Asylum seeking children and adolescents in Australian immigration detention on Nauru: a longitudinal cohort study

Karen Zwi; Louise Sealy; Nora Samir; Nan Hu; Reza Rostami; Rishi Agrawal; Sarah Cherian; Jacinta Coleman; Josh Francis; Hasantha Gunasekera; David Isaacs; Penny Larcombe; David Levitt; Sarah Mares; Raewyn Mutch; Louise Newman; Shanti Raman; Helen Young; Christy Norwood; Raghu Lingam

doi:10.1136/bmjpo-2019-000615

Asylum seeking children and adolescents in Australian immigration detention on Nauru: a longitudinal cohort study

BMJ Paediatr Open. 2020 Mar 15;4(1):e000615. doi: 10.1136/bmjpo-2019-000615. eCollection 2020.

Authors

Karen Zwi^{1

2}, Louise Sealy², Nora Samir¹, Nan Hu¹, Reza Rostami³, Rishi Agrawal⁴, Sarah Cherian⁵, Jacinta Coleman⁶, Josh Francis⁷, Hasantha Gunasekera⁸, David Isaacs⁹, Penny Larcombe¹⁰, David Levitt¹¹, Sarah Mares³, Raewyn Mutch⁵, Louise Newman¹², Shanti Raman^{1

13}, Helen Young¹⁴, Christy Norwood², Raghu Lingam¹

Affiliations

¹ School of Women's and Children's Health, University of New South Wales - Randwick Campus, Randwick, New South Wales, Australia.
² Community Child Health, Sydney Children's Hospitals Network Randwick and Westmead, Westmead, New South Wales, Australia.
³ School of Psychiatry, University of New South Wales - Randwick Campus, Randwick, New South Wales, Australia.
⁴ General Paediatrics, Women's and Children's Hospital Adelaide Division of Paediatric Medicine, North Adelaide, South Australia, Australia.
⁵ Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia.
⁶ Adolescent Medicine, Monash Children's Hospital, Clayton, New South Wales, Australia.
⁷ Paediatric Infectious Diseases, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.
⁸ School of Paediatrics, The University of Sydney, Sydney, New South Wales, Australia.
⁹ Paediatric Infectious Diseases, Sydney Children's Hospitals Network Randwick and Westmead, Westmead, New South Wales, Australia.
¹⁰ Paediatrics, Gold Coast University Hospital, Southport, Queensland, Australia.
¹¹ Department of Paediatrics, Children's Health Queensland Hospital and Health Service, Herston, Queensland, Australia.
¹² Child Psychiatry, The Royal Women's Hospital, Melbourne, Victoria, Australia.
¹³ Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.
¹⁴ Paediatrics, Royal North Shore Hospital School, Saint Leonards, New South Wales, Australia.

Abstract

Introduction: Immigration detention has a profound and negative impact on the physical health, mental health, development and social-emotional well-being of children, adolescents and their families. Australian clinicians will report results from detailed health and well-being assessments of asylum seeking children and adolescents who have experienced prolonged immigration detention.

Methods and analysis: This is a national, multicentre study with a longitudinal cohort design that will document health and well-being outcomes of the children and adolescents who have been detained in offshore detention on the remote island of Nauru. Outcome measures will be reported from the time arrival in Australia and repeated over a 5-year follow-up period. Measures include demographics, residency history and refugee status, physical health and well-being outcomes (including mental health, development and social-emotional well-being), clinical service utilisation and psychosocial risk and protective factors for health and well-being (eg, adverse childhood experiences). Longitudinal follow-up will capture outcomes over a 5-year period after arrival in Australia. Analysis will be undertaken to explore baseline risk and protective factors, with regression analyses to assess their impact on health and well-being outcomes. To understand how children's outcomes change over time, multilevel regression analysis will be utilised. Structural equation modelling will be conducted to explore the correlation between baseline factors, mediational factors and outcomes to assess trajectories over time.

Ethics and dissemination: This research project was approved by the Sydney Children's Hospitals Network Human Research Ethics Committee. Subsequent site-specific approvals have been approved in 5 of the 11 governing bodies where the clinical consultations took place. In order to ensure this research is relevant and sensitive to the needs of the cohort, our research team includes an asylum seeker who has spent time in Australian immigration detention. Results will be presented at conferences and published in peer-reviewed Medline-indexed journals.

Keywords: community child health; general paediatrics; health services research; neurodevelopment.