Rudd’s PNG plan could worsen asylum seekers' mental health

Asylum seekers are often left traumatised by their journey. Will they be able to receive appropriate mental health treatment when processed and resettled in PNG? EPA/Adrian Elang

It is currently unclear how Australia and Papua New Guinea will ensure a protective and supportive resettlement environment for refugees under the recently announced Regional Resettlement Arrangement (RRA).

Rather, it appears more likely this new policy will obstruct healthy post-resettlement adaptation.

Restoring wellbeing presents an enormous challenge to asylum seekers and refugees in any context, but may be particularly fraught territory when resettlement support is limited.

Refugees and asylum seekers are vulnerable to mental distress due to exposure to potentially traumatic incidents that include torture, witnessing unspeakable atrocities, family loss and separation, unrelenting persecution and forced displacement. The very nature of the post-traumatic environment can determine whether the mental health impact of trauma exposure is perpetuated or reduced.

For example, mandatory detention is known to be harmful to mental health by compounding symptoms of depression and post-traumatic stress. But there are now evidenced-based pathways that can facilitate recovery from human rights violations and displacement-related traumas. These factors include safety from physical and mental violence; a sense of belonging and community; preservation of attachment systems and family relationships and freedom from poverty, including employment.

For children and young people, the recovery environment must also support their physical and social development. The vast majority of trauma survivors will recover and thrive if these conditions are met upon resettlement.

Of particular concern is the potential impact the RRA policy will have on the hopes of new arrivals for reunification with family members already resettled in Australia. Unaccompanied minors who arrive by boat are not exempt from the RRA, even if they have family in Australia. A situation could arise where an unaccompanied minor found to be a genuine refugee and with family in Australia will be forced to live in PNG under the care of a government that struggles to provide any basic safety net for its most vulnerable citizens and children.

Furthermore, people from refugee backgrounds in Australia benefit highly from the support of their own cultural communities - an avenue of support that will be significantly limited for refugees in PNG. The lack of cultural and family connections will make it difficult for newly resettled refugees to adjust to their new home.

It will be almost impossible for the PNG government to guarantee that refugees will live in a safe environment, given the current lack of safety in PNG communities. Gender-based violence and inequality continues to undermine the safety of women.

It is also currently unclear how employment and livelihoods will be facilitated for resettled refugees and their families in PNG. The country already struggles to support disadvantaged members of their own population, with little support for those without financial independence. Resettled refugees often play a vital role in supporting the survival of family remaining in their country of origin via remittances. This practice is likely to be significantly curtailed upon resettlement in PNG.

Both official and news media reports have exposed dilapidated conditions on the Manus Island detention centre. AAP/Gary Ramage

Meeting the mental health needs of the current detainees on Manus Island has been challenging, as highlighted by the ABC Four Corners program “No Advantage”, reports of rape, torture and self-harm on SBS' Dateline, as well as reports by the United Nations High Commissioner for Refugees. Detention facilities have proven to be difficult places to conduct trauma-focused interventions where there is a lack of safety and significant ongoing stress, even if the services and expertise are available.

Delivery of mental health services to traumatised refugees in the PNG community may be even more difficult. Currently, access and coverage for basic health services in PNG is poor, with very limited mental health services. This contrasts substantially with the specialised services that have been established to provide care and support for people from refugee backgrounds resettled in Australia. These include a national network of torture and trauma rehabilitation and treatment agencies to assist with recovery from trauma.

The impact of a lack of such mental health services in PNG is likely to be significant. The RRA policy has the potential to create a class of traumatised individuals, living in a foreign country where they don’t speak the language, without family, infrastructure or support services to meet their intense needs, and with little guarantee for their safety. So, how does Australia begin to meet its responsibility to protect refugees from physical and mental harm under these circumstances?

Research shows that with the right support services upon resettlement, the majority of refugees not only recover from acute trauma, they thrive to meaningfully contribute to the economic, social and cultural fabric of their resettled society. But an adverse resettlement environment such as PNG will create the situation where the unspeakable trauma and distress that refugees have already suffered may only worsen, with little hope for real recovery.