Skip to main content
SpringerLink
Log in

A Community Standard: Equivalency of Healthcare in Australian Immigration Detention

  • Review Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

The Australian government has long maintained that the standard of healthcare provided in its immigration detention centres is broadly comparable with health services available within the Australian community. Drawing on the literature from prison healthcare, this article examines (1) whether the principle of equivalency is being applied in Australian immigration detention and (2) whether this standard of care is achievable given Australia’s current policies. This article argues that the principle of equivalency is not being applied and that this standard of health and healthcare will remain unachievable in Australian immigration detention without significant reform. Alternate approaches to addressing the well documented issues related to health and healthcare in Australian immigration detention are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Australian Border Force. Immigration detention and community statistics summary December 30 2015.

  2. Department of Immigration and Citizenship. Immigration detention statistics summary 30 June 2013.

  3. Australian Parliamentary Select Committee. Taking responsibility: conditions and circumstances at Australia’s regional processing centre in Nauru. Parliament House, Canberra: Senate Printing Unit; 2015.

  4. Moss P. Review into recent allegations relating to conditions and circumstances at the Regional Processing Centre in Nauru. 2015.

  5. Australian Human Rights Commission. The forgotten children: national inquiry into children in immigration detention. Australasia: Paragon Printing; 2014. http://www.humanrights.gov.au/publications-home/all.

  6. Australian Parliamentary Senate Legal and Constitutional Affairs References Committee. Incident at the Manus Island detention centre from 16 February to 18 February. Parliament House, Canberra: Senate Printing Unit; 2014.

  7. Deparmtnet of Immigration and Citizenship. Detention health framework: a policy framework for health care for people in immigration detention. The National Communications Branch of the Department of Immigration and Citizenship, Canberra; 2007.

  8. Commonwealth Ombudsman. Inquiry into the circumstances of the Vivian Alvarez Matter. Report no 3. 2005.

  9. Palmer M. Inquiry into the circumstances of the immigration detention of Cornelia Rau. Commonwealth of Australia, Canberra; 2005.

  10. Australian Parliamentary Joint Select Committee on Australia’s Immigration Detention Network. Parliament House, Canberra: Senate Printing Unit; 2012.

  11. Jotterand F, Wangmo T. The principle of equivalence reconsidered: assessing the relevance of the principle of equivalence in prison medicine. Am J Bioeth. 2014;14(7):4–12.

    Article  PubMed  Google Scholar 

  12. United Nations. Basic principles for the treatment of prisoners, Principle 9. 1990.

  13. World Health Organisation. Health in prisons: a WHO guide to the essentials in prison health. 2007. http://www.euro.who.int/en/publications/abstracts/health-in-prisons.-a-who-guide-to-the-essentials-in-prison-health.

  14. Australian Institute of Criminology. Standard guidelines for corrections in Australia. Revised 2012. 2012. http://www.aic.gov.au/criminal_justice_system/corrections/reform/standards.html.

  15. Australian Medical Association. Position statement: health and the criminal justice system. 2012. https://ama.com.au/position-statement/health-and-criminal-justice-system-2012.

  16. Charles A, Draper H. Equivalence of care’in prison medicine: is equivalence of process the right measure of equity? J Med Ethics. 2012;38(4):215–8.

    Article  PubMed  Google Scholar 

  17. Niveau G. Relevance and limits of the principle of “equivalence of care” in prison medicine. J Med Ethics. 2007;33(10):610–3.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Till A, Forrester A, Exworthy T. The development of equivalence as a mechanism to improve prison healthcare. J R Soc Med. 2014;107(5):179–182.

    Article  Google Scholar 

  19. Physicians for Human Rights and the Bellevue/NYU Program for Survivors of Torture. From persecution to prison: the health consequences of detention for asylum seekers. 2003. http://physiciansforhumanrights.org/library/reports/from-persecution-to-prison.html.

  20. Schubert CC, Punamäki R-L. Mental health among torture survivors: cultural background, refugee status and gender. Nord J Psychiatry. 2011;65(3):175–82.

    Article  PubMed  Google Scholar 

  21. Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, et al. Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. 2011;183(12):E959–67.

