Australian Immigration Detention Centres Research Articles

Health and health care in Australian immigration detention: a comparison between onshore and offshore data

PurposeThis study aims to compare the impact of Australian onshore and offshore immigration detention centres (IDCs) on detainees’ health and health-care events.Design/methodology/approachIt uses data extracted from the Australian Government’s quarterly health reports from 2014 to 2017. These reports contain a range of data about the health and well-being of detainees, including complaints/presenting symptoms and number of appointments and hospitalisations. To compare onshore and offshore data sets, the authors calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population. They ran a series of two-proportion z-tests for each matched quarter to calculate median z- and p-values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant.FindingsThe results suggest that adults detained onshore and offshore have substantial health needs, however, almost all rates were far higher in offshore detention, with people more likely to raise a health-related complaint, access health services and be prescribed medications, often at two to three times the rate of those onshore.Originality/valueThis paper adds to a modest body of literature that explains the health of people detained in Australian IDCs. To the best of the authors’ knowledge, this is the first paper to explore health service utilisation and a range of other variables found in the Australian Government’s quarterly health reports. These findings bolster the evidence which suggests that detention, and particularly offshore detention is particularly harmful to health.

Resistance and the delivery of healthcare in Australian immigration detention centres

There are few issues that have been as vexing for the Australian healthcare community as the Australian governments policy of mandatory, indefinite, immigration detention. While many concepts have been used to begin to describe the many dilemmas faced by healthcare professionals and their resolution, they are limited, perhaps most fundamentally by the fact that immigration detention is antithetical to health and wellbeing. Furthermore, and while most advice recognises that the abolition of detention is the only option in overcoming these issues, it provides little guidance on how action within detention could contribute to this. Drawing on the work of political theorists and the broader sociological literature, we will introduce and apply a form of action that has not yet been considered for healthcare workers within detention, resistance. We will draw on several examples from the literature to show how everyday resistance could be enacted in healthcare and immigration detention settings. We argue that the concept of resistance has several conceptual and practical advantages over much existing guidance for healthcare workers in these environments, namely that it politicises care and has synergies with other efforts aimed at the abolition of detention. We also offer some reflections on the justifiability of such action, arguing that it is largely consistent with the existing guidance produced by all major healthcare bodies in Australia.

Health of children in Australian immigration detention centres: An analysis of the quarterly health reports from 2014 to 2017.

AimThis study examines 3 years of child and adolescent health data from Australian onshore and offshore immigration detention centres from 2014 to 2017, quantifying the health presentation data of children and adolescents in Australian immigration detention and comparing rates between onshore and offshore detention.MethodsThis study utilised the Quarterly Immigration Detention Health Reports over a period of 3 years. To compare onshore and offshore datasets, we calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population of children. We ran a series of two‐proportion z‐tests for each matched quarter to calculate median z and P values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant.ResultsThe estimated number of children detained per quarter onshore ranged from 700 in 2014 (quarter 3) to 13 in 2016 (quarters 3 and 4); the estimated quarterly population of children in offshore detention ranged from 186 in 2014 (quarter 3) to 42 in 2017 (quarter 2). Children offshore had significantly higher rates of consultations with a mental health nurse (z = −1.96; P = 0.002), psychologist (z = −2.32; P = 0.01) and counsellor (z = −3.41; P < 0.001). As for reasons for presentation to general practitioners and psychiatrists, complaints related to skin (z = −1.97; P = 0.05), respiratory issues (z = −1.96; P = 0.05) and urological issues (z = −2.21; P = 0.03) were significantly higher amongst children detained offshore.ConclusionsCompared to children in the Australian community, children detained both onshore and offshore had greater health needs. Children offshore also presented more frequently with a range of complaints and accessed health services at higher rates than children detained onshore; this adds to growing evidence about the harms of offshore detention and detention more generally.

Do codes of ethics and position statements help guide ethical decision making in Australian immigration detention centres?

