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Policies of Deterrence and the Mental Health of Asylum Seekers Derrick Silove MD FRANZCP Zachary Steel MPsychol Charles Watters PhD In the past most refugees who permanently resettled in the traditional recipient countries of North America Europe and Australasia were screened prior to arrival in a host country In the last decade increasing numbers of unauthorized refugees or asylum seekers those who formally lodge application for refugee status in the country in which they are residing have applied for protection after crossing the borders of these countries Concerns about uncontrolled migration have encouraged host countries to adopt policies of deterrence in which increasingly restrictive measures are being imposed on persons seeking asylum These measures include variously confinement in detention centers enforced dispersal within the community the implementation of more stringent refugee determination procedures and temporary forms of asylum In several countries asylum seekers living in the community face restricted access to work education housing welfare and in some situations to basic health care services Allegations of abuse untreated medical and psychiatric illnesses suicidal behavior hunger strikes and outbreaks of violence among asylum seekers in detention centers have been reported Although systematic research into the mental health of asylum seekers is in its infancy and methods are limited by sampling difficulties there is growing evidence that salient postmigration stress facing asylum seekers adds to the effect of previous trauma in creating risk of ongoing posttraumatic stress disorder and other psychiatric symptoms The medical profession has a role in educating governments and the public about the potential risks of imposing excessively harsh policies of deterrence on the mental health of asylum seekers Riots The escape followed riots involving about 150 detainees at the facility last week The violence was begun by four men who had had refugee applications rejected and were told they would be deported One man tried to sew his lips together and two others cut themselves
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