Offshore detention: Cross-sectional analysis of the health of children and young people seeking asylum in Australia

Lahiru Amarasena, Nora Samir, Louise Sealy, Nan Hu, Mohammad Reza Rostami, David Isaacs, Hasantha Gunasekera, Helen Young, Rishi Agrawal, David Levitt, Joshua R Francis, Jacinta Coleman, Sarah Mares, Penny Larcombe, Sarah Cherian, Shanti Raman, Raghu Lingam, Karen Zwi

Research output: Contribution to journalArticlepeer-review


Objective: To describe the health and well-being of children and young people (CYP) seeking asylum subjected to Australia's immigration policy of indefinite mandatory detention on Nauru. Design: Cross-sectional analysis of a cohort of CYP seeking asylum. Setting: Australian paediatric clinicians from 10 health services completed detailed health assessments around the time of transfer from Nauru, mostly to Australia. Participants: Sixty-two CYP who were ≤18 years on entry into offshore immigration detention on Nauru between 2013 and 2019. Mean age at health assessment was 9 years. Main measures: Health outcomes were categorised as physical, mental or neurodevelopmental concerns/conditions. Risk and protective factor data were collected using the adverse childhood experiences and refugee-specific adverse childhood experiences tools. Results: Over half of the CYP (n=32, 52%) were held on Nauru for ≥4 years. The vast majority of CYP had physical health (n=55, 89%) and mental health (n=49, 79%) concerns including self-harm or suicidal ideation/attempt (n=28, 45%). Mental health concerns were more likely in CYP who were school-aged (p=0.001), had been held on Nauru for ≥1 year (p=0.01); originated from the Eastern Mediterranean region (p<0.05); witnessed trauma (p<0.05) or had exposure to ≥4 refugee-specific adverse childhood experiences (p<0.05). Neurodevelopmental concerns were seen in eight children (13%). Conclusions: This study highlights the almost universal physical and mental health difficulties in a sample of CYP who experienced forced migration and were subjected to Australia's offshore immigration detention policy. Immigration detention in recipient countries, a known adverse childhood experience, may contribute to or exacerbate harmful outcomes in CYP seeking asylum.

Original languageEnglish
Article number324442
Pages (from-to)185-191
Number of pages7
JournalArchives of Disease in Childhood
Issue number3
Early online date22 Dec 2022
Publication statusPublished - 17 Feb 2023


Dive into the research topics of 'Offshore detention: Cross-sectional analysis of the health of children and young people seeking asylum in Australia'. Together they form a unique fingerprint.

Cite this