Mental Health Services
Mental illness is the greatest health issue for detainees. Post-traumatic stress disorder is very common among those fleeing conflict or violent situations. A report from the Royal College of Psychiatrists Asylum Working Group believe those with PTSD and several other severe conditions cannot be satisfactorily managed in detention. See report.
Detention and its indeterminate nature exacerbates mental illness and distress. This can include illness so severe that the patient has to be transferred for compulsory treatment in a mental hospital. Amongst detainees with significant mental illness, are those without the mental capacity to make important judgments for themselves. There is no tradition of independent advocacy for people in detention and the lack of mental capacity is often not picked up or is ignored.
Many inspectorates and others have criticised the handling of mentally ill people in detention. There have been now 5 cases where the conditions someone was kept in were found to be Article 3 breaches (inhuman and degrading treatment) of the European Convention of Human Rights.
The standing guidance from the Home Office is that those whose mental health cannot be managed in detention should not be detained. In recent years there have been between 8 to 20 detainees transferred annually from IRCs to hospitals under the Mental Health Act, with over half these being from the Heathrow IRCs. The routine arrangement has been for transfer to take place under section 48 to hospital, after the usual assessment process. Once a patient has recovered, the patient is usually discharged back to the IRC. But often it was the IRC environment that led to deterioration in their mental health in the first place, so generating a vicious cycle. These cases should fall under Rule 35 but these cannot be done by psychiatrists, only by GPs working in IRCs. See report.