Mental Health and Mandatory Detention: bad on both sides of the wire

Since my last post, the Gillard Government has been forced to drop its attempts to pass amendments that would have enabled the ‘Malaysia Solution’ to go ahead, and concede that onshore processing in the community needs to be expanded, to alleviate crowding concerns in detention centres. Bridging visas will be issued but details of this new policy direction are yet to be finalised. Furthermore, the Commonwealth Ombudsman, Allan Asher, resigned after it was revealed that he had written questions for the Greens Senator Sarah Hanson-Young to ask him at the Senate estimates committee in May. The resignation is unfortunate, given Mr Asher’s earnestness in getting to the truth about mental health problems in mandatory detention, including calls for an evidence-based assessment of the extent and causes of self-harm and suicides in detention facilities relative to the general population, and guidelines and protocols for preventing and managing them.

In the meantime, detention centres – and the mental health related incidents occurring within them – continue to make the headlines. Last week, a 27-year old Sri Lankan refugee, still in detention awaiting security checks by ASIO, is believed to have taken his own, young life. ASIO has reiterated that it is not its policy, but the policy of the Government, that kept the man in detention.

My heartfelt concern is that we are creating mental illness and suffering COMPLETELY UNNECESSARILY, with a ridiculously expensive, pointlessly cruel and punitive policy. And I’d like to think Australia is better than that.

SELF-HARM: RECURRING THEME, “MORAL CRISIS”

Not every mental health practitioner agreed with Psychiatry Professor Louise Newman when she argued back in March that Australia faced a “significant moral crisis” over our treatment of asylum seekers. Yet the fact is that the number of suicide attempts and self-harm in immigration detention centres is significant, and many experts agree that the conditions which successive Governments have chosen to create – conditions that many Australians support – are exacerbating, if not creating, these problems. If true, a moral conscience would pause to consider whether or not it wanted to be supporting the destruction of people in the name of border security (let’s not pretend it’s about stopping people smuggling – it’s about stopping people from coming here). Particularly when a feasible, safe, cheaper and humane alternative exists for processing the petitions of asylum seekers (see ‘Myth 15’, pg 21 in this document). A moral country would do just the same. I’m glad at least some people are. One doesn’t need to be in favour of open borders (I am not) or people smuggling (a despicable trade in human misery and desperation) to not want to support an ineffective, redneck appeasing policy.

When the (former) Commonwealth Ombudsman launched his inquiry into detention centre suicides and self-harm in July, an average of three threatened or actual attempts occurred across the detention centre network per day. The Ombudsman obtained figures from the Immigration Department showing there were 1,132 instances of actual or threatened self-harm across the immigration detention network in the 12 months leading up to July. In the same period, there was one confirmed suicide; coronial inquests into another five suspected suicides were underway.

Louise Newman, who is also an independent advisor to the Government on mental health in Immigration detention centres, said on ABC Radio: “There are serious suicide attempts usually every night. So it’s a mass culture built around fear and despair. And in fact talking to detainees, they describe that: their preoccupation with death.”

“We have people who’ve experienced torture and trauma, and Government policy states that those people should not be detained. And yet they are.”

Despite former Immigration Minister Chris Evans statement that “Labor rejects the notion though that dehumanising and punishing unauthorised arrivals with long-term detention is an effective or civilised response.”

So they are still, by their own definition, continuing an ineffective and uncivilised response. I loved the rhetoric. All I want is Labor to embrace their own sense of decency.

FOUR CORNERS STORY ON MENTAL HEALTH IN “ASYLUM”.

Last Monday, the ABC’s Four Corners program ran this story exposing conditions inside Australian immigration detention centres. The focus: the mental health crisis occurring within it. Reporter Sarah Ferguson spoke to current detainees, former detainees, a former Curtin Detention Centre counsellor (whose identity was concealed, as former employees are not allowed to talk to the media), a former Northern Detention Centre nurse, and Dr Suresh Sunduram of the Mental Health Research Institute, who is one of the few psychiatrists to have visited Curtin recently to report for the human rights commission.

The picture painted by all testimonies is a grim one.

Dr Suresh saw people who were depressed (including some suffering psychotic depression), people with significant post-traumatic stress disorder, and people with psychotic illnesses (like schizophrenia). What is alarming, though, is the possible link between some cases of mental illness, and the conditions the people are subjected to, as a result of government policy, Serco internal operations, and inadequate mental health treatment:

“We get people who are, generally speaking, reasonably resilient, reasonably healthy and then subject them to extraordinary conditions where we appear to subvert their resilience and subvert their mental health.” Dr Suresh dispassionately described Curtin as “very akin to a prison.” He raised concerns that inappropriate medicating was occurring, with anti-depressants being doled out incorrectly and on an ad hoc basis.

The refugees interviewed on the program found it difficult to discuss their detention experiences, and pre-detention trauma (understandably).

And in regards to children, Immigration Minister Chris Bowen has moved more than 800 children into the community since taking up the portfolio. But at the beginning of October there were still 369 children in alternative places of detention. Dr Peter Morris, of the Australian Medical Association, said studies involving many countries and involving many thousands of children have found that overall between 10 and 30 per cent of children in detention are suffering from depression and between 20 and 50 per cent have post traumatic stress disorder.

BAD FOR “THE GUARDS” & BAD FOR US, TOO.

Back in 2008, it was Four Corners once again that exposed the terrible impact conditions in detention centres were having on Detention Centre guards, and by extension, the Australian community, too. Quentin McDermott told of inadequate training, of people with severe mental illnesses and significantly troubled backgrounds being recruited to guard equally troubled, and sometimes violent, asylum seekers. The mandatory detention policy we have now is softer, but the story is still relevant, as it highlights how detention centre conditions can actually breed mental illness and violent behaviour in both detainees and guards. This is a very human problem.

In July this year, Kieran Webb, a young guard at Curtin Detention Centre, took his own life after being among those who cut down a 19-year-old Afghan detainee who had hung himself in his room. He had worked as a security officer for six months. Fellow guards said he was deeply affected by the death and by the unrest that followed. Though counseling and other support was available to Mr Webb and others, his death highlighted concerns among guards and their union, United Voice, about the role of sub-contracted guards who are not required to undergo the same training as their Serco colleagues.

Paige Taylor reports in this article that the conditions within detention are harmful for asylum seekers and staff too. She also reported in July that Serco had circulated a memo warning it’s guards on Christmas Island that detainees were creating a “self-harm culture” as a bargaining tool, which is certainly telling in regards to the way that Serco views – and hence, deals – with self-harming in detention. Louise Newman said Serco’s memo indicated a lack of understanding about the nature and levels of mental distress in detention centres.

Then there is the issue of incidents of abuse of detainees at the hands of centre staff, which the 2008 Four Corners story also highlighted. That story told how some guards went from mildly resentful to angry racists against Muslims or Arabs – even from afar – under those working conditions. “I yell and scream and swear (seeing them) on TV,” said one young former guard. “I hated them and I wanted to run them over,” recalled a female guard. “I wanted to strangle them. I thought, ‘This is me, a compassionate person turning into an absolute animal’.” And in February, allegations of abuse and intimidation emerged at the Serco-run detention facility at Leonora in remote Western Australia. Out of sight, out of mind…

MENTAL ILLNESS FACTORIES.

I don’t know what it’s like to flee violence and persecution – to have loved ones killed or dispersed, to be stateless, or to be incarcerated for indefinite periods. But I do know what it is to be in psychological and physical limbo, to live with a mental illness, and to live with others with mental illnesses. It is extremely difficult – if not impossible – for most people who have never been seriously depressed, suicidal or wanting to self-harm to fully comprehend what it is like to be imprisoned in that mental state. Speaking to a friend after the suicide of another, my friend was at a complete loss as to what compelled our other friend to take his own life, asking whether if he knew what effect it would have on others, would he have still done it. Yet I, having reached that point myself before, more than once, understood – at that threshold, there is nothing else but the deep, endless despair. Nothing. Thoughts of death dominate, and all you want is for the pain to end. The illness separates you from life and even from those who love you. Its final victory is in claiming your body too.

I drew charcoal sketches during a time of such despair – the psychological equivalent of blood letting. I was not yet diagnosed nor in any kind of treatment. On my own, I drew the pain, hoping that by giving it form externally, I could somehow exorcise it and function like everyone else. A recurring image is that of an emaciated, deformed girl in solitary confinement. This was what my depression looked like, or rather, how it made me feel, and experience life. When I look at it, I remember what it was like to be in my head: behind me, a past filled with pain; ahead, eternal desolation, with no promise and no hope of ever being free before succumbing to natural causes. I desperately wanted out. I was twenty years old.

“I have seen only darkness in life and a dark future ahead.” That was what Jaffer, an Iraqi detainee, said on the Four Corners program last Monday, while recovering in hospital after trying to hang himself. He was not considered a genuine refugee, and had had his third application rejection. Nonetheless, I understood his mental state, and there are many others – who are and will be deemed genuine refugees – who suffer the same. I suppose my ongoing battles with the black dog cause me to identify with them, despite the fact I am an Australian and free.