Australian immigration detention has been called state sanctioned abuse and a crime against humanity. The Australian healthcare community has been closely involved with these policies, calling for their reform and working within detention centres to provide healthcare. As well as having a devastating impact on health, immigration detention changes the scope and nature of healthcare, with its delivery described as a Sisyphean task. In this article I will explore the guidance that is available to clinicians who work within detention centres and argue that codes, guidelines and positions statements provide little help in relation to ethical decision making. First I will outline guidance that can be found in codes of ethics and position statements, focusing on particularly relevant principles, such as advocacy, clinical independence and the clinicians’ relationship to human rights. I will then highlight the disparity between this guidance and the delivery of healthcare within detention by drawing on the testimony of clinicians who formerly worked in these environments. While this disparity should be cause for alarm and at a minimum call into question how codes and positions statements are being used (if at all), there are more fundamental reasons why codes and position statements fail to provide guidance in these circumstances. I will outline a more general criticism of codes of ethics and use this to suggest a way forward, including looking beyond codes and position statements to guide action within Australian immigration detention.

What is it like living in detention? Insights from asylum seeker children’s drawings

ABSTRACTDespite considerable research on the impact of Australia’s mandatory detention policy on children, there is sparse focus on asylum seeker children’s own perspectives of how they conceptualise their experiences of living in detention. We were curious to understand how children in detention would convey their views on their circumstances through the medium of drawing. This paper uses secondary data analysis to explore children’s perspectives by considering key themes from two drawings created by asylum seeker children in Australian immigration detention centres: one from the Australian Human Rights Commissions’ Forgotten Children: National Inquiry into Children in Immigration Detention 2014 report, and another published in prominent Australian newspaper, The Sydney Morning Herald. The focus on children’s first-hand experiences of mandatory detention through a non-invasive method conveyed a strong sense of isolation and ostracism, and revealed the mental health impacts on children and their families. These examples show that children were clearly able to convey how their rights were violated in the context of detention. Emerging themes highlight how children’s insightful perspectives of their own experiences are neglected in broader discourses, and provide a rationale for further visual research to provide nuanced understandings of asylum seeker wellbeing and children’s rights in particular.

Human Rights and Refugee Protest against Immigration Detention: Refugees’ Struggles for Recognition as Human

When detainees go on hunger strike or riot or occupy the roofs of detention centres, their actions are usually narrated by governments keen to discredit them and their actions as criminal and manipulative and evidence of their barbarity and difference. A secondary, counter-narration is provided by detainee supporters who explain the actions as evidence of detainees’ distress and deteriorating mental health. The voices of the actors themselves, people held in detention and taking protest action, are rarely heard in depth. Drawing on in-depth interviews with refugees formerly held in Australian immigration detention centres, and the works of Hannah Arendt, this article argues that the experience of immigration detention is fundamentally dehumanizing and that while detainee protest was aimed at attaining certain material outcomes, it also served important existential functions. The fact of protest was a rejection of a powerless state, a way for detained refugees to experience their own agency and, with it, restoration of some of the “essential characteristics of human life” and a means to use their reduction to “bare humanity” as a basis for insisting upon a place in the polis.

Are healthcare professionals working in Australia's immigration detention centres condoning torture?

Australian immigration detention centres are in secluded locations, some on offshore islands, and are subject to extreme secrecy, comparable with ‘black sites’ elsewhere. There are parallels between healthcare professionals working...

Black Fellas and Rainbow Fellas: Convergence of Cultures at the Aquarius Arts and Lifestyle Festival, Nimbin, 1973

Black Fellas and Rainbow Fellas: Convergence of Cultures at the Aquarius Arts and Lifestyle Festival, Nimbin, 1973

Riotous Refugees or Systemic Injustice? A Sociological Examination of Riots in Australian Immigration Detention Centres

This article draws on testimony from refugees formerly held in Australian immigration detention centres who either participated in or witnessed riots in detention, alongside academic literature examining riots in a range of settings, to elucidate how and why riots happen in immigration detention. The article outlines a model of contextualizing and immediate preconditions for riots and then uses this model to analyse a series of riots which occurred in Australian immigration detention centres between 1999 and 2011. The author proposes that conditions in immigration detention centres almost guarantee riots and that while practices such as arbitrary use of solitary confinement and excessive use of force commonly act as the immediate triggers to riot episodes, the daily regimen of detention produces the preconditions necessary for riots to occur.

