Sending children back to Nauru risks creating a generation of damaged people

The 37 asylum seeker babies and 54 children who risk deportation from Australia could face significant, irreversible mental health damage if sent back to Nauru. And the longer they’re detained, the greater the risk of damage.

A report released today by the Australian Human Rights Commission shows children previously detained on Nauru already show significant symptoms of trauma.

The word trauma is overused in everyday descriptions of stress and adversity. In a psychological sense, traumatic experiences pose a threat to an indivual’s psychological or physical integrity and overwhelm their capacity to cope or adapt.

Humans have enormous capacity to adapt and change in the face of stress. This neurological and physiological process forms the basis of what is currently described as resilience.

But there is only so much trauma an individual can endure before it causes long-term problems for mental health, cognition and behaviour. And there’s only so much difference good mental health care can make in undoing the damage.

Trauma from Nauru

In October 2015, delegates from the Australian Human Rights Commission, accompanied by two paediatricians, visited the Wickham Point Detention Centre in Darwin to assess the well-being of children and their families.

Most of the children the paediatricians interviewed at Wickham Point had spent several months on Nauru. When asked if he was scared about being sent back to Nauru, a nine-year-old boy replied:

I am scared in my room every night at 10pm when they walk and open the door for the head count. I think someone is going to take me away.

The paediatricians say the children are among the most traumatised they have seen. Nineteen of the 20 children who completed the childhood trauma screening questionnaire were deemed at high risk of developing post-traumatic stress disorder.

Some were experiencing nightmares, bed-wetting, flashbacks and physical symptoms of anxiety such as heart palpitations, vomiting and nausea.

Asked about their hope for the future in another questionnaire, as an indicator of their resilience, more than 95% of the children and adolescents received the highest possible score for hopelessness. Around 90% received the highest possible score for despair.

There was little access to paediatric psychiatrists and psychologists with appropriate training to be able to adequately care for these children.

How trauma affects the brain

The brain is particularly vulnerable to stress in the first three years of life. During this period of rapid growth and organisation, a rise in stress-related hormones may impact the development of emerging neural networks.

Studies in animals and humans show stress hormones such as cortisol and adrenalin are implicated in brain changes and longer-term vulnerability to stress. The question of threshold – how much stress is damaging – remains open.

There are also ongoing questions about how much recovery can occur over time and what sorts of interventions might be effective. There is little evidence to guide the development of treatment programs.

The long-term issues for traumatised children are frequently serious, with effects on emotional health and cognitive function. In cases of sustained and severe trauma in the early years, changes in brain functioning have been found to persist into adolescence and young adulthood.

Trauma can result in ongoing difficulty in managing stress, memories of early trauma and problems with mood and anxiety. These can be debilitating conditions with implications for all relationships, work capacity and parenting.

Some of the most stigmatised and misunderstood conditions (such as so-called borderline personality disorder), become much more comprehensible if their traumatic origins and responses are understood.

Immigration policy must protect young brains

Protecting the brains of children during critical periods of early development is a priority in the child protection and mental health systems. It must also be a priority in Australia’s immigration response.

Infants of asylum-seeking parents who are detained are exposed to multiple developmental risks and traumatic experiences. Parents are often depressed and despairing and in seemingly unresolvable situations of ongoing and indefinite detention.

Older children are impacted by the lack of safety and threat of child assault, and exposure to behavioural disturbances, violence and even suicidal behaviour. As one 15-year-old girl told the paediatricians:

When I think about the rape that is happening in Nauru I think it will happen to me. I miss my friends. I am staying here – we came in the same boat but they are free. Sometimes I think if I hurt myself we will get out.

Akin to children in a war zone, asylum seeking children on Nauru are haunted by their experiences. Parents feel profound guilt about having a child in this situation and little is available in terms of support or treatment of the inevitable depression and anxiety.

We must condemn any government policy that damages children and vulnerable individuals, and is directly implicated in the production of mental disorders. The potential return of infants and children to Nauru can only be seen as an action condoning child abuse with the clear potential for producing a generation of damaged individuals.

Louise Newman is affiliated with Doctors for Refugees.