The Erosion of Health in Detention (and the Erosion of Oversight)

By Benjamin Pynt

The idea that detention causes harm is not new. In a rare public statement in July 2014, the President of the Royal Australia and New Zealand College of Psychiatrists stated, “any sustained period of detention has the potential to be harmful to their mental health.”

The constant threat of offshore detention at Manus Island or Nauru (or equally Christmas Island) as a behavioural deterrent has deepened the despair suffered by thousands of asylum seekers in the onshore immigration detention network.

Despite the abject secrecy adopted by this government in relation to the health and welfare of asylum seekers, a lot of information exists about detention. Every facet of detention centre operations are logged daily, recorded on CCTV and discussed at managerial meetings at various levels. But that information is not normally publicly available.

Today long-term detention is not the exception but the rule.

In the wake of the Cornelia Rau affair in 2004-2005, the Palmer Inquiry was tasked with reporting on the causes of the failures that led to a mentally ill Ms Rau being detained for a lengthy period in a Brisbane prison and then at Baxter before being identified as Australian. The Inquiry found “deep seated attitudinal problems within [the Department of Immigration]” that contributed to high rates of mental illness in detention. Those high rates of mental illness made Ms Rau fit the profile of an asylum seeker who was simply suffering from the strain of detention.

The Detention Health Advisory Group was set up in response to the Cornelia Rau affair as a strong independent oversight mechanism. It was recently disbanded by the Abbott Government and replaced with a single military health advisor. There is, however, one body that has unparalleled access to detention that conducts its affairs in public. The Commonwealth Ombudsman has access to every asylum seeker in detention, and is mandated to report on their detention, health and visa history every six months pursuant to section 486O of the Migration Act.

Those reviews are tabled in Parliament, but barely see the light of day. Last year there was one news report recording their passing. Not even the Ombudsman conducts longitudinal analysis of its own reviews. The Minister personally acknowledges and responds to the tabling, but is only forced to deal with individual reports when the Ombudsman makes a substantive recommendation, which is not often (about 13% or 88 reviews in 2013).

Reviews tabled by the Ombudsman in 2013 record mental harm on a truly shocking scale

Where the Ombudsman does make a substantive recommendation, the Minister responds with comments so laden with misdirection they would fit better in a Kafka novel than they do in a Parliamentary Tabling Statement:

I note the Ombudsman’s recommendation in regard to each of these persons. The Government’s policy is currently being implemented in regard to the detention placement of detainees. Once implemented, and if appropriate, my Department will prepare advice to me, in relation to these persons’ detention placement” (The Hon. Scott Morrison MP, 4 December 2013).

The Ombudsman is so overstretched that more than a third of reviews were presented in a simplified format. The reason is clear: the number of people in long-term immigration detention has been growing too rapidly to manage. In 2013 there were 686 section 486O reviews, while in 2012 only 297, in 2011 there were 52 reviews, and in 2010 there were a mere 28.

What does this tell us? In 2010 the 28 asylum seekers who had been in long-term detention were likely people with adverse security assessments or unusual problems with their cases that required prolonged examination. Today long-term detention is not the exception but the rule.

The section 486O reviews tabled by the Ombudsman in 2013 record mental harm on a truly shocking scale. Importantly, children recorded mental health problems at roughly the same proportions as their parents.

686 reviews were tabled in 2013 covering 754 asylum seekers who had all been in detention for at least two years, at an average of 32 months. The longest had been in detention for close to 9 years. 72 per cent had mental health problems including post-traumatic stress disorder (59 per cent), depression (55 per cent), anxiety (40 per cent) and sleep problems (35 per cent).

More than two thirds of reviewees (68 per cent – 516 people) had mental problems as a direct result of, or exacerbated by, their detention. Asylum seekers in long-term detention suffer mental health problems at roughly four times the rate of the general population in Australia.

37 per cent of asylum seekers reviewed had attempted self-harm and 9 per cent had attempted suicide, often more than once. People in long-term detention attempt self-harm or suicide at six times the rate of Australians, and double the rate of Australia’s prison population.

In 67 cases (13 per cent) mental health professionals recommended that the person be moved to a less restrictive environment due to the harm detention was causing.

A batch of reviews tabled in December 2013 covered 10-15 year old unaccompanied minors, most of whom had been in detention for more than thirty months, and were on removal pathways. All were affected by their experience in detention. Some of these children participated in hunger strikes, while others attempted self-harm, or suffered adjustment and anxiety disorders. No recommendations were made and the Minister made no comment.

Mental health in detention is not a problem, it’s an entirely predictable and preventable epidemic. The root cause of the massive rates of depression, anxiety, insomnia and self-harm is the same as it was ten years ago: a policy of harming a few to deter the many.

This harm is inflicted in the form of a punitive detention environment, behind layers of razor-wire and electrified fences. It is inflicted in dehumanising practices such as addressing asylum seekers by number and not by name, and as “illegals” and “detainees” rather than human beings. It is also in the rationing of sanitary products and nappies, and the lengthy delays in doing everything from getting basic items such as clothing to actually getting to see a doctor.

The worst harm is inflicted in the series of threats including constant transfers, deportation, or being sent to an offshore processing centre.

On top of this, the mandatory and indefinite nature of detention has led to overcrowding, long delays in processing and an overburdening of the support systems inside detention, including (and perhaps especially) healthcare.

Despite the overwhelming need for independent oversight in this time of increased strain, the power of oversight mechanisms that exist is being eroded or dismantled altogether. The Ombudsman is no longer capable of comprehensively handling the large numbers of asylum seekers in long-term detention, and this burden will grow exponentially as those first affected by the No Advantage principle reach their second year in detention this month.

The government cannot plausibly deny knowledge of the inevitable ill effects of detention. Although the Minister may gloss over the content of the Ombudsman’s reviews, they are a powerful official record of the harm caused as a matter of policy.

As each asylum seeker enters detention the government should have pause to think: in the future, will this person claim damages for their treatment under our policy? Or even: will this person’s detention be the catalyst for an action for crimes against humanity?

These are serious questions that demand consideration.

The full report is available at www.humanitarianresearchpartners.org/publications

Benjamin Pynt is Director of Human Rights Advocacy, Humanitarian Research Partners.

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