B. Detention centres - Доклад Специального докладчика по вопросу о праве каждого человека на наивысший достижимый...

B. Detention centres

82. In Australia, the Migration Act 1958 (Cth) (“Migration Act”) regulates the entry into, and presence in, Australia of non-citizens. In accordance with the Act, non-citizens within the migration zone who do not hold a valid visa are required to be detained, and unless they are granted permission to remain in Australia, they must be removed as soon as reasonably practicable.

83. Those subject to mandatory detention include 1) all unauthorized arrivals, for management of health, identity and security checks; 2) unlawful non-citizens who present unacceptable risks to the community; and 3) unlawful non-citizens who repeatedly refuse to comply with their visa conditions.82 Detainees are placed in immigration detention centres, community detention, immigration residential housing, immigration transit accommodation or alternative temporary detention in the community.

84. In July 2008, the current government announced its seven ‘Key Immigration Detention Values’ which utilize a risk-based approach to immigration detention and seek a prompt resolution of cases, but maintain mandatory detention as an essential component of Australia’s border control. The Department of Immigration and Citizenship has stated its commitment to detention as a last resort, to avoid detention of children in immigration detention centres, to review the length and conditions of detention regularly, and to treat people in detention fairly, reasonably within the law, and with respect of their inherent dignity.83

85. While the Special Rapporteur welcomes the fundamental shift in immigration detention policy presented by the new Values, and the decrease in detainee numbers and detention time that have resulted, he notes with concern that mandatory immigration detention remains a central feature of immigration policy in Australia, and the additional freeze imposed on processing of new claims by Sri Lankan and Afghan nationals.84 Repeal of mandatory detention has been recommended by CESCR, and reiterates the concerns of Australia’s National Human Rights Commission.85 There is no evidence to suggest that immigration detention acts as a deterrent to illegal non-citizens entering Australia.86 Indeed, over 90 per cent of asylum seekers that arrive in Australia by boat are later recognized as refugees and granted permanent protection visas.87

86. The Special Rapporteur underlines that the seven key values are not legally binding, and welcomes the draft legislation designed to amend the Migration Act to include the Values. However, he notes with concern that the proposed Bill fails to apply the new detention values to offshore excised territory, and specify a maximum detention period.

87. The government of Australia’s delivery of health care to people in immigration detention is guided by its Detention Health Framework,88 which is designed to ensure that the quality of health services provided in detention is comparable to that available to the Australian population. The Department of Immigration and Citizenship’s goal for health service delivery is “to ensure that the only change to an individual’s well-being as a result of being in detention is the restriction of freedom of movement”.89

88. The Department of Immigration and Citizenship (DIAC) has a duty of care towards those whom it detains to provide accessible, appropriate, and good quality health care services. Primary health care in immigration detention centres is provided by a private company selected through a tendering process conducted by the DIAC, who are contractually bound to deliver agreed services in the relevant settings. All detainees undergo a health check on entry, and primary health care services are provided in mainland immigration detention centres (IDCs) through nurses’ clinics, general practitioners and mental health professionals, who are on site for set clinic sessions. Access to emergency and specialist care is available through on-site specialist visits, or referrals to community providers. As detainees cannot access Medicare, the DIAC pays for health services through fee arrangements with the private provider (which, for example, covers on-site health staffing costs) and pays other expenses such as specialist care on a cost-recovery basis.

89. The Special Rapporteur visited Villawood Immigration Detention Centre, Maribyrnong Immigration Detention Centre and the Brisbane Immigration Transit Accommodation and commends the provision of health care services in these facilities. Overall, the services provided met the needs of the detainees; however, the Special Rapporteur notes with concern the prevalence of mental health issues among detainees, particularly those detained for lengthy periods.

90. Although it appears that health services of acceptable quality are currently being provided, the Special Rapporteur regrets that there is no specific independent monitoring and accountability mechanism in place for health services provision. The obligation to ensure enjoyment of the right to health includes the adoption of legislation or other administrative measures ensuring equal access to health care and health-related services provided by third parties, and ensuring that third parties do not limit people's access to health-related information and services.90 Detainees highlighted some concerns relating to inefficient exchange of medical information between various elements of the health care system: for instance, those detained under Section 501 of the Migration Act noted problems with medical records transfer between prisons and IDCs, which poses challenges for continuity of care.

