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Submission to the National

Inquiry into Children in Immigration Detention from

Anita

Chauvin


The

immediate and long-term impact of trauma on children and young people:

The implications of placement in detention centres for recovery from

trauma and development of resilience

The

Developing Brains of Children and Young People and the Immediate and

Long-Term Effects of Trauma

Intergenerational

Effects


Why

Some People Survive Trauma Better Than Others: Programs Which Support

Recovery and Build Resilience



Stabilising

Children and Young People Who Are Traumatised


Conclusion


The

immediate and long-term impact of trauma on children and young people:

The implications of placement in detention centres for recovery from trauma

and development of resilience

It is important that

the impact of the trauma of exposure to violence, abuse, armed conflict,

displacement and the absence of any support systems or social networks

on children and young people are understood. The immediate impact of such

trauma, the possible long term consequences, and the strategies to support

recovery and build resilience need to be considered when Governments make

decisions about placement of children who are asylum seekers. At the international

conference, The Refugee Convention, Where to From Here? (Sydney,

2001), reports by lawyers, health professionals and others involved with

asylum seekers in Detention Centres, described an environment which is,

at best, sterile and devoid of opportunities for constructive daily activity

and, at worst, unpredictably hostile, with frequent distressing incidents

a part of daily life. These issues have also been raised by some 150 submissions

to the Human Rights and Equal Opportunity Commission (HREOC) Children

in Detention Enquiry by academics, non-government organisations and medical

professionals (www.humanarights.gov.au).


Reports included descriptions of daily procedures reminiscent of a prisoner

of war camp, with random military-style raids by guards in full riot gear;

regular daily musters in a dusty, treeless compound; unaccompanied children/minors

sitting outside their huts each day for six months, waiting for someone

to come and interview them, no-one having explained the Immigration Department’s

procedures to them. Children have watched attempted suicides and listen

to the screaming and wailing of traumatised adults. Their parents, if

they have any friends or relations in the Detention Centre, are often

frightened and psychologically distressed and provide no reassuring reference

point. There is a reported absence of health and support services, with

detainees who have serious illnesses reported being given Panadol instead

of the anti-biotics or other medication they may need. New detainees quickly

become aware that there are residents in the Centres who have been there

for years, not accepted as refugees yet not sent home, presumably because

their homeland is dangerous. There are children in Detention who were

born there and are now up to four years old. In what research tells us

are their most critical years, this lifestyle is all they have known.

Detention Centres may well exacerbate the repercussions of trauma, or

even retraumatise children and young people.


Studies examining the impact of trauma demonstrate a significant effect

on the developing brain of children and young people, which can lead to

a range of health and behavioural problems later in life (Beall, 1997;

Bremner et al., 1998; Nurcombe, 1999; Perry, 1997; Pynoos, Steinberg &

Goenjian, 1996; van der Kolk, McFarlane & Weisaeth, 1996). There are

a number of factors which interact to determine the extent of the damage

a child or young person may experience in the face of violence, abuse

and/or neglect. These include

  • the severity

    and duration of the violence, abuse and/or neglect;

  • the age of onset

    of violence, abuse and/or neglect;

  • the presence

    of other risk factors; and

  • the presence of

    protective factors to mediate the impact of the above, or to provide

    support or coping mechanisms to deal with the impact of violence, abuse

    and neglect (Commonwealth Government National Anti-Crime Strategy (CGNACS),

    1999; Perry, 1999; van der Kolk, van der Hart & Marmor, 1996; van

    der Kolk, 1994).