    Article  Google Scholar 

  22. Fazel M, Karunakara U, Newnham EA. Detention, denial, and death: migration hazards for refugee children. Lancet Glob Health. 2014;2(6):e313–4.

    Article  PubMed  Google Scholar 

  23. Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012;379(9812):266–82.

    Article  PubMed  Google Scholar 

  24. Reed RV, Fazel M, Jones L, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet. 2012;379(9812):250–82.

    Article  PubMed  Google Scholar 

  25. Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365(9467):1309–14.

    Article  PubMed  Google Scholar 

  26. Keyes EF. Mental health status in refugees: an integrative review of current research. Issues Ment Health Nurs. 2000;21(4):397–410.

    Article  CAS  PubMed  Google Scholar 

  27. Johnston V, Smith L, Roydhouse H. The health of newly arrived refugees to the top end of Australia: results of a clinical audit at the Darwin Refugee Health Service. Aust J Prim Health. 2012;18(3):242–7.

    Article  PubMed  Google Scholar 

  28. Bull M, Schindeler E, Berkman D, Ransley J. Sickness in the system of long-term immigration detention. J Refug Stud. 2013;26(1):47–68.

    Article  Google Scholar 

  29. Green JP, Eagar K. The health of people in Australian immigration detention centres. Med J Aust. 2010;192:65–70.

    PubMed  Google Scholar 

  30. Sultan A, O’Sullivan K. Psychological disturbances in asylum seekers held in long term detention: a participant-observer account. Med J Aust. 2001;11:593–6.

    Google Scholar 

  31. Young P. Mental health screening and outcome measures in immigration detention. In: Presented at The Royal Australian and New Zealand College of Psychiatrists’ annual congress, 13 May 2014.

  32. Dudley M. Contradictory Australian national policies on self-harm and suicide: the case of asylum seekers in mandatory detention. Australas Psychiatry. 2003;11(1 suppl):S102–8.

    Article  Google Scholar 

  33. The Border Crossing Observatory. Australian border deaths database. 2016. http://artsonline.monash.edu.au/thebordercrossingobservatory/publications/australian-border-deathsdatabase/.

  34. Borrello E, Glenday J. Gillian Triggs: Tony Abbott says Government has lost confidence in human rights commission president. Australian Broadcasting Corporation News; 2015. http://www.abc.net.au/news/2015-02-24/gillian-triggs-says-brandis-wants-her-to-quit-rights-commission/6247520.

  35. Farrell P. Police carry out more raids on Save the Children staff at Nauru detention centre. The Guardian Australia; 2015. http://www.theguardian.com/world/2015/oct/22/police-carry-out-more-raids-on-save-the-children-staff-at-nauru-detention-centre.

  36. Hoang K. Border Force Act entrenches secrecy around Australia’s asylum seeker regime. The Conversation; 2015. https://theconversation.com/border-force-act-entrenches-secrecy-around-australias-asylum-seeker-regime-44136.

  37. Laughland O. Coalition disbands advisory group on asylum seeker healthcare. The Guardian Australia; 2013. http://www.theguardian.com/world/2013/dec/16/tony-abbott-disbands-advisory-group-on-asylum-seeker-healthcare.

  38. Kerridge I, Isaacs D. Asylum seeker’s ‘brain death’ shows failure of care and of democracy. The Conversation; 2014. http://theconversation.com/asylum-seekers-brain-death-shows-failure-of-care-and-of-democracy-31274.

  39. Newman LK, Dudley M, Steel Z. Asylum, detention, and mental health in Australia. Refug Surv Q. 2008;27(3):110–27.

    Article  Google Scholar 

  40. Steel Z, Silove D. Science and the common good: indefinite, non-reviewable mandatory detention of asylum seekers and the research imperative. Monash Bioeth Rev. 2004;23(4):93–103.

    Article  PubMed  Google Scholar 

  41. Marr D, Laughland O. Australia’s detention regime sets out to make asylum seekers suffer, says chief immigration psychiatrist. The Guardian Australia; 2014. http://www.theguardian.com/world/2014/aug/05/-sp-australias-detention-regime-sets-out-to-make-asylum-seekers-suffer-says-chief-immigration-psychiatrist.