With this in mind, consider, again, the plight of the detainee: if someone who is not in detention, not stateless, not under threat of persecution can suffer this mindset, how much more would a person suffer in indefinite detention, surrounded by others also afflicted with mental illness? In a veritable petri dish of psychosis?

2010 Australian of the Year Professor Patrick McGorry, one of the nations leading mental health experts, has been recognised for his work in the mental health field and, in particular, his achievements in improving the mental health of young people. During his acceptance speech in 2010, he described detention centres as factories for producing mental illness. Professor McGorry called for an end to immigration detention centres, saying he had seen some lives shattered by the policy.

A common “angry online reader” type retort to claims that detainees are suffering psychological damage under the conditions of mandatory detention is that these “queue jumpers” should be grateful we are sheltering them at all, in “luxurious” accommodation, no less (food and shelter is a luxury, apparently). Such retorts merely reflect the profound ignorance of the people who spit such vitriol, particularly in regards to what mental illness is. For sure, we do need to distinguish between individuals trying to coerce the process of their applications with threats, and mental illness manifesting as self-harm, because mental illness is just that – an illness. People don’t get depressed, disfigures themselves, try to terminate their lives because they aren’t grateful, or want pity, or some such nonsense. When mental illness occurs, it means something has gone very wrong in a person’s head, and they need care. Sometimes, it is the conditions that the person is living under that cause this dysfunction, and the care required involves removing them from those conditions.

The possibility that we are creating such conditions – these “mental illness factories” – in ANY context – be it with our immigration policy, in our military, or any other institution, is a concern to anyone with a brain and a heart.

Everyone else should be on the transplant list.

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About Pauline Vetuna

paulinevetuna.wordpress.com

Posted on October 30, 2011, in Australia, Depression, Human Rights, Humanity, Refugees and tagged , , , , , . Bookmark the permalink. 4 Comments.

  1. While naturally i feel very uneasy about what happens in detention centres etc, I also think about the australians who are suffering without asistance. I was diagnosed with mental illness disorders, which were bought on by inappropriate treatment at our hospital here in australia. I have lost my job, my independance and am now agoraphobic. The problem I have is that we are unable to access free mental health resources which angers me a lot. I am unable to access treatment to get better unless i consent to being pumped full of mind altering drugs, which i will not do. So, who stands up for us australians going through the same thing?

    • Thankyou for sharing your thoughts Fiona. I really feel for you and your predicament, and am myself currently investigating the inappropriate treatment of a friend of mine within Australia’s mental health system. The state government in Victoria announced an inquiry into the high rates of unexpected and unnatural deaths in the state’s mental health wards on 5 September. I myself, at the age of 14 onward, suffered from severe anxiety, depression, and eating disorder, that went completely untreated for years despite I being in the public health system for physical illness (which was also misdiagnosed, but that’s another issue) and showing clears symptoms of all those disorders. I believe the way we view, understand, and treat mental illness is still not up to scratch.

      I guess my point about asylum seeker mental health issues is that compassion for some people never has to be at the expense of other people. It disturbs me that we might be worsening and even creating mental illness in people with the policies we are choosing to implement – regardless of who the people are. Particularly if the policy is expensive, ineffective, and unnecessary. Possibly creating problems that will cost us more in the long run. Not to mention stunt and damage human lives.

      In essence, I don’t view them as separate issues. This is about our understanding of mental health, how we view it (which influences how we treat it) and the ways in which such issues could be prevented in the first place. There’s a reason why many mental health professionals have spoken out about this, and I don’t think it’s because they are all bleeding heart lefties.

      “So, who stands up for us australians going through the same thing?”

      WE do, Fiona. Or, rather, we MUST.
      I’ve had conversations with a few people before who are very anti-asylum seeker, who only raise the issue of “but what about our own mentally ill” when attacking asylum seekers, but who’s “concern” for *our* mentally ill doesn’t extend beyond those glib remarks (I hasten to add I do not think you are at all in this category). But I would say to such people: care about the mental health of your fellow citizens? OK. Campaign, lobby, protest, fundraise, write to your MPs, raise community awareness, tell your story, volunteer to support people with mental illness in your community and programs related to mental illness. Back up that great reservoir of concern for your fellow Australians with real, positive ACTION. And the beautiful thing is that you never have to bash or resent any other group to do that.

      I wish you recovery and wellness, in good time.

      • Thanks for your reply 🙂 I still agree with you on the whole asylum seeker thing, i just get frustrated thta we cant get help either! I have done everything I can, written to every celebrity /media person etc but with no avail. But in being honest, there isnt all that much I can do when I am in my bedroom 23 out of every 24 hours 🙂
        Keep up the blog x

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