The brain develops in response to its environment. Clinical trials show

anatomical, neurophysiological and neurochemical changes are a common

result of exposure to prolonged violence, abuse and/or neglect in childhood

(Bremner et al., 1998; Perry, Pollard, Blakley, Baker & Vigilante,

1995; Perry, 1997; van der Kolk & Fisler, 1995). When a child adopts

hypervigilant or avoidant coping mechanisms to deal with an unsafe environment,

this chronic reactivity exacerbates neurochemical changes, which can lead

to anxiety, depression, problems with anger management, impulsive sexuality,

self-harming, and excessive risk taking later in life. This places children

and adolescents who have been exposed to acute or longstanding stress,

overwhelming anxiety, or trauma at increased risk of mental health problems

and self-harming behaviours, including suicide, substance use, and unsafe

sexual behaviours later in life (CGNACS, 1999; Perry et al., 1995; Perry,

1997; van der Kolk, 1994; Yehuda et al., 1997). The chronic mental health

problems which can occur include symptoms that cross diagnoses such as

post-traumatic stress disorder (PTSD), dissociation, somatic disorders

and suicidality (van der Kolk, B. A., Pelcovitz, D., Roth, S., Mandel,

F. S., McFarlane, A. & Herman, J. L., 1996).


Recovery from trauma is possible, given reduction of risk factors, interventions

to establish protective factors and linkage with appropriate therapies

(Chauvin, 1998; CGNACS, 1999; Commonwealth Department of Health and Aged

Care (CDHAC)b, 2000). A person’s ability to recover from difficulties,

or even to become stronger as a result of adversity, is known as resilience.

There is now a significant body of literature which demonstrates that

there are identifiable risk factors which can be minimised, and protective

factors which can be built to support the development of resilience (CGNACS,

1999; CDHACb, 2000). The key factors which support resilience, and which

enable children and young people to build positive life experiences in

the future, need to be developed across a number of domains and include:

  • developing insight

    into distress, patterns of behaviour and triggers for destructive or

    self-harming behaviours;

  • developing life-skills,

    (for example, reflection and analysis, communication, problem-solving,

    anger management, and conflict resolution);

  • establishing supportive

    peer networks;

  • feeling linked

    to, and embraced by, a community or sub-culture (geographic, ideological

    or lifestyle);

  • being exposed

    to positive role models (especially peer role models) and linked to

    mentors (having at least one positive, stable and supporting adult in

    their life); and

  • having opportunities

    to experience success in some domain of their life, to develop optimism

    about the future.

The Commonwealth

and State Governments of Australia have recognised and responded to this

research through the policies and strategies encompassed by the National

Anti-Crime Strategy (CGNACS, 1999), the National Suicide Prevention Strategy

(CDHACc, 2000), the National Mental Health Strategy (CDHACb, 2000), and

the Youth Pathways Strategy (CGYPAPT, 2001), which are largely mirrored

in State and Territory policies and strategies. Yet children and young

people who are asylum seekers continue to be placed in Detention Centres,

which demonstrably increase risk factors and reduce protective factors.

Further, when they act out in response to their distress, they are described

as behaving provocatively. People working with asylum seeker populations

need to be able to identify when health or behavioural problems are sequelae

to trauma, and respond appropriately, if unnecessary lifelong distress

and dysfunction are to be prevented. It is likely that current policies

and practices around placement of children and young people who are asylum

seekers in Detention Centres removes the protective factors necessary

to recover from trauma and to build resilience and can place them at significant

risk of lifelong distress and dysfunction.

Detention centres

strip children and young people of most protective factors that could

ameliorate the impact of exposure to trauma, such as strong family relationships,

supportive adult relationships, attachment to community networks and opportunities

for success and achievement. There is evidence that adolescence is a critical

time since brain development lays down neural pathways which support constructive

or destructive responses to heightened flight, freeze, submit reactions

programmed in the early years of trauma (The Refugee Convention, Where

to From Here Report, p. 18).

This chapter examines

the effect of trauma on the developing brains of children and young people,

including the possible long term psychological, behavioural and social

consequences later in life and the ways in which intergenerational trauma

occurs. The risk factors which exacerbate distress, and the protective

factors which support recovery and build resilience, are identified. This

research is then applied specifically to children and young people who

are asylum seekers to consider what impact their placement in Detention

Centres may have on them. The chapter considers these findings, given

the Government’s current practice of placing children and young

people in high risk settings. Also outlined are alternative approaches

which would be more congruent with contemporary Government policies on

the protection of children and young people and the strengthening of families

and communities.


The Developing Brains of Children and Young People

and the Immediate and Long-Term Effects of Trauma

Children’s

brains develop in response to their environment and so they are particularly

affected by violence, abuse and neglect (Perry et al., 1995; van der Kolk,

1994). The impact may occur because they themselves are being tortured,

caught in war, or experiencing violence, abuse or neglect, or because

they are experiencing threat through the chaotic behaviour of their traumatised

parents (Yehuda et al., 1997; Bremner et al., 1997).

