Following the screening of a confronting Four Cornersinvestigation into the mental health of people being detained in immigration centres while their applications for refugee and asylum status are being (slowly) assessed, a colleague in the mental health sector commented, "I'm ashamed to be Australian."
It is indeed shameful that thousands of people, many of them children or unaccompanied minors, who have arrived here seeking sanctuary from their previous experiences of trauma and torture, are not being provided with proper mental health care.
The issue for the mental health sector is not the rights and wrongs of people arriving by boat, it is what happens to them once they come under the duty of care of Australian authorities.
The majority – the vast majority in fact – who come to our shores seeking asylum are granted Australian residency. The overwhelming majority have fled war-torn countries and many are experiencing conditions such as post traumatic stress disorder (PTSD); or have seen and experienced horror, torture and trauma in ways most of us cannot comprehend.
Irregular maritime arrivals from countries such as Afghanistan, of which the Department of Foreign Affairs says:
We strongly advise you not to travel to Afghanistan because of the extremely dangerous security situation and the very high threat of terrorist attack. If you are in Afghanistan, you should consider leaving. Serious terrorist incidents, including suicide bombings and other bomb attacks, occur regularly in Afghanistan, including in Kabul. Militants continue to plan and carry out attacks in major cities throughout Afghanistan.
No wonder families are fleeing.
When these refugees from Iran, Iraq, Sri Lanka, Syria, Afghanistan and other countries in turmoil arrive here seeking a better life, they often require specialist care as they transition into Australian society. This is not a new phenomenon – waves of asylum seekers and/or refugees have arrived from Indo-China, Zimbabwe and South Africa, the Baltic states and after WWII tens of thousands of Europeans, including Holocaust survivors.
Yet when the asylum seekers arrive now they get detention in isolated and remote locations, or if they're lucky they are allowed into the community with few avenues for ongoing support and mental health services, and barely enough money to provide basic housing and food. Adding to this burden is the additional stress of facing a prolonged or indefinite period of detention or awaiting processing of their claims.
Detained asylum seekers have higher rates of depression, anxiety, and PTSD symptoms than those living in the community. There is evidence regarding the length of detention and prior exposure to interpersonal trauma on rates of depression.
This is why so many of Australia's mental health and health organisations have united in demanding the Federal Government immediately launch an independent investigation into the standards of mental health care in our detention centres.
This group of organisations includes: The Australian College of Mental Health Nurses, the Australian Nursing Federation (ANF), Australian Medical Association (AMA), Royal Australian & New Zealand College of Psychiatrists (RANZCP), Mental Health Council of Australia (MHCA), Brain & Mind Research Institute, Orygen Young Health, National Mental Health Consumer & Carer Forum (NMHCCF), Australian Psychological Society (APS), SANE Australia, Professor Louise Newman, Royal College of Nursing Australia, Lifeline Australia, Australian College of Psychological Medicine, Mental Health Research Institute, Catholic Social Services Australia, The Mental Health Association of Central Australia, Alcohol and Other Drugs Council of Australia, Australian Association of Social Workers, The Royal Australian College of General Practitioners and Suicide Prevention Australia.
This collective (and there are more than those mentioned) is not challenging the Government's policy of mandatory detention as that is a separate and extremely complicated debate. However, while policy is being resolved and evolved, the Government has a responsibility – a duty of care – to those who are already here. The Government has a responsibility to provide culturally appropriate and adequate mental health care.
The Commonwealth Ombudsman is currently investigating suicide and self-harm in immigration detention centres, but there are more issues that need to be addressed. We don't know how many more suicides or attempted suicides it will take before the Government and the Opposition acknowledge that the current immigration detention system is, as aptly described by former Australian of the Year Pat McGorry, a factory for mental illness.
It is shameful that we even have to petition the Government to act now to review the system and make the changes to the delivery of mental health services to improve the mental health and wellbeing of people in detention.
Asylum seekers have the right to mental health care commensurate with their need and equal to the level available to all Australians. In early October 2011, a report from the Australian Human Rights Commission was released which raised serious questions about the mental health impacts of indefinite detention on people being held at the Curtin Immigration Detention Centre.
There are genuine concerns that the Government is not providing adequate mental health care to people in detention centres at a time when incidents of self-harm and suicide have increased, and riots, protests, and hunger strikes have become common.
It is clear that conditions inside immigration detention centres are unacceptable. Last week Fairfax papers reported on the International Health and Medical Services (IMHS), which is funded to provide services in immigration detention centres. This report revealed that they are failing to provide the necessary health services.
IHMS has only one psychiatrist on staff, used on a casual contract basis in the months of May, September and October. Although outside psychiatrists are used, detainees can wait up to six weeks for treatment... IHMS also said detainees with complex mental health issues need to be in cities such as Sydney, Melbourne or Perth. According to immigration data, the remote Curtin desert centre and Northern detention centre, in Darwin, have the highest incidence of detainees diagnosed with a mental illness.
It is also absolutely clear to the mental health sector that asylum seekers released into the community require a proper level of support and assistance.
Even those opposed to so-called 'boat people' must realise that genuine refugees are almost always granted residency and it is in everyone's interests that we make sure they get proper mental health care.
The Federal Government and the Coalition should take note when the country's leading health organisations unite in demanding an immediate independent investigation into the standards of mental health care in Australia's immigration detention centres.
As more asylum seekers take their own life or try to, as more asylum seekers are released into the community with complex and serious mental health problems, as more asylum seekers churn through the factories of mental illness that are the remote and almost inaccessible immigration detention centres, the need for an immediate inquiry into the standards of care becomes more urgent.
Every person has the right to be treated with dignity and respect, and we as Australians have a duty of care to all people on Australian soil.
We have a duty of care to extend that to the thousands being detained for months, if not years, while the slow wheels of bureaucratic processing turn.
Simon Tatz is the director of communications for the Mental Health Council of Australia. Kim Ryan is the CEO of the College of Mental Health Nurses.
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