In The BMJ this week, experts say the system of mental health care at UK immigration centers is broken and they call on NHS England to ensure that detainees are screened for mental health problems and that facilities maintain the standards of care expected of the NHS.
They also warn that doctors "must not be complicit in a system that prioritizes deterrence over protection of refugees and asylum seekers."
The number of people held in immigration removal centres in the UK has steadily increased, with a total of over 30,000 held in 2013, they write. At any one time, up to 3,000 people can be detained.
Although immigration detention is for administrative purposes (to process an asylum application or to facilitate removal from the UK), detainees and staff both view it as punitive, they add. Furthermore, no time limit currently exists on the duration of detention, and detainees "can remain in limbo for several years, not knowing their ultimate fate."
Available evidence indicates that immigration detention can be harmful to both physical and mental health. This, say the authors, is consistent with our collective experience: "we have seen detention precipitate mental health disorders, cause severe relapses, and substantially increase the risk of self harm and suicide."
They also point to repeated criticism of both the immigration detention of mentally ill people and the conditions in which detainees are held -- as well as established cases of serious neglect and violation of human rights.
"Asylum seekers are often highly vulnerable, particularly if they have mental health disorders; we have a professional duty of care to ensure that their needs are appropriately met," they argue.
A joint statement issued in November 2013 by NHS England and the Home Office gave an assurance that NHS England would "actively promote the rights and standards guaranteed by the NHS Constitution," they explain. "We now call on NHS England to ensure that detainees are screened for mental health problems and that all facilities under its umbrella maintain the standards of care expected of the NHS."
Many alternatives to immigration detention exist, they conclude, and these "should be explored before vulnerable people are placed in such facilities."
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