An environment of unpredictable danger leads to:

  • a brain which

    is always scanning for signs of imminent danger;

  • a hair trigger

    ‘fight/ flight/ freeze/ submit’ adrenalin response, which

    suppresses normal bodily functions, including the immune system; and

  • the body’s

    adaptation to try and cut short the adrenalin reaction by changing the

    neurochemistry, to ‘damp down’, which can lead to depression

    and numbness (van der Kolk & Fisler, 1995; Yehuda et al., 1997).


Early identification of children, young people and/or their families who

have these chronic sequelae to the trauma of violence, abuse and neglect

is important as these conditions are treatable and a lifetime of distress

and other more serious sequelae in adulthood can be prevented (CGNACS,

1999; CDHAC, 2000b).


If untreated, the sequelae of trauma, including depression, anxiety, affect

dysregulation, dissociation and post-traumatic stress symptoms, can generate

self-destructive or impulsive behaviour, which does not change simply

in response to information or education programs. Often children or young

people who are seen as recalcitrant may simply be struggling with such

neurophysiological problems, learned coping mechanisms and an increasing

sense of hopelessness and fear. Programs and services need to address

their complex and interacting issues (Chauvin, 1998; Chauvin, 2001).


There can be a range of flow-on effects in the way people live their lives

due to exposure to trauma in childhood or adolescence. These effects can

be understood to result from neurophysiological changes in response to

trauma and to be reinforced by learned behaviour and established cognitive-behavioural

patterns developed over time as a result of the maladaptive brain/nervous

system responses and altered neurochemistry. Studies have shown that women

who have been sexually abused are at higher risk of sexual assault or

further episodes of abuse later in life (van der Kolk, 1989; Webster &

le Brocq, 1995; Hastings & Hamberger, 1997; Melzer-Lange, 1998; Johns

Hopkins School of Public Health, 2000). It may be that this increased

risk is a result of a dissociative response (van der Kolk et al., 1996;

Steele, van der Hart & Nijenhuis, 2001). Studies showed that the earlier

in life a person was traumatised, the more likely they were to dissociate

as a coping mechanism, and that women are more inclined to dissociate

under stress as a result of early trauma (van der Kolk & Fisler, 1995).

Women may find themselves in compromising circumstances or feeling intimidated

by a ‘date’ or partner and dissociate in response, appearing

passive and perhaps therefore compliant with sexual overtures. When they

are distressed and dissociating, they may respond to fight/flight triggers

with a learned freeze or submit response (Herman, 1992; Van der Hart,

2000).


Studies (Webster & Le Brocq, 1995; Hastings & Hamberger, 1997;

Melzer-Lange, 1998) have shown that people who engage in a whole range

of risk-taking, self-harming and harmful behaviours have a higher proportion

of family dysfunction in their background. Studies suggest that this risk

taking, self-harming and harming behaviour may be driven by the neurophysiological

changes which occur in childhood in relation to the trauma of violence

and abuse, particularly the effect on impulse control. It may also be

that the tendency to dissociate can make the threat of harm seem remote

and theoretical, rather than real and imminent. There is also some speculation

that the numbness associated with chronic dissociation is only broken

through when extreme arousal occurs — for example, sexually, through

self-harming and/or excessive risk taking (FYCCQ, 2000).


Self-harming is also not always obvious and a range of data sources would

seem to suggest that numbers of young people who are self-harming may

be quite high and that this behaviour seems to affect young women more

than young men (Department of Families, Youth and Community Care (DFYCC),

2000). Self-harming can be caused by many things, including depression

and/or a reaction to trauma in the past or present. Where there is a background

of trauma, the person could be acting out to cope with internalised pain,

trying to break through dissociation — to feel, rather than be numb;

and/or they could be expressing a desire to feel in control of some part

of their life.


Self-harming can include:

  • self-injury
  • substance abuse
  • eating disorders
  • unsafe sex and

    unsafe needle use

  • excessive risk

    taking

  • being ‘driven’

    to the point of burnout (for example, with studies, work).

