The federal government has tabled the long-awaited Australian Human Rights Commission (AHRC) report into children held in immigration detention. The report, which recommends a royal commission be held into the issue, has been subject to intense politicisation. This has included the AHRC and its president, Gillian Triggs, coming in for criticism from government MPs and media commentators.

The report found that children in immigration detention had been involved in nearly 300 instances of actual or threatened self-harm between January 2013 and March 2014. It also revealed that more than one-third of children detained have developed a mental illness requiring psychiatric care.

The Conversation’s experts assessed the report’s implications for asylum seeker law, policy and health. Their responses follow.

Elizabeth Elliott, Professor of Paediatrics and Child Health, Sydney Medical School at University of Sydney

The Forgotten Children. Three words that encapsulate the fate of children forcibly detained in Australia’s immigration detention centres. Children stripped of their identity and denied the basic human rights of freedom and education. Vulnerable children, many suffering post-traumatic stress disorder, with mothers who have lost hope. Children who have, for many months, remained invisible to the average Australian.

Invisible, inaudible and forgotten. That is, until the advent of the 2014 Australian Human Rights Commission’s National Inquiry into Children in Immigration Detention.

The inquiry’s report finally gives asylum seekers and their children a voice. It humanises the children and it helps us to visualise their plight. The report provides tangible, credible, quantitative evidence to underpin observations reported by clinicians, including me, who’ve visited detention centres – on the mainland, Christmas Island and Nauru – and those who provided submissions to the inquiry or appeared at hearings.

It highlights the harms – to health, mental health and well-being – that result from detention in hostile, inappropriate settings.

In March 2014, at the start of the inquiry, more than 1000 children under 18 years (153 under four years, 336 primary school-aged and 196 teenagers) had been held in arbitrary detention in centres in mainland Australia, Christmas Island and Nauru – for more than eight months on average (now more than 17 months), in violation of international human rights law.

Among these children we documented mental health disorders sufficient to warrant treatment in 34%, a level that wildly surpasses the 2% of the general child population who use outpatient mental health services. More than 30% of children surveyed report being always sad or crying; 25% are always worried; 18% sleep badly or have nightmares; 12% eat poorly; 4% self-harm.

The severity of their mental ill-health was measured using a validated tool, the Health of the Nation Outcomes Scales for Children and Adolescents (HoNOSCA). This revealed moderate to severe problems across all domains measured including behaviour, mood and social skills. Specific problems with concentration, language, and emotional control and anti-social behaviour were moderate or severe in more than 10%.

Perhaps these results should not surprise, considering the toxic environment. In one 14-month period, the Department of Immigration recorded 233 assaults, 27 cases of voluntary starvation and 128 incidents of actual self-harm in children in detention. The risk of suicide or self-harm was “high-imminent” or “moderate” in 105 of these children, ten of them under the age of ten. Add to this mix the mental ill-health of their parents and detention cannot but provide a bad beginning in life for child detainees.

We acknowledge the government’s efforts to decrease the number of children in detention, but have a duty of care to those who remain. We must also provide ongoing assessment and treatment to minimise long-term health and mental health outcomes for those living in the community. In future, the detention of children must not be arbitrary, should be a measure of last resort, and must be for the shortest possible time. Our evidence confirms that the longer the duration of detention, the worse the outcomes.

The report flags the urgent need for Australia to release all remaining child detainees into the community and to consider legislative change to ensure we manage children differently into the future. As a society we owe it to all children, in or out of detention to offer compassion, humanity and the health care and education that is their right.

Note: Elizabeth Elliott travelled to Christmas Island as part of the ARHC’s inquiry. Read her account here.

Madeline Gleeson, Research Associate, Andrew & Renata Kaldor Centre for International Refugee Law at UNSW Australia

International law is clear on the circumstances in which detention will be arbitrary and unlawful. Detention, whether of asylum seekers or anyone else, is prohibited unless it is “reasonable, necessary and proportionate to a legitimate purpose”.

This “legitimate purpose” is the linchpin. The purposes that may justify detention of asylum seekers have traditionally been constrained to initial identity, health and security checks, and a few other specific grounds. More recently, there has been debate about whether these grounds could be expanded to include deterring irregular migration.

The Human Rights Commission’s inquiry renders this debate moot.

In evidence to the inquiry, former immigration ministers Scott Morrison and Chris Bowen admitted on oath that detaining children does not deter either asylum seekers or people smugglers. In conceding this point, they undermined the purported “legitimate purpose” that successive Australian governments have relied on to justify mandatory detention. In the words of the ARHC:

… there appears to be no rational explanation for the prolonged detention of children.

The tests of reasonableness and necessity require that detention be based on a detailed assessment of the necessity to detain, taking into account the circumstances and needs of each individual, and possible alternatives to detention.

When a child is involved, international law demands an even higher level of protection. The best interests of each child must be assessed individually and taken into account as a primary consideration, and no child should be detained except as a last resort. This final requirement is also enshrined in the Migration Act.

Australia’s current regime does not comply with any of these obligations. No real best interests assessments are conducted, nor are less restrictive arrangements considered for any child. Detention itself is causing harm, as children are exposed to assaults, sexual assaults and self-harm. 34% of detained children have mental health disorders so severe as to require hospital-based outpatient psychiatric treatment, compared to 2% in the Australian community. Children on Nauru in particular are:

… suffering from extreme levels of physical, emotional, psychological and developmental distress.

These findings are unequivocal. The detention of Australia’s “forgotten children” will not “stop the boats”. But it will cause potentially irreversible harm to young people in our care, many of whom may become Australian citizens one day.

More to come.

Elizabeth Elliott presented the findings of her visit to Christmas Island in a submission to a hearing of the Australian Human Rights Commission's National Inquiry into Children in Immigration Detention in 2014.

Madeline Gleeson does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.