91. The health care service provider in IDCs faces particular challenges in meeting the cultural needs of detainees. Medical staff and detainees reported that telephone interpretation services were used for most interactions if translation was needed. In the context of such language barriers, ensuring informed consent poses a challenge for medical professionals. Whilst telephone interpretation services may provide some support, on-site interpreters would improve information exchange and ensure that detainees are fully supported to provide informed consent. As almost 50 per cent of detainees of Maribyrnong IDC come mainly from only four different countries, providing on-site part-time interpreters for the main languages represented in the centre would not be particularly onerous.

(a) Mental health

92. A correlation between length of stay in immigration detention and mental health issues has been established through various studies,91 including a large-scale review of health in Australian immigration detention centres.92 The results indicate that those detained for longer periods of time (greater than 24 months) had particularly poor health, both mental and physical. Significantly, people detained for over 24 months had rates of new mental illness 3.6 times higher than for those released within 3 months.93 The mental health of detainees reportedly deteriorates significantly during immigration detention, and numerous instances of self-harming behaviour have been documented, including among children.94

93. Although it is commendable that the current Government has taken significant steps to reduce lengths of stay in detention, as of 23 October 2009, 30 per cent of the detainees in Australia’s IDCs were detained for more than 3 months. As such, length of detention remains an area of concern for the Special Rapporteur. Depressive, anxiety and post-traumatic stress disorders are common psychological sequelae of torture and trauma, which are well-documented among refugee and asylum seekers.95 Under conditions of detention or prolonged uncertainty about the future, the negative psychological impact of previous experiences of trauma is exacerbated.

94. During his mission, the Special Rapporteur was impressed by the standard of mental health services provided in the IDCs by specialist nurses, counsellors, psychologists and psychiatrists. However, he notes with some concern the role of the centre’s security services in facilitating access to mental health and other health services. Detainees generally communicate their need for medical care to security officers, who then facilitate access to services. Detainees who are at risk of suicide and self-harm (SASH) are identified by security services personnel; their behaviour is monitored once they have been placed in SASH rooms, and security personnel can make decisions regarding the detainees’ placement back into the regular facilities. The Special Rapporteur is concerned about the lack of support and specialized training provided to security personnel to adequately fill these roles.

(b) Excised offshore places

95. In September 2001, the Migration Amendment (Excision from Migration Zone) Act 2001 (Cth) was enacted, with the effect that non-citizens who first enter Australia at an excised offshore place without a valid visa are, in effect, prohibited from applying for visas on arrival or during their stay in Australia, unless the Minister determines it is in the public interest to lift the ban prohibiting them from doing so. Furthermore, offshore entry persons are barred from initiating certain legal proceedings in Australian courts, including in relation to the lawfulness of their detention. Under the current government’s policy, all people who arrive by boat without a valid visa are taken into immigration detention on Christmas Island.96 The excised offshore places, which include the Territory of Christmas Island, remain under Australian jurisdiction and the Act applies to these places in all respects, other than extending the visa application process to unauthorized arrivals. Since 2001, Christmas Island also hosts an Immigration Detention Centre.

96. While the Special Rapporteur was unable to visit Christmas Island and the immigration detention centre there due to time constraints, he notes with concern information provided to him during his mission; in particular, the fact that children continue to be detained on Christmas Island, albeit in community detention. As at 5 March 2010, there were 1,808 people in immigration detention on Christmas Island.97 Conditions in the immigration detention centre have been described as cramped and the temporary accommodation of tents and converted classrooms as “unacceptable”.98

97. The remoteness of the island (2,650 km northwest of Perth) poses significant challenges regarding service provision – legal aid, community advocacy and support networks, care and support by non-governmental organizations, are particularly compromised due to the limited charter flights available, and expense associated with reaching the island.99 Although it was noted that the island is no more remote than certain parts of mainland Australia, and provides medical services at least equivalent to those of remote communities, the utility of locating the facility in such an inaccessible place has to be questioned.

98. The lack of specialist mental health and psychiatric services on the island is of particular concern, in light of the vulnerable population detained there. In conjunction with the reported “prison-like”, high security environment,100 the shortage of community-based accommodation – leading to detainees with mental health concerns or a background of torture and trauma being held in closed detention facilities – the lack of local mental health services101 presents exacerbating factors for poor mental health.