Risk-taking, self-harming

and harming behaviours which can be associated with past trauma include:

  • misuse of alcohol,

    prescription and illicit drugs

  • unsafe sex
  • unsafe needle

    use

  • self-harming

    and self-mutilation

  • taking excessive

    risks

  • delinquency
  • violence
  • sexual assault

    (perpetration/higher risk for experiencing).

These behaviours

and their consequences can result in retraumatisation. If children and

young people stay locked in these cycles, and their neurophysiology is

predisposing them to depression, intrusive violent and fearful images

and suicidal ideation, their risk of self-harming and suicide are also

increased (Chauvin, 1998; CDHAC, 2000b; CDHAC, 2000c).



Intergenerational

Effects

When a child is

cared for by a parent who is suffering from symptoms such as PTSD and

other sequelae, that child can be raised, developing significant anxiety,

with a view of the world as a dangerous and distressing place. The parent

may care about the child deeply, but have dysfunctional behaviours that

put the child at risk. Yehuda et al. (1997) demonstrated that the offspring

of parents suffering PTSD as a result of the Holocaust, engagement in

war, or through becoming refugees, often develop the same neurochemical

changes as their parents. The impact of a parent who has had a background

of violence, abuse and neglect may be compounded if the parent has also

adopted dysfunctional coping mechanisms. These may include emotional disconnectedness

(for example, attachment problems at birth and through childhood) and/or

by the parent’s self-destructive or destructive coping mechanisms,

such as alcohol, tobacco and drug use, violence, changing sexual partners,

or lifestyle instability (Chauvin, 1998). A parent in Detention, who has

not had the opportunity to recover from their experience of trauma, is

therefore at higher risk of having an unintended negative impact on their

child.

Why Some

People Survive Trauma Better Than Others: Programs Which Support Recovery

and Build Resilience

We have all met individuals

who have experienced prolonged distress and difficulties, or who have

gone through traumatic events, and observed how some bounce back and survive

well while others may remain fragile or distressed or even deteriorate

and become depressed and anxious. A person’s ability to recover

from difficulties or even become stronger as a result of adversity is

known as resilience. There is now a significant body of literature

which demonstrates that there are identifiable risk factors which can

be minimised and protective factors which can be built upon to support

the development of resilience (CGNACS, 1999; CDHAC, 2000b). Some of the

key factors which support resilience and which enable children and young

people to build positive life experiences in the future include:

  • strong sense

    of identity and culture;

  • developing insight

    into distress, patterns of behaviour and triggers for destructive or

    self-harming behaviours;

  • developing life-skills

    (for example, reflection and analysis, communication, problem-solving,

    anger management, conflict resolution, learning to survive in a new

    environment);

  • establishing

    supportive peer networks;

  • feeling linked

    to, and embraced by, a community or sub-culture (geographic, ideological

    or lifestyle);

  • being exposed

    to positive role models (especially peer role models) and linked to

    mentors (having at least one positive, supporting adult in their life);

    and

  • having opportunities

    to experience success in some domain of their life, to develop optimism

    about the future (Chauvin, 1998, 2001; CGNACS, 1999; CDHAC, 2000a; CDHAC,

    2000b; CDHAC, 2000d).

Many of these elements

are captured when children and young people are involved in well-facilitated

community development programs, such as group/team-based projects to achieve

some end, community art/theatre/music projects (Chauvin, 1998; 2001).

Reintegration into normal community life, in a community which embraces

them and experiences which generate a sense of optimism about the future

are critical to recovery from trauma (CGNACS, 1999; CDHAC, 2000c).


Stabilising

Children and Young People Who Are Traumatised

The most important

point to consider in designing interventions to support recovery is the

need to stabilise symptoms, to identify and build on strengths and to

build life skills (Steele, van der Hart & Nijenhuis, 2001; van der

Kolk, van der Hart & Marmor, 1996). It is then possible to deal with

the trauma (only if the person wants to and/or feels ready to) and then

to integrate the learning or gains from these interventions into a constructive

approach to life in the future (Steele, van der Hart, Nijenhuis, 2001;

van der Hart, 2000). If it is decided by the person that it is inappropriate

to address the trauma directly, at least for some time, then this must

be respected. To deal with trauma directly before the person has developed

their strengths and established protective factors around themselves could

actually be harmful and result in retraumatising them.