The health of people in Australian immigration detention centres

To determine the health status of people in Australian immigration detention centres and the effect of time in, and reason for, detention. An analysis of the health records of 720 of the 7375 people in detention in the financial year 1 July 2005-30 June 2006, with oversampling of those detained for > 3 months. Health encounters and health condition categories; estimated incidence rates of new health conditions, new mental health conditions, and new injuries for each cohort (defined by time in, and reason for, detention). People in detention had an estimated 1.2 (95% CI, 1.18-1.27) health encounters per person-week. Those detained for > 24 months had particularly poor health, both mental and physical. Asylum seekers had more health problems than other people in detention. The main health problems varied depending on the length of time in detention, but included dental, mental health, and musculoskeletal problems, and lacerations. Both time in, and reason for, detention were significantly related to the rate of new mental health problems (P = 0.018 and P < 0.001, respectively). The relationship between these variables and the incidence rates of physical health problems was more complex. People in immigration detention are frequent users of health services, and there is a clear association between time in detention and rates of mental illness. Government policies internationally should be informed by evidence from studies of the health of this marginalised and often traumatised group.

Bodies ‘locked up’: intersections of disability and race in Australian immigration

Between 2005 and 2006 it came to be known that over 200 people had been wrongfully detained in Australian immigration detention centres, of whom 13 were people with a disability. A review of the subsequent Commonwealth Ombudsman Reports into the wrongful detentions exposed an organizational culture in which othered voices were discredited and disregarded, an over‐willingness to detain a person and a lack of proper oversight of these powers. This paper explores these reports and argues that proper investigation needs to go beyond organizational culture and to look also at historical, social, political and cultural forces shaping Australia’s use of immigration detention. The authors propose that the intersection of disability and race leaves people vulnerable to human rights violations primarily because this is also the intersection of both racial and rational prejudices of the dominant hegemony.

Corrosive places, inhuman spaces: Mental health in Australian immigration detention

Since their establishment in 1992, Australian Immigration Detention Centres have been the focus of increasing concern due to allegations of their serious impact on the mental health of asylum seekers. Informed by Foucault's treatise on surveillance and the phenomenological work of Casey, this paper extends the current clinical data by examining the architecture and location of detention centres, and the complex relationships between space, place and mental health. In spatialising these relationships, we argue that Immigration Detention Centres operate not only as Panopticons, but are embodied by asylum seekers as ‘anti-places’: as places that mediate and constitute thinned out and liminal experiences. In particular, it is the embodied effects of surveillance and suspended liminality that impact on mental health. An approach which locates the embodiment of place and space as central to the poor mental health of asylum seekers adds an important dimension to our understandings of (dis)placement and mental health in the lives of the exiled.

Contradictory Australian National Policies on Self-Harm And Suicide: The Case of Asylum Seekers in Mandatory Detention

Objective: This paper argues that the decision by the Australian Commonwealth Government to continue its policy of indefinite mandatory detention, without review, in the face of the accumulated evidence regarding the harmful effects, amounts to state-sponsored trauma and child neglect and/or abuse.Conclusions: The Australian government's policies supporting successful suicide prevention programs stand in contrast to its policy regarding indefinite mandatory detention of onshore asylumseekers. Men's and women's rates of suicidal behaviours in Australian immigration detention centres (IDCs), while imprecise, are calculated as 41 and 26 times the national average, respectively, and male IDC rates are 1.8 times the male prison rates. Self-harm in detention reflects a convergence of (child) health, protection and human rights concerns, and is driven by the extremity of detention and the detention environment. Recommendations are made for these concerns to be immediately addressed. It is noted that in handling ...