitored.