Detention centres compromise minimum health standards: nurses

The Australian College of Mental Health nurses has renewed its call for the government to dump its policy of mandatory detention, amid concerns of a worsening health crisis in the system.

College CEO, Kim Ryan said conditions in detention compromised Australia’s own mandated standards for mental health and called for greater transparency in relation to the availability of services.

“There is clear evidence that indefinite detention is causing an enormous amount of stress and strain for detainees,” she told Nursing Review.

Immigration documents submitted last month to the current parliamentary inquiry into the practice of mandatory detention revealed 213 detainees were treated for self-inflicted injuries and 700 for voluntary starvation between January and June this year.

In particular, mental health professionals had raised serious concerns about access to quality, culturally appropriate mental health services to adequately meet their often high-level needs.

“There are significant ramifications of detaining people who are in detention for indefinite periods of time, particularly those who have already come from countries of war or have come from places where they have been recipients of torture or trauma,” Ryan said.

It was also unacceptable that the National Practice Standards for the Mental Health Workforce had not been implemented in detention settings, she said.

The college, in collaboration with the Australian Psychological Society and the Department of Immigration’s Detention Health Advisory Group has called on the Federal Minister for Mental Health, Mark Butler to intervene.

Nurses and psychologists made up the primary mental health workforce within immigration detention centres.

Ryan said the government and the mental health professions had a responsibility to guarantee that services were provided in line with best practice standards and the government’s own national standards.

“We need to ensure that we are providing adequate mental health and healthcare to people that are detainees and if we were, I would imagine there wouldn’t be a need for a Commonwealth Ombudsman Inquiry into suicide and self harm in detention,” she said.

On July 29, the Commonwealth Ombudsman, Allan Asher launched an investigation into suicide and self-harm into Australian immigration detention facilities, which coincides with the broader parliamentary review.

In the preceding months, Asher had raised public concerns about the impact of long-term detention on the ongoing psychological health and wellbeing of detainees. He said all immigration detention facilities had experienced an upsurge in incidents of self-harm and attempted suicide.

For example, in a visit to Christmas Island in June, there were more than 30 incidents of self-harm by detainees reported within the space of a week.

Professor Louise Newman, Chair of DEHAG said the system was in crisis, contributing to an epidemic of self-harm and suicide.

“While all this is happening, health professionals are not being granted access or are limited in what they can provide to those in such acute distress. Basic standards must be restored to ensure effective health care for those detained in this way.”

Amanda Gordon from the Australian Psychological Society said staff were inadequately trained and supported.

Ryan also defended the right for nurses to speak out on the issue.

She said this is was not about nurses waging into a political debate but making informed, evidence-based statements about the impact of government policies on their professional standards.

“Detainees are on Australian soil and they need to have the same access to services that anybody else would have, regardless of whether they are in detention or the in community,” she said.

The opening hearing of the parliamentary inquiry into mandatory detention heard in August that the Department of Immigration and Citizenship was working to identify the patterns and causes of self-harm in detention, and how this differed among asylum seekers within the community.

Andrew Metcalfe, the Secretary of the department said this would include whether detention contributed to psychological harm.

He attributed the growing number of actual cases of self-harm to higher numbers of people in detention, more people seeking asylum and more people being told that they were not getting a visa.

“The issue of attempted or actual self-harm is a combination of a number of factors. It is a combination of, the length of time that a person is awaiting an outcome and what the outcome is that they receive. When they receive a positive outcome people rarely self- harm, but when they receive a negative outcome self-harm is a feature of the management of the case in some situations,” Metcalfe told the inquiry.

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