Two prominent psychiatrists have accused the Federal Government of ignoring evidence of an unfolding mental health crisis among children on Nauru.
Background Briefing has obtained dozens of mental health assessments completed by child refugees and asylum seekers on the island and their parents.
The so-called Strength and Difficulties Questionnaires provide a snapshot of how kids in the offshore processing facility were faring between 2015 and 2017.
Dr Peter Young was the director of International Health and Medical Services (IHMS), the company providing health care across Australia's immigration detention centre network, between 2011 and 2014.
He said the leaked documents are consistent with reports from clinicians at the time.
"It's really significant to see this data because it's exactly the sort of data the government and the department doesn't want to see in the public domain," he said.
The questionnaires asked children and their parents to respond with "certainly true", "somewhat true", or "not true" to a range of statements relating to their mental health.
Nurses collated the results and assigned a score to each child, with anyone placed between 17 and 40 representing a "substantial clinical risk".
Of the 41 children surveyed over the two-year period, 37 were placed in that category.
"This reinforces the fact the regime of keeping people in Nauru and detention generally causes harm to their mental health, particularly children," Dr Young said.
According to Dr Young, questionnaires like these, along with reports from clinicians, would typically be presented to senior bureaucrats at what was then the immigration department.
"I have personal experience of advising those people of this and was directly told this was not what they wanted to hear," Dr Young said.
"I was told we should not present data in such a way that it can be analysed over time because when you did that, of course, you could see the deterioration."
The Department of Home Affairs initially did not respond to specific enquiries from Background Briefing regarding the questionnaires, but released a statement late today, denying the allegations raised by the program.
''Claims that the Department sought to cover-up mental health data are incorrect," a spokesperson said.
''The Department has appropriate mental health assessment and treatment in place and continues to use expert advice to maintain currency of services.''
Immigration Minister David Coleman declined to be interviewed.
Advocate stops short of calling for all kids to be removed
As opposition to the offshore detention of children grows, National Children's Commissioner Megan Mitchell surprised commentators by appearing to suggest it would be okay for some kids to remain on Nauru.
Speaking on ABC News Breakfast this morning, Ms Mitchell said conditions there were not necessarily harmful to every child.
"There has to be a case-by-case basis here," she said.
"There may be some children who are not having deleterious impacts on their health by being there."
When pressed by host Virginia Trioli to clarify her position, Ms Mitchell stopped short of calling for the removal of all kids on the island.
"If there are concerns about their health needs and their rights being protected, they need to be transferred to Australia," she said.
On Friday, Prime Minister Scott Morrison said more than 200 children had been taken off Nauru to date.
"We've been doing it for a long time through our agreement with the United States," he told the Nine Network.
"We actually have more medical staff on Nauru than we have children."
Requests for medical evacuations denied
Maya, not her real name, spent almost half her life on Nauru.
In January 2016, her parents filled out a questionnaire on her behalf, which returned a score of 25.
"That suggests there is something extremely severe going on for that young person," said Dr Vernon Reynolds, a psychiatrist turned whistleblower who worked on Nauru.
Two years later, Maya was still on the island.
"It's like we're in a zoo," she told Background Briefing.
"Even animals, they shouldn't be treated like this."
Around 50 children have been sent from Nauru to Australia for medical treatment since 2017, according to figures from the Asylum Seeker Resource Centre.
Eleven of those children arrived this week while 52 remain there.
During her time at the facility, Maya lived in a tent and later a demountable on the site of an abandoned phosphate mine.
After years of boredom and despair, she said her friends began to self-harm.
"Kids have tried to burn themselves," she said.
"Twelve-year-old girls have tried to do stuff they're not meant to do to themselves."
A mental health program for young refugees and asylum seekers was introduced on Nauru in October 2016.
The program was staffed by fly-in, fly-out psychiatrists but Dr Reynolds claims it was cut without explanation in March the following year.
Dr Reynolds said it soon became impossible to secure overseas medical referrals for "critically ill" children.
He made up to 15 requests and all but two were knocked back.
"There was no action happening," he told Background Briefing.
"I would come back three months later and these incredibly sick kids would be just rotting in their rooms."
Dr Reynolds began writing reports to his employer, IHMS, in a desperate bid to have the children brought to Australia, but says he was told the Australian Border Force (ABF) was uncomfortable with his actions.
The ABF did not respond to specific questions about the questionnaires and whether the Government knew there were children on Nauru assessed as being at severe risk of mental illness up to three years ago.
In April this year, Dr Reynolds says the ABF blocked him from returning to the island, effectively denying him access to his patients.
"I had this naive kind of belief the Government had a caring paternal role over these people," he said.
"It was only over time I realised that, actually, the Government's really punishing these people and has no real interest in their wellbeing whatsoever."
PM under pressure to find a fix
The Prime Minister is facing growing calls to bring every child being held in detention on Nauru to Australia.
The presumptive winner of the recent Wentworth by-election, Dr Kerryn Phelps, said on Sunday their relocation would be her "first order of business".
If the result goes her way, the Coalition will lose its one-seat parliamentary majority.
Under that scenario, crossbenchers Cathy McGowan and Rebekha Sharkie have said their support for the Government would be tied to the fate of young detainees on Nauru.
Mr Morrison, who is also under internal pressure to intervene, recently put the prospect of resettling asylum seekers in New Zealand back on the table.
But the proposal would include a lifetime ban on those asylum seekers entering Australia — something Labor has described as "overreach".
While an agreement is yet to be reached, Dr Young believes the recent influx of children into Australia from Nauru suggests the Government is finally relenting.
"They need to get these people off Nauru as quickly as possible, they need to process them properly through immigration, and they need to do everything they need to do to remediate the harm they've done to them," he said.
