Skip to main content

Impact of immigration detention and temporary protection on the mental health of refugees

  • Zachary Steel (a1), Derrick Silove (a2), Robert Brooks (a3), Shakeh Momartin (a3), Bushra Alzuhairi (a3) and Ina Susljik (a3)...

Over the past decade, developed Western countries have supplied increasingly stringent measures to discourage those seeking asylum.


To investigate the longer-term mental health effects of mandatory detention and subsequent temporary protection on refugees.


Lists of names provided by community leaders were supplemented by snowball sampling to recruit 241 Arabic-speaking Mandaean refugees in Sydney (60% of the total adult Mandaean population). Interviews assessed posttraumatic stress disorder (PTSD), major depressive episodes, and indices of stress related to pasttrauma, detention and temporary protection.


A multilevel model which included age, gender, family clustering, pre-migration trauma and length of residency revealed that past immigration detention and ongoing temporary protection each contributed independently to risk of ongoing PTSD, depression and mental health-related disability. Longer detention was associated with more severe mental disturbance, an effect that persisted for an average of 3 years after release.


Policies of detention and temporary protection appear to be detrimental to the longer-term mental health of refugees.

Corresponding author
Zachary Steel, Psychiatry Research and Teaching Unit, Level 4, Health Services Building, Liverpool Hospital, Liverpool, NSW 2170, Australia. Tel: +61 2 9828 4902; fax: +61 2 9828 4910; e-mail:
Hide All

Declaration of interest

None. Funding detailed in Acknowledgement.

Hide All
Bontempo, R. (1993) Translation fidelity of psychological scales: an item response theory analysis of an individualism–collectivism scale. Journal of Cross-Cultural Psychology, 24, 1449–1166.
Buckley, J. J. (2002) The Mandaeans: Ancient Texts and Modern People. London: Oxford University Press.
Crisp, J. (2003) A New Asylum Paradigm? Globalization, Migration and the Uncertain Future of the International Refugee Regime. Geneva: United Nations High Commission for Refugees.
De Jong, J. T. V., Komproe, I. H., Ommeren, M. V., et al (2001) Lifetime events and posttraumatic stress disorder in 4 post conflict settings. JAMA, 286, 555562.
Gandek, B., Ware, J. E., Aaronson, N. K., et al (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51, 11711178.
Goldstein, H. (1995) Multilevel Statistical Models (2nd edn). London: Edward Arnold.
Goodman, L. (1961) Snowball sampling. Annals of Mathematical Statistics, 32, 245268.
Hauff, E. & Vaglum, P. (1994) Chronic posttraumatic stress disorder in Vietnamese refugees. A prospective community study of prevalence, course, psychopathology, and stressors. Journal of Nervous and Mental Disease, 182, 8590.
Herlihy, J., Scragg, P. & Turner, S. (2002) Discrepancies in autobiographical memories – implications for the assessment of asylum seekers: repeated interviews study. BMJ, 324, 324327.
Hobbs, M., Moor, C., Wansbrough, T., et al (2002) The health status of asylum seekers screened by Auckland Public Health in 1999 and 2000. New Zealand Medical Journal, 115, U152.
Human Rights and Equal Opportunity Commission (1998) Those Who've Come Across the Seas: Detention of Unauthorised Arrivals. Canberra: Commonwealth of Australia.
Keller, A. S., Rosenfeld, B., Trinh-Shevrin, C., et al (2003) Mental health of detained asylum seekers. Lancet, 362, 17211723.
Kendal, E. (2004) Iraq: The Persecution of Mandaeans. Garden Grove, CA: ASSIST News Service.
Milne, S. & Travis, A. (2003) Safe Havens Plan to Slash Asylum Numbers. The Guardian 5 February.,3604,889014,00.html
Mollica, R. F., Wyshak, G., de Marneffe, D., et al (1987) Indochinese versions of the Hopkins Symptom Checklist–25: a screening instrument for the psychiatric care of refugees. American Journal of Psychiatry, 144, 497500.
Mollica, R. F., Caspi-Yavin, Y., Bollini, P., et al (1992) The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease, 180, 111116.
Mollica, R. F., McInnes, K., Poole, C., et al (1998) Dose–effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. British Journal of Psychiatry, 173, 482488.
Mollica, R. F., Sarajlic, N., Chernoff, M., et al (2001) Longitudinal study of psychiatric symptoms, disability, mortality, and emigration among Bosnian refugees. JAMA, 285, 546554.
Office of the High Commissioner for Human Rights (2002) Report of Justice P. N. Bhagwati, Regional Advisor for Asia and the Pacific of the United Nations High Commissioner for Human Rights. Mission to Australia 24 May to 2 June 2002. Human Rights and Immigration Detention in Australia. Geneva: UNHCR.$FILE/Report.doc
Patrick, J. H., Pruchno, R. A. & Rose, M. S. (1998) Recruiting research participants: a comparison of the costs and effectiveness of five recruitment strategies. Gerontologist, 38, 295303.
Rasbash, J., Browne, W., Goldstein, H., et al (2001) A User's Guide to MLwiN Centre for Multilevel Modelling. London: Institute of Education, University of London.
Sanderson, K. & Andrews, G. (2003) Prevalence and severity of mental health-related disability and relationship to diagnosis. Psychiatric Services, 53, 8086.
Silove, D., Steel, Z., McGorry, P., et al (1998) Psychiatric symptoms and living difficulties in Tamil asylum seekers: comparisons with refugees and immigrants. Acta Psychiatrica Scandinavica, 97, 175181.
Silove, D., Steel, Z. & Watters, C. (2000) Policies of deterrence and the mental health of asylum seekers in Western countries. JAMA, 284, 604611.
Silove, D., Steel, Z., McGorry, P., et al (2002) The impact of torture on post-traumatic stress symptoms in war-affected Tamil refugees and immigrants. Comprehensive Psychiatry, 43, 4955.
Spring, M., Westermeyer, J., Halcon, L., et al (2003) Sampling in difficult to access refugee and immigrant communities. Journal of Nervous and Mental Disease, 191, 813819.
Steel, Z. & Silove, D. M. (2001) The mental health implications of detaining asylum seekers. Medical Journal of Australia, 175, 596599.
Steel, Z., Silove, D., Bird, K., et al (1999) Pathways from war trauma to posttraumatic stress symptoms among Tamil asylum seekers, refugees, and immigrants. Journal of Traumatic Stress, 12, 421435.
Steel, Z., Silove, D., Phan, T., et al (2002) The long-term impact of trauma on the mental Health of Vietnamese refugees resettled in Australia. Lancet, 360, 156162.
Steel, Z., Momartin, S., Bateman, C., et al (2004) Psychiatric status of asylum seeker families held for a protracted period in a remote detention centre in Australia. Australian and New Zealand Journal of Public Health, 28, 2332.
Sultan, A. & O'Sullivan, K. (2001) Psychological disturbances in asylum seekers held in long term detention: a participant–observer account. Medical Journal of Australia, 175, 593596.
United Nations High Commissioner for Refugees (2000) The State of the World's Refugees: A Humanitarian Agenda. Geneva: United Nations High Commission for Refugees.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 93 *
Loading metrics...

Abstract views

Total abstract views: 398 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 21st March 2018. This data will be updated every 24 hours.

Impact of immigration detention and temporary protection on the mental health of refugees

  • Zachary Steel (a1), Derrick Silove (a2), Robert Brooks (a3), Shakeh Momartin (a3), Bushra Alzuhairi (a3) and Ina Susljik (a3)...
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *