4.3 Article

Moral injury related to immigration detention on Nauru: a qualitative study

Journal

EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY
Volume 13, Issue 1, Pages -

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/20008198.2022.2029042

Keywords

Moral injury; post-migration living difficulties; immigration detention; asylum seeker; refugee mental health; Nauru

Funding

  1. Swiss National Science Foundation [184612]
  2. Child and Community Wellbeing Unit (Centre for Health Equity)
  3. Monash University

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This study explores the moral injury appraisals and associated mental health outcomes related to immigration detention on Nauru. The findings suggest that mandatory immigration detention can cause harm through moral injury. Collective efforts are needed to prevent the deterioration of refugee mental health.
Background Immigration detention is associated with detrimental mental health outcomes but little is known about the underlying psychological processes. Moral injury, the experience of transgression of moral beliefs, may play an important role. Objective Our aim was to explore moral injury appraisals and associated mental health outcomes related to immigration detention on Nauru. Methods In this retrospective study, we conducted in-depth interviews with 13 individuals who had sought refuge in Australia and, due to arriving by boat, had been transferred to immigration detention on Nauru. At the time of the study, they lived in Australia following medical transfer. We used reflexive thematic analysis to develop themes from the data. Results Major themes included 1) how participants' home country experience and the expectation to get protection led them to seek safety in Australia; 2) how they experienced deprivation, lack of agency, violence, and dehumanization after arrival, with the Australian government seen as the driving force behind these experiences; and 3) how these experiences led to feeling irreparably damaged. The participant statement 'In my country they torture your body but in Australia they kill your mind.' conveyed these three key themes in our analysis. Conclusion Our findings suggest that moral injury may be one of the processes by which mandatory immigration detention can cause harm. Although refugees returned to Australia from offshore detention may benefit from interventions that specifically target moral injury, collective steps are needed to diminish deterioration of refugee mental health. Our results highlight the potentially deleterious mental health impact of experiencing multiple subtle and substantial transgressions of one's moral frameworks. Policy makers should incorporate moral injury considerations to prevent eroding refugee mental health.

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