99. The Special Rapporteur also notes with concern the non-statutory refugee status assessment process, which applies only to those who arrive in excised offshore places and is not governed by the Migration Act. It removes the right to submit an application for any visa (including a protection visa) unless the Minister determines it is in the public interest for the ban to be lifted, bars access to independent merits review by the Refugee Review Tribunal or Administrative Appeals Tribunal, and provides only limited access to judicial review of decisions regarding refugee status. This arbitrary distinction between mainland and non-mainland arrivals increases the risk of refoulement, and potentially violates Australia’s obligations under the 1951 Refugee Convention, which prohibits State parties from penalizing asylum seekers on account of their unlawful entry where they are coming directly from a territory where their life or freedom was threatened.102

V. Conclusions and recommendations

100. The Special Rapporteur calls upon the Government of Australia to:

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1  Articles 21 and 24 of the Declaration on the Rights of Indigenous Peoples.

2  ICESCR, Article 2(2); E/C.12/2000/4, para. 12.

3  E/C.12/2000/4, para. 34.

4  Ibid., para. 27.

5  Idem.

6  ICCPR, Article 10(1).

7  E/C.12/2000/4, para. 34.

8  United Nations Principles of Medical Ethics relevant to the Role of Health Personnel, Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Res. 37/194, principle 1.

9  General comment 21, art. 10, para. 7; see HRI/GEN/1/Rev.1, para. 7.

10  Basic Principles for the Treatment of Prisoners, adopted December 14, 1990, A/45/111 (A/45/49 (1990), art. 9); United Nations Human Rights Committee (HRC), “Replaces general comment 9 concerning humane treatment of persons deprived of liberty,” A/47/40 (1992), para. 3.

11  Basic Principles for the Treatment of Prisoners, Rule 22(2) and 25(1)

12  National Human Rights Consultation Report (2009, p. xxix.

13  National Human Rights Consultation Report (2009), Recommendations, p. xxxv.

14  E/C.12/2000/4, para. 27.

15  Department of Immigration and Citizenship, ^ Life in Australia, (Canberra, Australian Government, Department of Immigration and Citizenship, 2007).

16  Jupp, J., ed.. The Australian people: An encyclopedia of the nation, its people and their origins, (Cambridge University Press, 2002)

17  National Enquiry into the Separation of ATSI children from their families, ^ Bringing them home, Commonwealth of Australia, 1997

18  Mabo v Queensland (No 2) (1992) 175 CLR 1.

19  World Health Organization (WHO), Social Determinants and indigenous health: The International experience and its policy implications - Report on specially prepared documents, presentations and discussion at the International Symposium on the Social Determinants of Indigenous Health Adelaide, 29-30 April 2007 for the Commission on Social Determinants of Health (CSDH) (WHO, 2007)

20  Idem.

21  Marmot, M., ‘Self-esteem and health’ ^ British Medical Journal vol. 327, pp. 574-575 (2003).

22  E/C.12/2000/4, para. 27.

23  Watson, N. L. ‘Implications of land rights reform for indigenous health’ 186 (10) ^ Medical Journal of Australia, pp. 534-536 (2007).

24  WHO, Social Determinants and indigenous health: The International experience and its policy implications - Report on specially prepared documents, presentations and discussion at the International Symposium on the Social Determinants of Indigenous Health Adelaide, 29-30 April 2007 for the Commission on Social Determinants of Health (CSDH) (WHO, 2007).

25  WHO, ^ Social Determinants of health – the solid facts. Eds: Wilkinson, R. and Marmot, M. (2nd ed.), 16 (2003).

26  Idem.

27  The disparity in key health indicators between indigenous and non-indigenous peoples has been previously noted with concern by the Committee on the Rights of the Child (CRC/C/153), the Committee on the Elimination of Racial Discrimination (CERD/C/AUS/CO/14) and the Committee on Economic, Social and Cultural Rights (E/C.12/AUS/CO/4).

28  Australian Government Closing the Gap: Prime Minister’s Report 2010, p. 13 (2010).

29  Australian Bureau of Statistics. ^ The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008. (Canberra, Australian Institute of Health and Welfare 2009) xxii.

30  Ibid., 107.

31  Ibid., 108, 110.

32  Ibid., para. 126.

33  Australian Government Closing the Gap: Prime Minister’s Report 2010, p. 18 (2010).

34  Aboriginal and Torres Strait Islander Health Performance Framework Report (2008), 29.

35  E/C.12/2000/4, para. 4.

36  A/HRC/4/18/Add.2

37  Australian Bureau of Statistics, The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008, (Canberra, Australian Institute of Health and Welfare, 2009) 39.

