Asylum seekers detained offshore face a 20-times greater risk of post-traumatic disorder than someone who is not detained or held onshore for less than six months, new research from the University of New South Wales has found.
In a letter to the editor published in the British Journal of Psychiatry on Tuesday, researchers detailed a study that surveyed 990 adult refugees and asylum seekers living in the Australian community between 2011 and 2018. Of those, 215 had spent some time in detention.
Offshore detention was acutely damaging, the survey found.
“We found that if you had been in onshore detention for longer than six months, or offshore detention for any length of time, your risk of having subsequent PTSD, depression or suicidal ideation was significantly greater,” said Dr Philippa Specker, the study’s lead author and clinical psychologist at UNSW’s school of psychology.
“People were between 17 and 20 times more likely to report PTSD symptoms if they’d spent a long time in onshore detention, or if they’d spent any amount of time in offshore detention.”
While it has long been understood the conditions and uncertainty of offshore detention were significantly more damaging, the new data is the first to quantify just how much more harmful offshore detention is.
The survey also revealed that people who were detained in any form were twice as likely to have probable PTSD, two and a half times more likely to have probable depression and almost twice as likely to have suicidal ideation, compared with refugees and asylum seekers who were never detained.
When comparing the experience of offshore and onshore detention of any length, offshore detainees were 2.71 times more likely to have probable PTSD.
The increased mental health risks were evident despite comparing against a control group of refugees and asylum seekers, and despite controlling for age, gender, time in Australia and marital status. These controls suggest that it is the exposure to detention that carries significant impact on mental health over and above other factors.
Specker said the study represented the largest known available dataset relating to offshore processing and mental health. She said because of legal and logistical barriers to contacting people held in offshore detention, research could only be conducted with people once they were released.
“This survey data allowed us to test for the first time whether previous experiences of offshore detention impacted someone’s risk of experiencing long-term serious mental illness once living in the community, by comparing them to people who had been detained onshore for less than six months.”
The researchers said previous studies had established that onshore detention had a destabilising effect on asylum seekers, but the new data showed those negative effects were multiplied offshore.
“Being removed to another country by the government that one is applying for asylum from can undermine one’s sense of safety, agency, and certainty about the future. It is understandable then, that such practices might also carry serious and long-term psychological consequences,” Specker said.
Since 1992, all asylum seekers who arrive in Australia by boat are mandatorily detained. Those who arrive by plane – a significantly larger number – are not detained. As of July 2024, the average length of time people were held in onshore detention was 545 days, about one and a half years.
Offshore detention – on Papua New Guinea’s Manus Island and Nauru – was introduced in 2001. Shuttered in 2008, it was reintroduced in 2012, and remains bipartisan policy.
Australia’s offshore detention centre on Manus Island was ruled unconstitutional by the PNG supreme court in 2016. There are still about 70 asylum seekers and refugees who remain stranded in PNG – most are in Port Moresby and have been held offshore more than a decade.
Nauru remains Australia’s “enduring” offshore processing centre. There are now just under 100 people held on the island, most of whom have been there more than a year.
Specker said while asylum claims “require some degree of administrative processing … what our findings are telling us is that the way a person is treated while their asylum claim is being processed can make a really big difference”.
• In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978. In the UK, the charity Mind is available on 0300 123 3393 and Childline on 0800 1111. In the US, call or text Mental Health America at 988 or chat 988lifeline.org
