Addressing the mental health needs of asylum seekers: A compassionate and trauma-informed approach

A new study by The University of South Australia has found mental health issues such as post-traumatic stress disorder (PTSD), anxiety, depression and suicidality are widespread among people seeking asylum in Western nations, including Australia.

The research, conducted by UniSA's Mental Health and Suicide Prevention Research Group (MHSPRG), was published in the British Medical Bulletin, and examined data from Australia, Europe, Canada and the United States, finding asylum seekers from all regions face numerous systemic mental health challenges.

MHSPRG researcher, Heather McIntyre, says the team reviewed 25 studies which included a total of 3504 asylum seekers from 12 countries, and results indicate mental health problems are relatively common and often co-occur.

"The experience of seeking asylum is unique and problematic when compared to other migration trajectories, and this review suggests harsh and restrictive immigration policy settings initiated by governments severely affect asylum seekers' mental health," McIntyre says.

"Significantly, our review finds this population group experiences high rates of PTSD, anxiety and depressive symptoms, with 25-54 percent of participants meeting criteria for at least two of these conditions."

The MHSPRG review also indicates self-harm and suicidality are linked to the asylum immigration process, reinforcing similar findings from other studies over many years.

"Rejection of asylum seeker claims is a major driver (61 percent) of suicidal thoughts and behavior and presentation to psychiatric emergency services—uncertainty for the future and perceived burdensomeness all contribute to suicidal ideation and acting upon those thoughts," McIntyre says.

"Advocates and care workers of asylum seekers and refugees see these outcomes weekly, and publicly available information (unconfirmed and provisional data) shows us that asylum seekers are thought to die by suicide at a higher rate than their male Australian-born counterparts."

The MHSPRG study recognizes asylum seekers often express mental distress in ways consistent with their culture and suggests the medical and professional response should be "trauma-informed."

"A trauma-informed approach acknowledges that behaviors and expressions of distress are coping strategies instinctively developed to manage trauma," McIntyre says.

"Being aware of trauma and consciously working to avoid causing more trauma or re-traumatisation is the approach needed—showing empathy toward the person, while gently encouraging them to develop their autonomy and support them to make positive mental health care choices."

The study also emphasized that work rights and employment prospects can be a significant factor in protecting and promoting mental health for asylum seekers.

"Feeling psychologically safe and being able to work increases well-being for the asylum seeker; living a life as normal as possible is also a driver for personal autonomy and will improve mental health," McIntyre says.