  42. Farrell P, Jabour B, Evershed N. Immigration department sought private medical records ‘for political reasons’. The Guardian Australia; 2015. http://www.theguardian.com/australia-news/2015/jul/23/immigration-department-sought-private-medical-records-for-political-reasons.

  43. Zion D, Briskman L, Loff B. Nursing in asylum seeker detention in Australia: care, rights and witnessing. J Med Ethics. 2009;35(9):546–51.

    Article  CAS  PubMed  Google Scholar 

  44. Essex R. Human rights, dual loyalties, and clinical independence: challenges facing mental health professionals working in Australia’s immigration detention network. J Bioeth Inq. 2014;11(1):75–83.

    Article  PubMed  Google Scholar 

  45. Birmingham L, Wilson S, Adshead G. Prison medicine: ethics and equivalence. Br J Psychiatry. 2006;188(1):4–6.

    Article  PubMed  Google Scholar 

  46. Coffey G. ‘Locked up without guilt or sin’: the ethics of mental health service delivery in immigration detention. Psychiatry Psychol Law. 2006;13(1):67–90.

    Article  Google Scholar 

  47. Grewcock M. Australia’s ongoing border wars. Race Cl. 2013;54(3):10–32.

    Article  Google Scholar 

  48. Isaacs D. Are healthcare professionals working in Australia’s immigration detention centres condoning torture? J Med Ethics. 2015. http://jme.bmj.com/content/early/2015/12/20/medethics-2015-103066.abstract.

  49. Procter N, Sundram S, Singleton G, Paxton G, Block A. Physical and Mental Health Subcommittee of the Joint Advisory Committee for Nauru Regional Processing Arrangements Nauru site visit report, 16–19 February 2014.

  50. Exworthy T, Samele C, Urquía N, Forrester A. Asserting prisoners’ right to health: progressing beyond equivalence. Psychiatric Serv. 2014;63(3):270–5.

    Article  Google Scholar 

  51. Clyne M. The use of exclusionary language to manipulate opinion: John Howard, asylum seekers and the reemergence of political incorrectness in Australia. J Lang Polit. 2005;4(2):173–96.

    Article  Google Scholar 

  52. Klocker N, Dunn K. Who’s driving the asylum debate? Newspaper and government representations of asylum seekers. Media Int Aust. 2003;109:71–92.

    Google Scholar 

  53. Rowe E, O’Brien E. ‘Genuine’ refugees or illegitimate ‘boat people’: Political constructions of asylum seekers and refugees in the Malaysia Deal debate. Aust J Soc Issues. 2014;49(2):171–93, 242.

  54. McKenzie J, Hasmath R. Deterring the ‘boat people’: explaining the Australian government’s People Swap response to asylum seekers. Aust J Polit Sci. 2013;48(4):417–30.

    Article  Google Scholar 

  55. Owler B. Speech to AMA forum on health of asylum seekers. 2016. https://ama.com.au/media/ama-speech-prof-owler-ama-asylum-seeker-health-forum.

  56. Isaacs D. Doctors should boycott working in Australia’s immigration centres and must continue to speak out on mistreatment of detainees-despite the law. BMJ (Clin Res Ed). 2015;350:h3269.

    Google Scholar 

  57. Sanggaran J-P. Asylum seekers are being abused on our watch. It’s time to put detention under surveillance. The Guardian Australia; 2015. http://www.theguardian.com/commentisfree/2015/sep/12/asylum-seekers-are-being-abused-on-our-watch-its-time-to-put-detention-under-surveillance.

  58. Sanggaran J-P, Ferguson GM, Haire BG. Ethical challenges for doctors working in immigration detention. Med J Aust. 2014;201(7):1–3.

    Article  Google Scholar 

  59. McNeil PM. Public health ethics: asylum seekers and the case for political action. Bioethics. 2003;17(5–6):487–502.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Centre for Values, Ethics and the Law in Medicine, School of Public Health, The University of Sydney, Medical Foundation Building K25, Sydney, NSW, 2006, Australia

    Ryan Essex

Authors
  1. Ryan Essex
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryan Essex.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Essex, R. A Community Standard: Equivalency of Healthcare in Australian Immigration Detention. J Immigrant Minority Health 19, 974–981 (2017). https://doi.org/10.1007/s10903-016-0438-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-016-0438-7

Keywords

Search

Navigation