As long as children and young people who have been traumatised have to

reside in a Detention Centre, where factors that allow them to stabilise

are absent, they are not able to recover, let alone develop life skills

and resilience. The absence of support services, the lack of opportunity

for their family to be strengthened, or for supportive networks and a

sense of belonging in a community to be established — all these

factors actively undermine their opportunity to stabilise, avoid retraumatisation

and to recover mental health. Government programs are very clear on the

range of protective factors which need to be in place at an individual,

family, school, community and cultural level, in order for children and

young people to recover from prolonged exposure to trauma and to build

resilience (CGNACS, 1999; CDHAC, 2000b).


When the young person is ready to deal with the trauma through psychotherapeutic

interventions they can be linked into appropriate services. There are

a number of therapies that are appropriate at different phases of recovery

and which might need to be linked/coordinated with other interventions.

A range of individual and family therapies may be helpful at different

times in the healing process, including those which provide insight, build

self-awareness and strengthen problem-solving skills: cognitive behavioural

therapy; behavioural and solution-focussed strategies; therapies such

as EMDR (eye movement desensitisation and reprocessing); relaxation/stress

management; and meditation exercises. Research suggests that all these

therapies may also help with neurophysiologically-programmed fight, flight,

freeze and submit responses and other sequelae resulting from prolonged

trauma, including anxiety, depression and suicidal ideation. Detoxification

and treatment programs are available for alcohol and drug-use; and pharmacological

and other interventions are appropriate for depression and/or comorbidities

(van der Kolk, McFarlane & Weisaeth, 1996; Nurcombe, 1999).

Building

on strengths and establishing resilience

The guidelines for

fostering and building on strengths and for the establishment of sustainable

protective factors are very clearly laid out in contemporary Government

programs for children and young people (CGNACS, 1999; CDHAC, 2000b; CDHAC,

2000c).


In the table of risk and protective factors, Table 1 below, it becomes

clear that children and young people need to feel embraced by a community

which values and protects them. They need to have a sense of belonging.

Research supporting the programs cited above also cites the importance

of a cohesive family or where a family is disrupted, for strong linkages

with respectful, affirming adults and good role models. The importance

of strong, supportive peer networks is also recognised, both as a vehicle

for learning and to support the sustaining of positive behaviour changes.

The school as a community and a potential health promoting environment

is recognised and emphasised globally (CDHAC, 2000a) and the protective

value of learning life skills and being exposed to positive life experiences

and experiences of success has been demonstrated to build optimism and

reduce recidivism (CGNACS, 1999).


Studies and reports from agencies working with traumatised young people

suggest a fine balance is required between acknowledging and dealing with

the impact of past trauma, and focussing on building on the positives,

thinking forward. The growing literature on building strengths or protective

factors suggests that it is important to first build strength, life skills

and support to stabilise the person before attempting to deal with examining

the issues around trauma (Steele, van der Hart & Nijenhuis, 2001).

It is the person’s choice whether, in fact, they ever choose to

examine the trauma — for some it may simply serve to retraumatise

them. The key issue is to reduce the risk of further trauma in the future

through isolation and self-destructiveness.


Healthy lifestyle and relationship patterns are able to grow stronger

when there is a focus on enhancing the strengths which clearly exist in

someone who has survived violence, abuse, neglect, displacement, loss

and/or other distress. The development of insight and skills supports

constructive life experiences in the future and with each experience of

success and of positive intimacy resilience is reinforced. Over time,

with the absence of repeated cycles of trauma and distress, and consequent

retraumatisation, the young person has the opportunity to make the best

of their life. They are more able to fulfill their potential, enjoy happy

relationships, and in time, if they wish, to become a constructive, caring

parent themselves, not repeating the cycles of violence, abuse or neglect

which may have harmed them in the first place.


