Policies of Deterrence and the Mental Health of Asylum Seekers

Derrick M. Silove

361 citations0/0 files storedJAMA

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Migration, Health and Trauma Migration, Refugees, and Integration Migration, Racism, and Human Rights

Abstract

In the past, most refugees who permanently resettled in the traditional recipient countries of North America, Europe, and Australasia were screened prior to arrival in a host country. In the last decade, increasing numbers of unauthorized refugees or asylum seekers, those who formally lodge application for refugee status in the country in which they are residing, have applied for protection after crossing the borders of these countries. Concerns about uncontrolled migration have encouraged host countries to adopt policies of deterrence in which increasingly restrictive measures are being imposed on persons seeking asylum. These measures include, variously, confinement in detention centers, enforced dispersal within the community, the implementation of more stringent refugee determination procedures, and temporary forms of asylum. In several countries, asylum seekers living in the community face restricted access to work, education, housing, welfare, and, in some situations, to basic health care services. Allegations of abuse, untreated medical and psychiatric illnesses, suicidal behavior, hunger strikes, and outbreaks of violence among asylum seekers in detention centers have been reported. Although systematic research into the mental health of asylum seekers is in its infancy, and methods are limited by sampling difficulties, there is growing evidence that salient postmigration stress facing asylum seekers adds to the effect of previous trauma in creating risk of ongoing posttraumatic stress disorder and other psychiatric symptoms. The medical profession has a role in educating governments and the public about the potential risks of imposing excessively harsh policies of deterrence on the mental health of asylum seekers. JAMA. 2000;284:604-611

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References

1997Anxiety, depression and PTSD in asylum-seekers: Assocations with pre-migration trauma and post-migration stressors 1999The Psychosocial Effects of Torture, Mass Human Rights Violations, and Refugee Trauma 1998Psychological sequelae of torture and organised violence suffered by refugees from Iraq 1999Disability Associated With Psychiatric Comorbidity and Health Status in Bosnian Refugees Living in Croatia 1993The Effect of Trauma and Confinement on Functional Health and Mental Health Status of Cambodians Living in Thailand-Cambodia Border Camps 1998Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence 1999Pathways from war trauma to posttraumatic stress symptoms among Tamil asylum seekers, refugees, and immigrants

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2003Cultural Consultation: A Model of Mental Health Service for Multicultural Societies 2005Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1).2002A 3‐year follow‐up study of psychosocial functioning and general symptoms in settled refugees 2010A Systematic Review of Treatments for Post-Traumatic Stress Disorder Among Refugees and Asylum-Seekers

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