"Driven mad by cruel uncertainty"

This article by Adele Horin, writing in the Sydney Morning Herald on May 28, deserves to be read in full. I could not get the link so here it is:

The Howard Government is in a mess over its immigration detention policies at last. While the Prime Minister decides how to soften the cruelties he once boasted about, without loss of face or capitulation to the party renegades, the social experiment continues to wreak its terrible toll.

Cornelia Rau is out of detention. But others, who were perfectly sane when first locked up, have gone mad inside. Mentally ill Australians were carted off to detention centres by mistake, and the public woke up in shock. Yet the mistake, on one level, was understandable. Detention centres have become de facto mental asylums.

Psychiatrists have told us for years that detention centres drive people crazy. And that the system of three-year temporary protection visas for "genuine" refugees who arrive by boat only exacerbates the psychological damage.

Now new research quantifies the human costs of a Government policy that has inflicted unprecedented levels of mental illness on its victims.

Derrick Silove, Zachary Steel and Shakeh Momartin, and others from the University of NSW school of psychiatry, have completed a series of projects on post-traumatic stress disorder. They found the Government's cruel social experiment has caused more psychological
damage to refugees than have the traumas from which they fled.

It is understandable why the Royal Australian and New Zealand College of Psychiatrists and the Australian Psychological Society advised mental-health workers this week against responding to the sudden recruitment drive of GSL (Australia) Pty Ltd, the manager of detention centres, which is seeking to hire psychiatrists and psychologists on a sessional basis to assess people in detention. It is a fundamental conflict of interest to be paid by the agency - in effect, an arm of government - that inflicts the psychological damage the doctors are meant to treat.

>From separate research projects undertaken by the university's team, a picture emerges of how traumatised people can recover from appalling experiences. They need safety, peace and security. They cannot regain their mental equilibrium if they are made to live in perpetual fear and uncertainty.

One of the research projects compared two groups of Iranian refugees who had experienced similar traumas in Iran, such as torture and the disappearance of family members. One group arrived in Australia by boat. They were put into detention, and later, when found to be genuine refugees, were granted three-year temporary protection visas that left them in limbo; the visas needed to be renewed, the people were unable to settle down, to leave the country, or to bring family to join them. The other Iranians arrived by air, through the offshore refugee program, and were given a visa that ensured permanence and full rights.

Both groups were studied over two years. Those on temporary protection visas were just as traumatised after two years of freedom as on the day they left the detention centre. Nothing was resolved for them because of fear about the future and the uncertainty of their status as "temporaries".

The Iranians on permanent protection visas showed almost no signs of mental illness after two years.

"The most effective mental-health intervention is not psychiatrists," Steel told me. "It's to provide a safe environment, and that means security about the future."

In another study of Mandean refugees from Iraq, to be reported soon in the British Journal of Psychiatry, the team was able to isolate what contributed most to mental health problems - the traumas in Iraq, or in Australia. The Mandeans' experience was diverse: some had been in detention, some not; some had temporary visas, others were on permanent visas. Those who had suffered the full brunt of Australian policy were worse off. The team was able to calculate that what Australia had done to the Mandeans was twice as destructive to their mental health as the trauma that caused them to flee.

Finally, the team examined an earlier group of boat people - Vietnamese who arrived before 1975, under a very different conservative government. Malcolm Fraser welcomed them, and accorded them permanent refugee status and settlement help. Thirty years on, their mental health was positively glowing. Problems were found in only 6 per cent of the Vietnamese, compared with 20 per cent of Australians.

Other evidence of how people recover from terrible traumas can be found in East Timor. The East Timorese suffered high levels of post- traumatic stress disorders in the aftermath of the militia's anti-independence rampage. Australian psychiatrists who went to East Timor
soon after found that almost 40 per cent of the East Timorese surveyed suffered post-traumatic stress disorders. Returning last year, after four years of relative peace, they were hard-pressed to find anyone with mental illness. With stability, the whole society had recovered.

The sad saga of mentally ill Australians thrown into detention, even deported, has rightly provoked an outcry. But the Government should also answer for policies that put sane people into detention and turned them mad.

At the very least, it could throw out its temporary protection visas. If people are found to be refugees, that should be the end of their nightmare. There are 9000 refugees whose mental health is in jeopardy because the Government forces them to live in limbo. "It's like keeping people permanently on death row," Steel said.

This research makes the perfidy of Australia's treatment of refugees clearer than ever. To recover, traumatised people don't need psychiatrists. They need permanent residence, security, stability and hope.