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In a recent to an on the health of asylum seekers, she spoke about the serious mental and physical harms affecting a majority of adults and children being held in detention. The forum closely followed The High Court鈥檚 recent in favour of the Australian government regarding the legality of offshore detention and processing of asylum seekers. In her speech Professor Elliott noted the following:

鈥淎s a result of the ruling, 267 asylum seekers, including almost 100 children, who were transferred to the Australian mainland for medical care, face imminent return to offshore detention centres. This group of asylum seekers all arrived by boat in Australian waters without a valid visa after July 19, 2013 and have been caught up in the law that states they will 鈥榥ever be settled in Australia鈥� regardless of their refugee status.

鈥淎lthough up to 90 per cent of similar cohorts have previously been found to be genuine refugees, the government has capitalised on the current law by sending this group of people to live off-shore 鈥� first on Christmas Island, now on Nauru or Mannus. This action has been explicitly billed as a 鈥榙eterrent鈥�, though ironically Immigration ministers from both sides of government have admitted that the evidence for this is lacking.

鈥溌爓ho visited Nauru in 2013 concluded that: 鈥楾he harsh and unsuitable environment is particularly inappropriate for the care and support of child asylum-seekers (and that) no child, whether unaccompanied or within a family group, should be transferred from Australia to Nauru.鈥�

鈥淎s a result of our policy, hundreds of children have been deprived of their human rights 鈥� denied the right to be treated fairly, to safety and protection, to privacy 鈥� denied the right to education and play, and to accessible, appropriate health care. More than that, research shows that prolonged detention 鈥� and the average is about two years 鈥� irreparably harms the health and mental health of these children, and as a pediatrician I know that the impacts will be lifelong.

鈥淎t the invitation of Professor Gillian Triggs I accompanied her and her team to Christmas Island in July 2014, as part of the聽. There we conducted detailed interviews with over 100 families with nearly 200 children.

鈥淐hristmas Island is billed as a tropical paradise. But Christmas Island was no party. Unbearably hot, humid, dusted with phosphate powder from the mines, and populated by the most extraordinary range of animals (and humans I might say). High wire fences, high security, guards, small 3 by 2.5 metre metal cabins for a home.

鈥�, the Australian Human Rights Commission published their Inquiry into Children in Immigration. Much of the data was provided by the Immigration Department and the International Health and Medical Service themselves, who reported that:

• On formal assessment, 34 per cent of children in detention had moderate to very severe mental health disorders 鈥� compared to less than two per cent in the general Australian population. This was manifest in diagnoses of anxiety, depression, Post Traumatic Stress Disorder, Attention Deficit Hyperactivity Disorder, Conduct Disorder and attachment disorder; disruptive behaviour, and problems with sleep and attention. Physical symptoms included stalled or regressive development, bed-wetting, social withdrawal, mutism and food refusal
• 38 per cent of children interviewed said they were always sad or crying and 21% were always worried; 13 per cent had lost weight
• In one 15 month period, the Immigration Department recorded 233 assaults involving children in Australian detention centres, including 33 reported sexual assaults (mostly in children)
• During the same period 128 children had self-harmed, 105 of whom were deemed to be at 鈥榟igh imminent鈥� or 鈥榤oderate鈥� risk of suicide or self-harm, sufficient to warrant monitoring.

鈥淭he key recommendation was that all families with children be assessed as soon as possible and released into community detention or to the community on bridging visas.

鈥淧olitics aside, we all have a responsibility for the well-being of children in the 鈥榗are鈥� of Australia.鈥�

聽AM is Professor of Pediatrics and Child Health at the University of Sydney Medical School and Consultant Pediatrician, , Westmead.