We extracted data from clinical records (including clinician notes and letters, referrals, health assessments/reports, available detention health documentation, Australian Immunisation Register (AIR) records, and/or school feedback/reports) using a standardised audit form created within the CAReHR™ database. This form included demographic information, details on detention (duration and location), reported trauma experience, symptoms, physical or mental health diagnoses made during clinical review, and treatment and other supports provided. We included data from any time during or after held detention to capture the spectrum of impact.
We reported a range of clinical outcomes selected by clinical consensus, previous Australian refugee health research, and national guidelines for new arrival screening [20 (link), 21 (link)]. We focused reporting on outcomes that were present at the time of first clinical assessment or became apparent in subsequent evaluation, documenting longer-term evolution of symptomatology where possible. Mental health diagnoses were included if they had been made by a child psychiatrist, paediatrician or psychologist, or where symptoms met Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria [22 ]. Developmental disorders were included if diagnosed by a paediatrician or through a standardised multidisciplinary assessment (e.g. Autism Diagnostic Observation Schedule). Whilst standardised measurements for childhood trauma are often not validated for refugee/asylum seeker populations, our survey broadly covers domains of the Adverse Childhood Experience Rating Scores [23 (link)]. Absence of documentation was considered to be negative for symptoms and diagnosis. Six clinicians (ST, HG, GP, RH, TV, ILR) completed the initial data extraction; three investigators (ST, HG, GP) performed a secondary review to check for accuracy.
We reported a range of clinical outcomes selected by clinical consensus, previous Australian refugee health research, and national guidelines for new arrival screening [20 (link), 21 (link)]. We focused reporting on outcomes that were present at the time of first clinical assessment or became apparent in subsequent evaluation, documenting longer-term evolution of symptomatology where possible. Mental health diagnoses were included if they had been made by a child psychiatrist, paediatrician or psychologist, or where symptoms met Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria [22 ]. Developmental disorders were included if diagnosed by a paediatrician or through a standardised multidisciplinary assessment (e.g. Autism Diagnostic Observation Schedule). Whilst standardised measurements for childhood trauma are often not validated for refugee/asylum seeker populations, our survey broadly covers domains of the Adverse Childhood Experience Rating Scores [23 (link)]. Absence of documentation was considered to be negative for symptoms and diagnosis. Six clinicians (ST, HG, GP, RH, TV, ILR) completed the initial data extraction; three investigators (ST, HG, GP) performed a secondary review to check for accuracy.
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