'Locked Up Without Guilt or Sin': The Ethics of Mental Health Service Delivery in Immigration Detention

Abstract

Immigration Detention Centres are a historically recent phenomenon in Australia, but they possess many of the characteristics of older closed institutions of incarceration. Modern principles of administrative law and government service delivery have not informed the manner in which the centres have operated. This has had many consequences, not the least being manifest inadequacies in detention centre mental health services. The Commonwealth's failure to create agreements with the states in order to ensure access to state mental health services, the isolation of immigration detention health services from state health legislation and policy, and the delivery of detention health care by means of private contractual arrangements have in combination resulted in highly unregulated mental health services for detainees. Mental health clinicians working with detainees have been confronted by ethical challenges less commonly encountered in orthodox treatment settings. This article describes such challenges as they have arisen during the 8 years in which detention centres have been privately managed.