This week, Sky News Australia aired a report from Nauru – having been given rare access to the island nation – on the Australia-US deal to resettle refugees detained there and on Manus Island.

The reporter, Laura Jayes, had visited Nauru in the previous week. Her report contained footage of interactions with some asylum seekers and refugees responding to questions put to them on the resettlement deal. The report included claims the arrangement would be restricted to around 300 people in family groups.

Immediately after the story was broadcast, Immigration Minister Peter Dutton denied the cap of 300-400 people but would not confirm what numbers the US would take. But issues beyond the numbers of refugees involved in the deal exist, and must be tackled.

The importance of restoring hope

Jayes observed the basic needs of the refugees and asylum seekers were provided for on Nauru. However, “hope” was missing – this was “what they desperately want”.

Hope and trust are fundamental requirements for mental stability.

The UN High Commissioner for Refugees and other expert groups have been consistent in their view that many people on Nauru and Manus Island have suffered excruciating despair and hopelessness. This largely stems from not knowing where and when they may be able to restart normal lives.

Stories of refugees ‘rejecting America’

Jayes spoke to some on Nauru who were sceptical about the arrangement with the US. They expressed a lack of trust in the process.

One Rohingyan man expressed concern about whether, as a Muslim, he would be welcome in the US once President-elect Donald Trump took office in January 2017. Others expressed a desire to come to Australia only.

Jayes turned up in these refugees’ lives and wanted them to go to the heart of their dilemma within seconds or minutes. Some were clearly distressed; none had English as a first language – nor was there evidence of an interpreter being present.

The impacts of trauma on language and self-expression at the time of being interviewed on camera, as well as trust in the questioner, cannot be overestimated. Expressions of mental distress, as well as the effects of refugee and asylum seeker-specific stress, cannot be separated from talk of resettlement options.

Information is critical. Staff from the health provider International Health and Medical Services spoke of people needing “concrete proof”. A representative from the Australian Border Force said expressions of interest in the resettlement arrangement were strong, but some wanted legal advice.

The UN Special Rapporteur on the Human Rights of Migrants recently visited Nauru and observed:

The testimonies were often of despair due to the lack of or contradictory information concerning … their future.

Contradictory information was evident in the assertion that only 300-400 people would be resettled.

It is safe to assume those who want more information and legal advice need to disentangle the personal and family implications of accepting the US offer.

Potential uncertainty about whether Trump will adhere to the deal has been the subject of some debate. The assistant UN High Commissioner for Refugees, Volker Türk, was optimistic that the new administration would resettle the refugees from Manus Island and Nauru.

A trauma-informed approach is the way forward

The UN special rapporteur recently said:

Any agreement regarding third country resettlement must be meaningful – in terms of numbers, timeliness and opportunities to rebuild – and adhere to Australia’s international humanitarian and human rights obligations.

There must be genuine efforts to ensure transition from uncertainty to permanent status for refugees as soon as possible.

Accurate and clear advice and other information, including access to legal advice, must be given if requested. This will go a long way to reduce ambiguity and help resolve the fear and anxiety the trauma will have generated.

There must be strong consultation with refugees in an atmosphere that is not adversarial. Personal, trusting relationships are critical.

The resolution of “life on hold” for the refugees on Manus Island and Nauru should be a very positive conclusion to a long-running and psychologically traumatic experience. However, some factors may make it less than smooth.

People who are temporarily in Australia may need to return to Manus Island or Nauru if they are to have access to the new deal. This may be a difficult and complex process to negotiate – particularly for children.

Priority is being given to families and children, often viewed as the most vulnerable. However, there are many adults, mostly men but some women, who are also very vulnerable and traumatised.

Those managing the process – starting with US officials undertaking the assessment – need to do so with a full understanding of the effects of trauma. An important start will be to ensure the settlement process is experienced as something done with them, not to them.

The US government asserts that refugees share many of America’s values: courage, resilience, openness to new experiences, and the determination to rebuild their lives in a new place.

This is a valuable sentiment. It should be front of mind as the US government undertakes the process of resettlement so that it helps heal the trauma and bring an end to the excruciating uncertainty these refugees have endured.