New evidence shows extreme mental health suffering on Nauru due to the Australian policy of indefinite offshore processing.

Among the 208 asylum seekers and refugees Médecins Sans Frontières/Doctors Without Borders (MSF) have treated on Nauru, the group says 124 had suicidal thoughts and 63 had attempted suicide.

Twelve adults and children who MSF treated were diagnosed with resignation syndrome, existing in a semi-comatose state and unable to eat or drink.

Although three-quarters of refugee and asylum seeker patients reported experiencing traumatic events before reaching Nauru, such as conflict situations or detention, MSF’s report shows that it was the situation on Nauru that was most damaging to their mental health.

A total of 65 per cent of asylum seekers and refugee patients felt they lacked control over their lives, and these patients were significantly more likely to be suicidal or diagnosed with major psychiatric conditions.

“The medical data we release today confirms the heart-breaking reality that I witnessed on Nauru. Every day I worried which of my patients might attempt to take their own lives because after five years of waiting people had lost all sense of hope,” says Dr Christine Rufener, clinical psychologist and MSF Mental Health Activities Manager.

“While many of our patients had experienced trauma, it was the Australian policy of indefinite processing that destroyed all their hope for the future and devastated their mental health.”

More than one-third of asylum seeker and refugee patients were separated from close family members.

Many have been split from their families because some members were medically evacuated from the island.

The advocates say this is a tactic used by the Australian government to coerce medically evacuated refugees to return to Nauru.

Those who were dislocated from families were 40 per cent more likely to be suicidal.

In 11 months on Nauru, MSF provided mental healthcare to 285 patients, including Nauruans, refugees and asylum seekers. A total of 1,526 consultations were provided for refugees and asylum seekers, and 591 for Nauruans.

The mental health situation of Nauruans was also concerning; almost half MSF’s Nauruan patients had psychosis, with many requiring psychiatric hospitalisation that was not available.

More than half of MSF’s Nauruan patients showed improvements in their mental health functioning under MSF’s care, while only 11 per cent of asylum seeker and refugee patients improved.

“Our Nauruan patients’ mental health improved in a way that was not mirrored in our asylum seeker and refugee patients, despite receiving the same quality of care. This illustrates that living under a policy of indefinite processing creates a perpetual state of despair, making it impossible for asylum seekers and refugees to recover,” said Dr Stewart Condon, MSF Australia President.

“The current mental health crisis on Nauru is tragically predictable. After five years of arbitrary deprivation of liberty, the situation is desperate. The Australian government must stop this brutal policy and immediately evacuate all refugees and asylum seekers from Nauru, as well as Manus island. There is no time to waste.”

The full report is available in PDF form, here.