Harming not healing the mind
We assist survivors of torture and trauma. By the time they arrive, it’s too little too late. After a thousand days in Nauru, one thousand days in Christmas Island, by the time they come through to be treated, it is too little too late.
– Torture and trauma counsellor
People seeking our protection are highly vulnerable. Many have already been through terrible trauma before arriving to Australia. Many have lost family and friends, on the journey and back home. Many have never experienced safety. All are faced with the challenge of living in a new place, with a foreign culture and language, sometimes without family or friends. All live in fear of detention. All live in fear of being sent back.
If they send me back to Afghanistan someone else will do it to us there anyway, better to do it here. People will harm themselves rather than go back. I would rather kill myself because I can’t bear to see my children tortured in Afghanistan. [through interpreter]
– Woman from an Arabic-speaking background
People who seek protection have already experienced terrible things. Yet, rather than helping people find safety and a place to start to heal, Australia’s asylum policies are breaking people. Many have been locked up in detention centres. Some have been on Nauru or Manus Island. Many are now spending very long periods of time in immigration detention with resulting very serious effects on their mental health, though with very limited access to psychiatric care.
Even if they are in the community, the people who arrived here by boat have been left for years in limbo, surviving on the margins, unable to legally work, to get an education, unable to settle in. It is Australia’s current policies, not their past trauma, that is breaking them.
[W]e don’t feel safe because we don’t know anything about the future. They are playing with your mind, with your life, with your everything. And after I left everything, my life, my country, everything… now I’m thinking all my life depends on one paper. So where is the humanity? We can see they don’t care. And after that people think about suicide
-Person seeking asylum, NSW
The deterioration in their mental health has the tragic effect of making it more difficult for people to be able to prove their claims.
I think mental health and this prolonged legal limbo often means people can’t remember when they came here and find it difficult to remember the details of their cases. It’s really impacting on their claims for protection. They are torture and trauma survivors, having waited for so long and have circumstantial mental health issues means they had difficulty articulating why they fled.
– Service provider, NSW
If individuals can make it through the myriad of pathways, interviews, undignified probing and paperwork, the best they can get is temporary safety. The fear of being returned always remains. Worst for many is, that loved ones have been left behind, from where they themselves have escaped, or somewhere on the journey to Australia, somewhere that is not safe. The fear for their safety and the real possibility that they know they may never see each other again adds to the anguish.
[A]ll of them have significant mental health stressors: increased sense of helplessness, increased feelings of ‘people are against me’, feelings of – ‘I’m being discriminated against; why is the government and country targeting me?’. And these feelings don’t go away – if you cannot get a job or not be reunited with your family and now you are even not allowed to visit them. We are saying yes, you are allowed to work and pay taxes but don’t even think about flying to New Zealand or anywhere else because you are not allowed. That’s really hard. And as a counselor you try to help people make sense of things but this is something that for no good reason can be made sense of and that’s the really difficult thing – it’s not that our clients don’t want to try and work through their challenges that they face in life like we all do, but this issue in particular [i.e. family reunion] is really hard for people to manage or to move through and sit with. It’s very damaging in a psychological way.
– Service provider, NT
More recently, support workers have told us that one of the most dangerous points in a person’s mental health is when the person might eventually receive a temporary visa. At this point, the compounding traumas the person has experienced comes to the surface, just as they are being exited from the only support system they have known. As such, people seeking asylum require greater support through most are not receiving it.
Sadly, many state health services are not designed to handle the specialist needs of people with such complex trauma histories. Often, there are not enough services, it takes a long time to get an appointment; and the sessions are often too short. Many find it difficult for many to ask for the help they need.
[I]f it is not considered a clinical mental health issue or psychiatric disorder then people have a tendency to fall through the cracks. Things like complex PTSD and those sorts of things – which do often involve a high suicidality rate – can unfortunately be overlooked and those people are just exited out of the system and left to try again.
– Service provider, NT
I think for some clients, there’s the stigma of accessing counselling… I find that the clients will tend to talk to people they know about how they’re feeling. And then when we suggest a referral onto [a torture and trauma counselling service organisation] or even our own counselling services, there’s a reluctance. Depends on where people are from, there is a reluctance to seek that help…
– Service provider, WA
In most regional and remote parts of Australia, the necessary support systems simply aren’t available. While many support services do outreach and fly in, this often isn’t enough. As people move in search of safety and work, they generally lose contact with services that had been supporting them. Communities also face cultural barriers and stigma in accessing mainstream health services. Yet, even if they can get counselling, the underlying problem remains:
[T]he basic essential [of the counselling framework] is about establishing safety but people seeking asylum don’t have that. Being told that they will never have permanent protection in Australia, where can you start in terms of recovering when that is everything in their world to begin with. This means I will never see my family again unless I return to the place where I was tortured and where I fled from. … We might provide a connection, like any service can, a connection with people and establish some trust with them and advocate in some areas but there’s basically nobody that really can help.
– Service provider, Victoria
For some, their own communities are taking on this support role. For all communities, with no funding or recognised support, it is a struggle. Throughout 2016, there have been too many reports of deaths: deaths in detention; and suicides in the community. Groups representing refugee communities have repeatedly raised their concerns that their community is on the brink, and that an epidemic of suicides is around the corner. As one person seeking asylum in Western Australia asked us:
How long should I wait for this political issue – until I lost everyone? Lost family, lost everything – mind, brain. [through interpreter]
– Person seeking asylum, WA