Australia’s

National and State Policies and Programs For Children and Young People

National and State

Governments in Australia have responded to research on the impact of violence,

abuse and neglect and the evidence of risk and protective factors, by

establishing a range of prevention and early intervention programs, including

parent skills development programs, young parent programs, home visitation,

and expanded child health centres. The Commonwealth Government has adopted

the findings on the impact of trauma on children and young people and

declared a commitment to act to reduce risks to children and young people

by establishing programs which identify and work to reduce risk and which

build protective factors to generate resilience. This commitment to identifying

and reducing risk factors and at the same time identifying and building

protective factors, underpins the approach taken in a range of programs,

including the National Anti-Crime Strategy, the National Mental Health

Strategy, and the National Suicide Prevention Strategy.

For reasons which are not clear, and despite the Government’s overt

acknowledgement of the impact of trauma on children and its acceptance

of the research on risk and protective factors, the Government continues

to place some of the most vulnerable children and young people in this

country into high risk settings, stripped of all the factors which enable

them or their families to recover and to build resilience. It is important

to have early identification of children, young people and their families

who have chronic sequelae to the trauma of armed conflict, oppression,

violence, abuse and neglect, as these conditions are treatable and a lifetime

of distress and other more serious roll-on effects in adulthood can be

prevented.


Table 1: Risk factors

and protective factors

R

I S K F A C T O R S

CHILD

FACTORS

FAMILY

FACTORS

SCHOOL

CONTENT

LIFE

EVENTS

COMMUNITY

AND CULTURAL FACTORS

  • Prematurity
  • low birth

    weight

    disability

  • prenatal

    brain damage

  • birth injury


  • low intelligence


  • difficult

    temperament

  • chronic

    illness

  • insecure

    attachment

  • poor problem

    solving

  • beliefs

    about aggression

  • attributions
  • poor social

    skills

  • low self-esteem
  • lack of

    empathy

  • alienation
  • hyperactivity/disruptive

    behaviour

  • impulsivity

Parental

characteristics:

  • teenage

    mothers

  • single parents
  • psychiatric

    disorder, especially depression

  • substance

    abuse

  • criminality
  • antisocial

    models


family environment:

  • family violence

    and disharmony

  • marital

    discord

  • disorganised
  • negative

    interaction/social

  • isolation
  • large family

    size

  • father absent
  • long-term

    parental unemployment


parenting style:

  • poor supervision

    and monitoring of child

    discipline style (harsh or inconsistent)

  • rejection

    of child

  • abuse
  • lack of

    warmth and affection

  • low involvement

    in child’s activities

  • neglect
  • school failure
  • normative

    beliefs about aggression

    deviant peer group

  • bullying


  • peer rejection
  • poor attachment

    to school

  • inadequate

    behaviour management

  • divorce

    and family break up

  • war or natural

    disasters

  • death of

    a family member

  • socioeconomic

    disadvantage

  • population

    density and housing conditions

  • urban area
  • neighbourhood

    violence and crime

  • cultural

    norms concerning violence as acceptable responses to frustration

  • media portrayal

    of violence

  • lack of

    support services

  • social or

    cultural discrimination

P

R O T E C T I V E F A C T O R S

  • social competence
  • social skills
  • above average

    intelligence

  • attachment

    to family

  • empathy
  • problem

    solving

  • optimism
  • school achievement
  • easy temperament
  • internal

    locus of control

  • moral beliefs
  • values
  • self-related

    cognitions

  • good coping

    style

  • supportive

    caring parents

  • family harmony
  • more than

    two years between siblings

  • responsibility

    for chores or required

  • helpfulness
  • secure and

    stable family

  • supportive

    relationship with other adult

  • small family

    size

  • strong family

    norms and morality

  • positive

    school climate

  • prosocial

    peer group

  • responsibility

    and required helpfulness

  • sense of

    belonging/ bonding

  • opportunity

    for some success at school and recognition of achievement

  • school norms

    concerning violence

  • meeting

    significant person

  • moving to

    new area

  • opportunities

    at critical turning points or major life transitions

  • access to

    support services

  • community

    networking

  • attachment

    to the community

  • participation

    in church or other community group

  • community/cultural

    norms against violence

  • a strong

    cultural identity and ethnic pride


Source: Pathways to Prevention, CGNACS, 1999, p. 136 & p. 138.


