A refugee girl held on Nauru was at “extreme risk” of making further suicide attempts if left on the island, a judge has said, ordering the Australian government to move her off the island and into specialist psychiatric care.

The girl, not yet a teenager, had made repeated attempts on her life, and continued to explicitly threaten suicide.



She arrived in Australia with her family by boat in 2013 and had been held on Nauru since that time.

In a federal court hearing, Justice Bernard Murphy heard the girl was “crying and screaming most of the time”, and that her mother had been forced to sleep by her side to stop her from harming herself.

Murphy granted an urgent injunction sought by lawyers of the girl’s family’s to transfer her to a specialist child mental health facility because she could not be adequately cared for on Nauru. The judge’s orders were made just before Christmas, but the reasons were published only on Friday.

The home affairs department has confirmed the girl has been transferred to Australia. The Guardian understands she continues to receive care in an Australian hospital.

“There is an extreme risk this unfortunate young girl will commit suicide or otherwise self-harm, or that her mental health will further deteriorate,” Murphy said.

“Being stuck on Nauru since 2013, coupled with the recent separation of her parents, appears to have taken a serious toll on the applicant’s mental health.”

He said the cost to the Australian government of moving the girl and having her treated in Australia, or the impact upon its policy of keeping refugees who arrived in Australia by boat offshore, was outweighed by the need to protect a vulnerable girl.

“The injury or damage the applicant may suffer if an injunction is refused – death or a further serious deterioration in her health – carries far more weight in the balance than the wasted expenditure the commonwealth may suffer if an injunction is granted.”

Notes from a psychologist employed by the Australian government’s offshore health contractor, IHMS, were tendered in court. Child psychologist Sharyn Bunn’s notes said: “[The child] stated that the voice tells her ‘dying is better than living, you’ll be free’. [The child] stated that she wants to die and she wants to kill herself and that if she was going to kill herself she would ‘make myself lost in the jungle and put a knife in my stomach’. [The child] blames the Australian government for her state of mind and says that she is trapped in no land and that she thinks about dying.”

Psychiatric care on Nauru is limited. A former senior medical officer with IHMS, Dr Nick Martin, told the court there was no permanent child psychologist available on Nauru, a fact conceded by the commonwealth.

“In my opinion, Nauru is ill-equipped to handle complex mental health cases, particularly child mental health, and does not have the facilities to handle a complex child psychiatric case,” Martin said.

The child needed to be transferred to Australia, he said.

The court heard from the girl’s mother who said she was told the Nauru hospital discharged her daughter because it “could not provide the mental health care she required”. The girl’s mother said “she was advised to keep [her daughter] away from items which could harm her”.

Professor Louise Newman, a developmental psychiatrist from the University of Melbourne, wrote five reports regarding the child’s condition.

“I remain of the view that her condition is extremely serious and not one that can be safely managed in a community setting on Nauru. The recent episode indicated that the risk remains at a crucial level … I stress that suicidal acts in young children are rare and extremely serious events which require specialist psychiatric assessment and treatment.”

For the commonwealth, the Australian Border Force’s assistant commissioner of detention and offshore operations, Kingsley Woodford-Smith, said there were several free healthcare options available to refugees held on Nauru.

He said the girl was being seen daily by a psychologist and that she could be adequately treated as an outpatient in the Nauruan community.

Woodford-Smith’s evidence to the court was that “too much additional attention may escalate [the girl’s] behaviour”.

“I prefer Prof Newman’s evidence,” Murphy said, “considered in light of the clinical notes, to that of Mr Woodford-Smith. The evidence indicates that the applicant’s psychiatric condition is very serious, that she poses an extreme suicide risk, and that her condition is such that she should be immediately admitted into a specialist child mental health facility for assessment and treatment.”

The girl’s case was brought by George Newhouse, principal solicitor with the National Justice Project.

Through Newhouse, the family of the girl issued a statement: “This is an extremely sensitive matter which is set out in some detail in the judge’s observations. Given the nature of what is disclosed in the decision, the family have asked that they have some privacy at this time.

• Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636