38  Ibid., 40, 44.

39  Coalition of Australian Governments, (2008). National Partnership Agreement on Remote Indigenous Housing. National Indigenous Reform Agreement.

40  De Bortoli, L. and Thomson, S., ^ The achievement of Australia’s indigenous students in PISA 2000-2006, OECD Programme for International Assessment (PISA), (ACER Press, 2009).

41  Australian Bureau of Statistics,,The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008 (Canberra, Australian Institute of Health and Welfare, 2009).

42  Ibid., 15.

43  Ibid., 24-25.

44  Aboriginal and Torres Strait Islander Health Performance Framework – 2008 Report, pp. 97-98.

45  Aboriginal and Torres Strait Islander Social Justice Commissioner, “Remote indigenous education”, Chap. 3, Social Justice Report 2008, (Sydney, Australian Human Rights Commission, 2009)

46  Kral, I., The literacy question in remote indigenous Australia, CAEPR Topical Issue No. 06/2009, Centre for Aboriginal Economic Policy research, Australian National University (2009).

47  Australian Government, ‘About Medicare Australia’, Department of Health and Ageing, http://www.medicareaustralia.gov.au/

48  http://www.naccho.org.au/aboutus/aboutus.html

49  Commonwealth of Australia, ^ Closing the Gap on indigenous disadvantage: the challenge for Australia, an Australian government Initiative. (2009).

50  Indigenous Health Equality Summit ‘Statement of Intent’ Close the Gap, 1 (Canberra, 2008).

51  Australian Bureau of Statistics,^ The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008, (Canberra, Australian Institute of Health and Welfare, 2009).

52  Idem.

53  Hoy, W. et al.. ‘Reducing premature death and renal failure in Australian Aboriginals’. ^ Medical Journal of Australia, vol. 172, 473-478 (2000).

54  The Fred Hollows Foundation. “Prevention is better than cure - Comprehensive Primary Health Care”, Indigenous Health in Australia (no date), www.eniar.org/pdf/7_primary_ health.pdf

55  Australian Bureau of Statistics, ^ The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008 (Canberra, Australian Institute of Health and Welfare, 2009).

56  National Aboriginal and Torres Strait Islander Health Council, A blueprint for action: pathways into the health workforce for Aboriginal and Torres Strait Islander people. Canberra, National Aboriginal and Torres Strait Islander Health Council (2008).

57  E/C.12/2000/4, para. 11.

58  ^ National Aboriginal and Torres Strait Islander Health Survey, 2004-05

59  For more detailed analysis, see Aboriginal and Torres Strait Islander Social Justice Commissioner and Race Discrimination Commissioner Submission to the National Health and Hospitals Reform Commission by the Close the Gap Steering Committee, March 2009, pp. 6-8.

60  Ibid., 3.

61  Australian Indigenous Doctors’ Association Submission to the Northern Territory Emergency Response Review Board (2008), http://www.aida.org.au/pdf/submissions/Submission_8.pdf

62  Australian Government (2009) Report on the Northern Territory Emergency Response Redesign Consultations.

63  Ibid., 30-38.

64  Ibid., 34.

65  E/C.12/2000/4, para. 34.

66  HRI/GEN/1/Rev.7/Add.1, para. 36.

67  Rules 22, 25.

68  National Indigenous Drug and Alcohol Committee, Bridges and Barriers - addressing Indigenous incarceration and health, 6 (2009).

69  Butler, T. et al. ‘Mental Disorder in the New South Wales prisoner population’ ^ Australian and New Zealand Journal of Psychiatry Vol 39. pp. 407, 409 (2005).

70  White, P. and Whiteford H., ‘Prisons: mental health institutions of the 21st century?’ Medical Journal of Australia vol. 185(6), pp. 302-303 (2006).

71  Whiteford, H. and Buckingham W., , ‘Ten years of mental health service reform in Australia: are we getting it right?’ ^ Medical Journal of Australia vol. 182(8) pp. 396-397 (2005).

72  Australian Capital Territory Human Rights Commission, Human rights audit on the operation of ACT correctional facilities under corrections legislation, p. 32; Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living – Mission to Australia (11 May 2007) see A/HRC/4/18/add.2, para. 121 (2007).

