Report analyses mental health challenges faced by detainees in immigration removal centres in England
The Centre for Mental Health released a report earlier this week analysing the mental health challenges faced by detainees in immigration removal centres (IRCs) in England.
You can read the 50-page report here.
The Centre for Mental Health was commissioned by NHS England to conduct the analysis, and the resulting review aims to support NHS England and the Home Office in planning to meet the wellbeing and mental health needs of people held in IRCs.
The report finds that all immigration detainees experience significant distress, and many had previously faced trauma, torture and oppression in their countries of origin.
Depression, anxiety and post-traumatic stress disorder were found to be the most common mental health problems suffered by detainees, with challenges to wellbeing partly caused by loss of liberty, the feeling of staying in a prison-like regime, and uncertainty about the future.
In addition, confusion about legal procedures was found to cause a huge amount of distress to detainees.
The report states: "Solicitors commented on how frequently the law changed, making the process increasingly confusing for detainees. Detainees discussed how much stress the legal procedures caused and often felt there was no one they could ask for help. They discussed the long waits between communication from the Home Office and how often the Immigration Enforcement officers in the centre were not able to help. Mental health staff discussed how they felt 'clueless' and powerless to offer emotional support around detainees' cases. In some centres, detainees described how they were discouraged from mentioning their legal case in their therapy sessions, even though they felt the need to vent. As can be seen in some cases it clearly impacts upon their mental wellbeing. Offering both practical support (i.e. helping them to make a call to their solicitor) and emotional support (i.e. acknowledging their distress) in these sessions may help to alleviate some of the distress."
The Centre for Mental Health found that mental health provision across the IRCs it visited varied significantly from centre to centre, from predominantly medication management, to varying psychological therapy provision and emotional wellbeing groups.
Detainees said they didn't feel listened to or believed when they asked for help. The report notes: "Most detainees perceived that they were not listened to, not taken seriously and treated as if they were lying if they disclosed vulnerability to either heath care or security staff. And some staff members reported that it was easy to become part of a culture which disbelieved detainees."
The fact that detainees may be removed at short notice and face high levels of uncertainty about their future was found to cause significant challenges for mental health care staff working in IRCs.
Working in an IRC is said to be extremely ethically challenging for health care and mental health care staff, as they are working with people detained against their will, in extremely uncertain circumstances and with uncertain futures.
One clinician said: "You can do nothing to reassure them, well all you can reassure them of is that they won’t be here forever… I feel like I’m letting these people down as a clinician…"
The report makes a number of recommendations and calls for all IRCs to become psychologically informed: providing all staff with training about mental health and trauma and offering a wide range of effective interventions to support the wellbeing of detainees and staff.
Dr Graham Durcan, the author of the report, was quoted as saying: "People held in Immigration Removal Centres face serious challenges to their mental health. Many have been through traumatic events and all face an uncertain future. While not all will have a diagnosable mental illness, most will need some help for their mental health and benefit from interventions to support their wellbeing. At present, such help is patchy and often limited to specialist medical care.
"Our report concludes that IRCs need to be psychologically informed throughout. All staff should be trained in mental health awareness, proven psychological interventions should be offered when people seek help and crisis care should be available 24/7. We welcome NHS England's commitment to improving mental health support in all IRCs and hope that the stepped care approach will ensure no one is left without the help they need when they need it."