Rachel Nowak, 'New Scientist' Melbourne, 19 December 01

A powerful new alliance of Australian doctors is to call for an immediate and independent clinical assessment of the physical and mental health needs of asylum seekers in the country's detention centres.

The action comes after the publication of a controversial article describing severe mental deterioration among some detainees in December's Medical Journal of Australia.

Every medical College in Australia, along with other interested groups have banded together to form the Alliance for the Health of Refugees and their Families.

Besides seeking independent health assessments of detainees, the Alliance will also lobby for the improved conditions for asylum seekers. This is particularly crucial for children, says Louise Newman, chair of the Royal Australian and New Zealand College of Psychiatrists' faculty of child psychiatry. Many other countries do not detain asylum seekers but allow them to live in the community, after ensuring that they are not a health or security risk.

In the MJA article, Kevin O'Sullivan, a former visiting psychologist at the Villawood Detention Centre in Sydney, and Aamar Sultan, an Iraqi doctor who has been detained in Villawood since May 1999, describe inmates passing through four main stages of psychological impairment.

Initially, asylum seekers are in a state of shock, but remain hopeful that their confinement will be short-lived. Once they realise that they face a serious threat of deportation, many become severely depressed. In others, the symptoms of pre-existing post-traumatic stress reactions worsen, and some detainees become violent. By the end of Wednesday, two days of rioting at the Woomera detention centre in South Australia had been quelled with water cannon and tear gas.

After repeated rejections of asylum applications, usually after six to 18 months, the depression often becomes more debilitating, and may be accompanied by impaired memory, thoughts of suicide, paranoid delusions, and psychotic behaviour. In the final stage, detainees may isolate themselves from others, become unable to perform simple tasks, and suffer hallucinations.

"We're not talking about people being glum," says O'Sullivan, "We're talking about people hearing voices, about paranoid delusions." In the study, 13 of 33 detainees who had been held for over nine months had paranoid delusions, and 19 had psychological symptoms requiring medication, primarily antidepressants.

The study also found that children who are held at Villawood suffer a wide range of psychological disturbances, including bed wetting, impaired cognitive function, and separation anxiety.

O'Sullivan says that the detainees' previous traumatic experiences - which may include torture - combined with a total loss of control of their lives, and the prison-like environment of the centres, may combine to destroy their mental health.

Finding a way to prevent and treat the mental deterioration is imperative, he says. "Paranoia is highly debilitating, it wrecks your environment because you no longer trust anything."

But Philip Ruddock, the Australian immigration minister, has written to the MJA, complaining that Sultan and O'Sullivan's article is inaccurate. In the letter, Ruddock writes that he is "not addressing medical issues", but claims that there are inaccuracies in the article's description of the treatment of detainees.

For example, the article claims that "there are multiple daily musters and nightly head counts, which may take place at 0200 and 0530". Ruddock writes that 0200 head counts have only taken place following escapes "and are not routine".

While insisting that the article's description of life in the centres is largely accurate, O'Sullivan accuses Ruddock of failing to address the main issue raised by the article, which is the mental deterioration of detainees.

The Human Rights and Equal Opportunity Commission is conducting an inquiry into Australia's treatment of child asylum seekers, but will not report for 12 months. The Alliance doctors say this is too slow, as action is needed now.

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Source: newscientist.com
http://www.newscientist.com/news/news.jsp?id=ns9999170