Detaining vulnerable immigrants negatively affects their mental health

Changing immigration patterns have been the focus of recent intense media coverage. However, research concerning the impact of immigration detention policies on those most vulnerable to these practices is limited in comparison. A recent systematic review published in BMC Psychiatry examines mental health in detained immigrants and brings this issue sharply into focus where it belongs. Here to discuss the study and to signpost future research is co-author Claire Mason.

Our systematic review found that detention had a detrimental effect on an individual’s mental health, over and above the negative impact caused by uncertain immigration status. Not exactly a shocking revelation, I know. However, this finding supports those of a previous review by Robjant and colleagues that demonstrated adverse mental health consequences of immigration detention are consistently recognised internationally.

A lack of clinical assessments conducted in detention settings has been identified…

Research into immigration detention is sparse and, when it is conducted, it often has various methodological problems. One of the reasons for this is that research in detention facilities is severely restricted, with random sampling being the norm. Consequently, recruiting detainees usually takes place in communal areas such as break rooms or cafeterias, which could result in a bias towards including individuals that are healthier than the average immigrant detainee.

Another issue regularly encountered, especially with studies analysing secondary data, is that data recording within detention centres is largely flawed and disorganised. For example, one study found a lack of available records for many detainees, and only 7% of all recorded detention centre interventions included a formal mental state examination.

Further problems can be identified in the execution and reporting of detention centre studies. That is, the majority of studies do not describe the detention environment in enough detail for it to be considered as a potential influencing factor (over and above the effect of being detained itself) on the mental health of detainees. This also makes it extremely difficult to generalise or compare the findings from different studies.

there are various ways to improve the current immigration system in order to minimise further harm…

Furthermore, many studies have relied on self-report measures, which are often not validated specifically for use with detainee populations, and should not be equated to diagnostic clinical assessments. A lack of clinical assessments conducted in detention settings has been identified as well. Finally, the majority of studies are cross-sectional rather than longitudinal which means that it is more difficult to be certain about the causal link between detention and worsening mental health.

In order to improve the research with an immigrant detainee population we suggest there needs to be:

  • More transparency and better accessibility for researchers in order for them to engage with any detainees that are willing to be interviewed.
  • More systematic and detailed record-keeping by staff at detention centres.
  • Longitudinal research that tracks the mental health of detainees from the first few days of being detained.
  • More detailed descriptions by researchers on the detention environment in their papers.
  • A shift from reliance on self-report questionnaires to implementing more clinical assessments.

Importantly, there are various ways to improve the current immigration system in order to minimise further harm being done to already vulnerable people. These may include:

  • Conducting a mental health assessment before detaining an asylum seeker or refugee, to ensure that any individuals deemed vulnerable or already suffering from a mental health problem are identified and not detained.
  • Mental health assessments routinely conducted to monitor the health of those people already in detention. These assessments should then lead to adequate mental health treatment for individuals and full consideration of their release from detention.
  • Improved training of detention staff could lead to improvements in the wellbeing of detainees. This suggestion is in line with research which demonstrated that perceived support from staff had a positive impact on quality of life.
  • A greater focus on minimising the length of detention with particular importance on introducing a statutory limit on duration of detention in the UK, such as that which exists in all other EU countries.
  • A detention policy that takes into account the multiple expressions of distress and vulnerability that does not rely solely on Western conceptualisations.

Detention should be viewed as a traumatic experience in and of itself. It worsens the mental health of asylum seekers and refugees, and this is particularly true for detainees who were vulnerable before detention. On a more hopeful note, there has been an increase in research on detained immigrants in the past 10 years and with this comes an increased profile with the media, public and policymakers – this might just be enough to lead to real positive changes in the near future.

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