Asylum seekers and healthcare

To the Editor: I am writing as a member of the Australian Medical Association, and hence a subscriber to the MJA, to express my concern over the recent publication of the participant–observer account of psychological disturbances in asylum seekers,1 and the subsequent media reporting of the issue as a consequence of the publication.

I would like to say at the outset my views are personal.

Like most healthcare professionals, I consider access to basic medical care, including care for those with mental illness, is a human right. However, I do not support the use of a peer-reviewed journal such as the MJA for political purposes. The right of freedom of speech is fundamental in a democratic society; however, if the AMA wishes to push a political issue then such articles should be published not in the MJA but in Australian Medicine, with appropriate recognition that the issue is medicopolitical and not scientific.

My concerns relate to the responsibility I consider peer-reviewed journals such as the MJA have in ensuring that articles, which include reports of alleged research, are scientifically valid. As can be seen by the media coverage on this issue, the fact that the "research study" was published in the MJA gave the impression to the general public that it was a valid scientific study and should be taken seriously.

I have a number of specific issues of concern in relation to the article.

• Firstly, there is the fact that the principal author and researcher, in being a detainee with serious concerns over his treatment by the democratically elected government of this country, obviously has considerable potential bias in reporting observational research of this kind.

• Secondly, there is no attempt to assess the baseline mental health of the detainees before coming to Australia, but an assumption that all the symptoms observed are a result of detention.

• Thirdly, it would appear that there was no attempt to validate the observational research using more rigorous psychological testing.

• Finally, the methodology of the survey is not outlined, nor is the sample size discussed from the point of view of statistical validity.

Admittedly, there was an acknowledgement of the survey's limitations; however, I do not consider that this article should have been published in the MJA. It does the Editorial Committee no credit and the Journal less so.