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Submission to the National
Inquiry into Children in Immigration Detention from
Anita
Chauvin
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
Developing Brains of Children and Young People and the Immediate and
Long-Term Effects of Trauma
Effects
Some People Survive Trauma Better Than Others: Programs Which Support
Children and Young People Who Are Traumatised
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).
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).
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.
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 |
|
Parental characteristics:
family environment:
parenting style:
|
|
|
|
|
P
R O T E C T I V E F A C T O R S |
||||
|
|
|
|
|
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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