Treatment of asylum seekers in detention an onshore problem too: Jane Leibowitz

Right now, more than 1,250 people – most of whom are seeking Australia’s protection from persecution – are being detained for long periods of time in prison-like conditions, despite having committed no crime.

To make matters worse, the level of healthcare that is provided to this group of people is often substandard, with long waits for necessary medicines and medical services. Sometimes required medical care is not being provided at all.

No, I’m not talking about the people currently stuck in Nauru and PNG – although Tuesday’s disturbing revelations reported by Buzzfeed and the ABC’s 7:30 have only further exposed the lack of proper care available there and the major problems posed by an offshore regime.

Instead, I am talking about the more than 1,250 people being held in detention centres across Australia, including Sydney’s Villawood immigration facility, in Melbourne’s Maribyrnong immigration facility and on Christmas Island.

Australia is an outlier when it comes to our practice of long-term, indefinite detention of asylum seekers. More than one-third of people in immigration detention have been held for over one year. More than one-in-five have been detained for more than two years. And it bears repeating: they are detained despite having committed no crime.

This is much longer than average periods of detention for people seeking asylum in comparable countries, including the United States and Canada (32 days and 25 days respectively).

We need to face up to the human impact of this. Long periods of detention – particularly indefinite detention, never knowing when you will be free – have serious damaging effects on health, and particularly mental health. Amongst other things, detention exacerbates existing mental health conditions that arise from the same factors that cause people to seek asylum in the first place, such as post-traumatic stress disorder for people fleeing warzones and other violent situations. Experts have been telling us about this for many years.

And yet many people are not getting access to medical services they desperately need. Too many people in our immigration detention centres do not have access to mental health specialists, while others experience significant delays in seeing a psychiatrist or psychologist during which their mental health issues can significantly worsen.

Serious health conditions, such as viral hepatitis, are going untreated, with people in immigration detention not provided with anything like the same basic standard of treatment that people in the community receive. This can lead to major health problems down the track.

The failure to provide adequate and appropriate healthcare for people in immigration detention is causing real harm to real people. And it’s happening in our backyard.

There are many contributing factors to this situation, including the absence of any legislative requirement that people in immigration detention are provided with the same level of healthcare as people in the community. The lack of legislative standards in immigration detention has been described by the Federal Court as a ‘legislative vacuum’.

When it comes to healthcare, people in immigration detention would do better if they were in jail. Prisoners in most Australian states and territories have a right to healthcare protected in legislation. For example, the Victorian Corrections Act 1986 provides a right to ‘reasonable medical care and treatment necessary for the preservation of health’, which specifically includes mental health care and treatment, and dental care.

This anomaly must be fixed. A legislative right to reasonable medical and mental health care should be created, and this should be done as a matter of priority.

However, as we all know, legislative change by itself is not enough – it will need to be backed-up by sufficient resources, and strictly managed contracting arrangements (given the outsourcing of health services in our detention centres) to ensure that people in immigration detention get the essential healthcare they need.

Sadly, in the contemporary political environment almost anything related to asylum seekers is seen as controversial. Debates quickly escalate and become politicised.

But, surely, there is at least one thing we can all agree on, irrespective of politics: if we are going to detain people, we owe them a duty of care. And meeting basic health needs is central to that duty, particularly when we know the harm that detention can cause.

Providing asylum seekers with a right to healthcare that is equivalent to the quality of care available in the community shouldn’t be too much to ask. In fact, it would seem to be the bare minimum.

Jane Leibowitz directs PIAC’s Asylum Seeker Health Rights Project which seeks equal access to healthcare for clients in immigration detention.

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