Helping detainees in need of medical assistance

Adults at risk and Rule 35


A new ‘adults at risk’ guidance came into effect on the 12th of September 2016. The guidance recognises that vulnerable individuals may be at increased risk of harm from detention. As a result the guidance states that vulnerable individuals (‘adults at risk’) should not normally be detained and can only be detained when immigration factors outweigh their indicators at risk.

Individuals will be regarded as ‘adults at risk’ if they declare or there is evidence that they “are suffering from a condition, or have experienced a traumatic event (such as trafficking, torture or sexual violence), that would be likely to render them particularly vulnerable to harm if they are placed in detention or remain in detention.”


Indicators of risk include:

  • suffering from a mental health condition or impairment
  • having been a victim of torture
  • having been a victim of sexual or gender based violence
  • having been a victim of human trafficking or modern slavery
  • suffering from post traumatic stress disorder
  • being pregnant
  • suffering from a serious physical disability
  • suffering from other serious physical health conditions or illnesses
  • being aged 70 or over
  • being a transsexual or intersex person.


However, Medical Justice has serious concerns about the effectiveness of this guidance. We have raised these concerns with the Home Office, see for example here for details. 

Rule 35 is a mechanisms which aims to ensure that particularly vulnerable detainees are brought to the attention of those with direct responsibility for reviewing detention. IRC GPs should raise a concern about detainees whose health would be injuriously affected by continued detention, they suspect has suicidal intentions or whom they are concern may have been a victim of torture. Many detainees who have been tortured remain in detention, for example because their evidence is not believed or immigration factors are deemed to outweigh their evidence of risk. The Rule 35 system is not working. The vast majority of reports that are done do not lead to any change in detention. The failure to undertake or to properly consider rule 35 report, often feature in legal claims of unlawful detention. See “The Second Torture: the detention of torture victims” – full version or 12 page summary. (Note: this report predates the Adults at Risk policy).


Aspects of the adults at risk policy is currently subject to legal challenge and there may therefore be some changes to this information in coming months.


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"Medical Justice helps people in situations of desperation that most of us could never imagine."

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