Intervention also reduces the likelihood of the cycle of violence being

repeated in the next generation and supports development of more stable,

peaceful societies. The placement of refugees, especially children and

young people, in community settings where they can begin to reduce the

risk factors in their lives and can establish protective factors, such

as a sense of belonging, peer support, building strength and achievement,

would not only be a constructive and compassionate response, but would

save Governments significant expense in the long term when chronic health

problems, crime and future conflict are prevented as a result.


It should also be borne in mind that young people from backgrounds of

trauma will need a long term, staged developmental and multimodal approach

to help them recover and to build resilient lives. The wealth of literature

on harm prevention and harm minimisation programs confirms that access

to community development programs is useful to lay important groundwork,

including building trust with health professionals, beginning to generate

constructive peer networks and developing life skills as a side effect

of interaction and problem-solving in group settings (Chauvin, 2001).

These interventions provide the first stage of the recovery process. Having

built trust with their health workers, and gained a level of comfort attending

the organisations that auspice these activities, young people are more

likely to seek help and return for other developmental and therapeutic

interventions.


Similarly, mental health services that provide sessions on site in youth

agencies or youth-friendly community-based agencies also become familiar

and trusted and are more readily accessed. This then provides the bridge

into the mental health services themselves and opens up the possibility

of more formal therapeutic interventions addressing trauma, should the

person continue to have intrusive symptoms or other sequelae.


The Commonwealth Government’s plethora of programs, cited herein,

for children and young people confirm the elements required for recovery

from trauma and establishment of constructive life patterns. When all

the interacting, complex issues affecting refugee and asylum seeker children,

young people and their families are addressed — that is, reducing

risk, building strengths and linking into therapeutic interventions when/if

ready — then self-maintaining and positively reinforcing lifestyle

patterns are established which contribute to resiliency and reduce self-harming

and harmful behaviours.


Service providers need to remember that young people from a background

of armed conflict, violence, abuse and neglect may go on to develop depression

and/or impulsivity and self-harming life patterns. The nature of their

neurophysiological state in itself undermines their ability to maintain

positive behaviour change in response to health promotion and prevention

programs, and treatment services.


Programs which address specific issues, such as alcohol, tobacco and other

drug interventions, sexual health promotion, suicide prevention and other

prevention and harm minimisation programs, need to take into account the

possibility that a young person from a refugee background may be ‘acting

out’ in response to the neurophysiological and cognitive-behavioural

patterns laid down in response to early trauma. These sequelae, including

depression, anxiety, affect dysregulation, dissociation and post traumatic

stress symptoms, can generate self-destructive or impulsive behaviour,

which does not change simply in response to information or education programs.

Often children or young people who are seen as recalcitrant are in fact

simply struggling with neurophysiology, learned coping mechanisms and

an increasing sense of hopelessness and fear. Programs and services need

to address their complex and interacting issues with compassion and a

spirit of genuine enquiry (Chauvin, 2001).

Conclusion


For children and young people who are asylum seekers/refugees it is likely

that placement in Detention Centres strips them of the protective factors

necessary to recover from trauma and to build resilience. The distress

of their parents further places them at risk. National and State Governments

have recognised the need to ‘strengthen families’ in a range

of policies, including Pathways to Prevention: Developmental and Early

Intervention Approaches to Crime in Australia (CGNACS, 1999), the Suicide

Prevention Strategy (CDHAC, 2000c) and the National Mental Health Strategy

(CDHAC, 2000b).

Appropriate placement within the community and interventions to reduce

the likelihood of the cycle of violence being repeated in the next generation

are cost effective and in line with current Government policies for strengthening

families and communities, and for nurturing the wellbeing of vulnerable

children and young people. The placement of refugees, especially children

and young people, in community settings where they can begin to reduce

the risk factors in their lives and can establish protective factors,

such as a sense of belonging, peer support, building strength and achievement,

would not only be a constructive and compassionate response, but would

save Governments significant expense in the long term when chronic health

problems, crime and future conflict are prevented as a result. Sadly many

of our health, welfare and justice systems do not recognise when destructive

or self-harming behaviour is the consequence of unresolved trauma. Consequently,

young people are punished, further retraumatising them, instead of providing

them with appropriate interventions and support.


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Last

Updated 14 July 2003.