Calls are growing louder for Canberra to bring all refugees - who had sought asylum in Australia but were detained offshore - into the country for medical treatment and processing.
Policies which have been implemented bilaterally, in Australia, have caused considerable mental harm to people who've experienced immigration detention, according to Monash University Head of Psychiatry Suresh Sundram.
"There is no doubt there is an element of attribution to those policies as to why these people are now so unwell," he said.
Professor Sundram, who has conducted extensive research into asylum seeker and refugee mental health, said mental symptoms or mental disorders in refugees held by Australia in Nauru and those left in Papua New Guinea (PNG) continue to deteriorate.
He said Canberra wiping its hands of its responsibility for those still in PNG is not okay.
On top of providing appropriate medical treatment for refugees offshore, he said, those that have been moved to Australia and were under temporary residential arrangements need to be given permanent protection.
"Such that they can restart their lives after more than a decade of uncertainty regarding their situation," Professor Sundram said.
A complex issue
The issue of mental health support for refugees is complex.
Refugees can experience pre-migration trauma, migration trauma and post-migration trauma, with mental symptoms or mental health disorders prevalent in many cases.
Professor Sundram said simply labelling refugees as "having mental health issues" does not explain the nuances, which were important, particularly for people who have been through a great deal already.
Refugee Action Coalition spokesperson Ian Rintoul said there are approximately 86 people in PNG, after they were moved from Manus Island to Port Moresby, and 22 in Nauru.
"We need more than an apology. We need active measures to rectify the injustice," Rintoul said.
Many more have been moved to Australia mostly for medical reasons and they too remain in limbo.
Amnesty International Australia refugee rights advisor Graham Thom has been calling for Canberra to step up for a while.
"It really is life and death for those men that are just so unwell," Thom said.
"They are in this terrible limbo that has meant there is more self-harm and there are more attempts on their lives because they are just so desperate."
Some of those on a pathway to New Zealand, Canada or the United States are only just managing to hold on to hope but many still need mental health care which they cannot receive in PNG, Thom said.
Two refugees and their families were transferred to New Zealand on May 29, Rintoul said.
Refugees who were on Manus Island and are now in Australia can be resettled under the Australia-New Zealand resettlement arrangement.
But those who are still in PNG are not included in that deal, Immigration New Zealand (INZ) said.
"It has been pretty traumatic for those individuals to be stuck there and now told that Australia has washed their hands of them," Thom said.
INZ is considering cases submitted by the United Nations High Commissioner for Refugees located in PNG, as part of the Asia-Pacific component of the Refugee Quota Programme.
An INZ spokesperson said in a statement to RNZ on May 30 that: "35 cases covering 58 people have been submitted from PNG. Six cases covering 15 persons have been approved and 14 have arrived."
While the focus was on resettling refugees eligible under the Australia-NZ deal, Thom said it was important not to forget there were also refugees stuck in PNG.
"Thankfully, countries like New Zealand have stepped up to make sure that there is a solution [for] at least for some of the men who are trapped in PNG," he said.
Thom wants Australia to again accept responsibility for the men who have been left behind in PNG and Professor Sundram agrees.
He said refugees need to be given permanent protection so they can restart their lives, and he wants Australia to close its offshore detention arrangements for good.
"They are using the Nauru regional processing centre as an element of the so-called deterrence policy; I am not convinced that that is an effective component of their policy.
"It would seem to me a comparative waste of money to keep it open," Professor Sundram added.
Nauru deal
But Australia does not plan on ending its offshore detention deal with Nauru anytime soon.
"Enduring regional processing capability in Nauru is a key pillar of Operation Sovereign Borders," a Department of Home Affairs spokesperson said.
It said Canberra is focused on supporting the Nauru government to resolve the regional processing caseload.
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