73  Butler, T. et al., ‘Mental Disorder in the New South Wales prisoner population’ ^ Australian and New Zealand Journal of Psychiatry Vol. 39 (5) pp. 407 and 410 (2005).

74  Human Rights and Equal Opportunity Commission Report of the National Inquiry into the Human Rights of People with Mental Illness (Burdekin Report) Chap.30 (1993).

75  Senate Standing Committee on Community Affairs Towards recovery: mental health services in Australia, Chap. 9, paras. 9.69-9.72 (2008)..

76  Australian Bureau of Statistics, Corrective Services Issue 4512.0 6 (2009).

77  Krieg, A. ‘Aboriginal incarceration: health and social impacts’ Medical Journal of Australia, vol. 184 (10) p. 534 (2006),.

78  National Indigenous Drug and Alcohol Committee, ^ Bridges and Barriers: addressing Indigenous incarceration and health, 6 (2009).

79  Ibid., para. 1.

80  Human Rights and Equal Opportunity Commission, Report of the National Inquiry into the Human Rights of People with Mental Illness (Burdekin Report) Chapter 30 (1993); this situation does not appear to have improved substantially since publication of this report.

81  Weatherburn, D. ‘The role of drug and alcohol policy in reducing Indigenous over-representation in prison’, Drug and Alcohol Review, vol. 27 (1), pp. 91-92 (2008).

82  Department of Immigration and Citizenship, ‘Key Immigration Detention Values’(2008), www.immi.gov.au/managing-australias-borders/detention/about/key-values.htm

83  New Directions in Detention – Restoring Integrity to Australia’s Immigration System, speech by Senator Chris Evans, Minister for Immigration and Citizenship, July 2008

84  Department of Immigration and Citizenship ‘Immediate changes to Australia’s refugee processing’ (media release, 6 May 2010).

85  E/C.12/AUS/CO/4

86  A Just Australia ‘Myths and facts about asylum seekers’ (2009), www.tsjc.org/uploads/media/AJA_Myths_Facts.pdf

87  Amnesty International, A short stay on Christmas Island, 22 December 2009, www.amnesty.org.au/refugees/comments/22308 (2009).

88  Department of Immigration and Citizenship (2007), Detention Health Framework.

89  Ibid., p. 34.

90  E/C.12/2000/4, para. 35.

91  See e.g. Keller, A. S., Rosenfeld, B., Trinh-Shevrin, C., et al. ‘Mental health of detained asylum seekers’ ^ The Lancet, vol. 362, Issue 9397, pp. 1721-1723 (2003); Ichikawa M., Nakahara S. & Wakai, S. ‘Effect of post-migration detention on mental health among Afghan asylum seekers in Japan’ Australian and New Zealand Journal of Psychiatry, vol. 40, Issue 4, pp. 341-346 (2006).

92  Green, J. P. and Eagar, K., ‘The health of people in Australian immigration detention centres’, ^ Medical Journal of Australia, 192(2) p. 65 (2009).

93  Ibid., p. 68.

94  Australian Human Rights and Equal Opportunity Commission, ^ A Last Resort? The National Inquiry into Children in Immigration Detention (2004).

95  Foundation House - The Victorian Foundation for Survivors of Torture Inc (Foundation House) to the Senate Legal and Constitutional Committee Inquiry into the Migration Amendment (Designated Unauthorised Arrivals) Bill 2006.

96  Australian Human Rights Commission, Immigration detention and offshore processing on Christmas Island (2009)

97  Department of Immigration and Citizenship, ‘Immigration Detention Statistics Summary’ 5 March 2010, Australian Government, 1 (2010).

98  Amnesty International, ‘A short stay on Christmas Island’, 22 December 2009, Amnesty International, 2009) (see http://www.amnesty.org.au/refugees/comments/22308)

99  Immigration detention and offshore processing on Christmas Island, Australian Human Rights Commission (2009); Refugee Council of Australia (2008), Joint letter concerning Christmas Island Immigration Detention Centre: “NEw high security detention centre unsuitable for asylum seekers”.

100  Refugee Council of Australia (2008),, Joint letter concerning Christmas Island Immigration Detention Centre: New high security detention centre unsuitable for asylum seekers”.

101  Immigration detention and offshore processing on Christmas Island, (Australian Human Rights Commission, 2009)

102  Article 31.

GE.10-13949 (R) 080710 090710

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