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Thursday, 25 July 2013

Children seeking asylum: trauma and adversity

Children seeking asylum: trauma and adversity

In the images of asylum seekers that are in the media at the moment, we are seeing many faces of adolescents, children and babies. It is a reminder that we need to be thinking more about what these children are experiencing. Some of them are travelling with their parents, some with other family members and some are alone. All of them have been on a journey that most of us can not begin to imagine. 

Children who are refugees or asylum seekers face huge adversities and traumatic experiences. Recently, the Network released this resource that discusses the refugee experience and how it impacts on children. Some of the adversities that are outlined in the resource include the impact of parental stress on children, children's exposure to violence and the potential exploitation of vulnerable children. 

What adversities are these children facing?

Children generally tend to follow a healthy pattern of development when they are in a safe, protective environment with adults who nurture them. Children need parents to respond appropriately and consistently to them, something that can be particularly difficult to do when they are under constant stress, living in uncertainty and finding it difficult to cope themselves. The nature of the refugee experience is one that places extreme stress on children and their families. The journey is usually arduous and may involve the loss or death of others making the same journey. The process for asylum seekers leads to further stress of prolonged detention and the uncertainty of the length of that detention and what the outcome will be at the end of this time. All of these contributing to the poor mental health of the parents and in turn the mental health of the child. 

Many children who are refugees or seeking asylum will also be exposed to violence. Often, their parents will have limited opportunities to protect their children from this violence. We already know from the research that exposure to violence can be particularly damaging to children. When this exposure is extreme or repeated, these traumatic experiences are likely to leave an indelible impression on the child. 

Children who are alone, or without a parent, become particularly vulnerable to exploitation at all stages of the refugee journey and whilst seeking asylum. They may experience physical or sexual abuse or witness violence or other inappropriate acts of others that their parents would otherwise shield them from. 

Long term impact of trauma

We know that many children can be resilient in the face of adversity, but we also know that the greater the number of adversities that a child faces, the more chance there is that there will be a detrimental impact on their outcomes. Trauma impacts on the physical and mental health of children, as well as their development, social functioning and their academic achievement. We know that the impact of trauma can last for a lifetime

It is everyone's role to make sure that children are protected from the harmful impact of trauma and adversity. We need to be thinking more about what can be done to protect this particularly vulnerable group of children. 

Wednesday, 10 July 2013

The ongoing impact of childhood trauma

We are now seeing a steady flow of research that is telling us more about the connections between childhood trauma and mental and physical health difficulties later in life. But, what is really great to see, is more research from here in Australia, talking about this.

New research that has just been published, has used an Australian community based survey (the 2007 National Survey of Mental Health and Wellbeing) to look at the relationship between child abuse and the long-term health care costs and impact on wellbeing.

This is what they have found:

".... that adults with a history of childhood abuse suffer from significantly more health conditions, incur higher annual health care costs and are more likely to harm themselves. Our results suggest that child abuse has long-lasting economic and welfare costs. These costs are greatest for those who experienced both physical and sexual abuse."

There have been many studies that have linked childhood trauma and child abuse to poor long term mental and physical health outcomes. The Adverse Childhood Experience (ACE) study in America has identified that childhood trauma contributes towards substance abuse, heart disease, smoking, suicide attempts, depression and many other illnesses in adulthood.

This new Australian research has not only shown a correlation between poor mental and physical health outcomes, but has also provided an estimate of the increased cost each year that childhood trauma is having. This research has found that for adults who were both physically and sexually abused as a child, the annual healthcare cost per person is approximately $1856 higher than for those in the general population. This means that childhood trauma has huge implications for the health care system and for the cost to the community as a whole.

What impact does childhood trauma have? 
The paper describes the many ways that childhood trauma can lead to poor adult health outcomes and increased health care costs. There is the immediate harm that is done to the child and the impact of the prolonged stress that the child lives under. This prolonged stress causes damaging, long term negative effects on the body, which become particularly apparent in the damage done to the heart and circulatory system. Prolonged stress also damages the immune system and leaves the child more vulnerable to a range of physical health problems that can last into adulthood.

Childhood trauma is also strongly associated with a range of mental health difficulties such as depression, anxiety and psychosis. Childhood trauma has negative impacts on self esteem and the child's ability to interact with others and develop appropriate interpersonal skills that are needed to develop and maintain the protective relationships of family and loved ones.

Adults who have experienced childhood trauma are also more likely to engage in more risk taking such as excessive drinking and drug taking, all of which we already know play a major role in contributing to poor health outcomes. They are also more likely to engage in self harming or suicide.

Another major area that childhood trauma impacts on, that is not mentioned in this current study, is the impact on educational engagement and success. Children who experience trauma or adversity are more likely to experience educational difficulties and poor academic achievement. This then impacts on their ability to be successful at school and go on to be a productive working member of the community.

What next? 
With the expanding body of research continuing to demonstrate that childhood trauma has such negative long term impacts, it is essential that more is done now to intervene early; to increase the knowledge around and awareness of these impacts; and to be more effective in treating children who have experienced trauma.