Special Situations: Places of Immigration Detention

  • Joost Jan den Otter
  • Thomas Wenzel
  • Bernadette McGrath
  • Andres Leal Osorio
  • Boris Drožđek


The detention of migrants and asylum seekers has become a common practice in both developing and high-economy regions. The fact of detention but also the conditions of detention are the subject of much criticism. They have been shown to frequently violate international human rights standards and to have an adverse impact on the psychological health and, later, the integration of migrants. In this chapter the authors outline standards and risks, based on research data and a case example, but also alternatives to detention as outlined by UNHCR.


Detention Prisons Asylum Children Hunger strike Post-traumatic stress disorder 


  1. 1.
    Flynn M. There and back again: on the diffusion of immigration detention. Journal on Migration and Human Security. 2014;2(3):32.CrossRefGoogle Scholar
  2. 2.
    Newman LK, Dudley M, Steel Z. Asylum, detention, and mental health in Australia. Refug Surv Q. 2008;27(1):17.Google Scholar
  3. 3.
    Newman L. Seeking asylum—trauma, mental health, and human rights: an Australian perspective. J Trauma Dissociation. 2013;14(2):213–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Grange M. MI. When is immigration detention lawful? The monitoring practices of UN human rights mechanisms. 2017.Google Scholar
  5. 5.
    Filges TME, Kastrup M, Jørgensen A-MK. The impact of detention on the health of asylum seekers: a systematic review. Campbell Systematic Reviews. 2015;13:104.Google Scholar
  6. 6.
    Goodwin-gill GS. International law and the detention of refugees and asylum seekers. Int Migr Rev. 1986;20(2):193–219.CrossRefPubMedGoogle Scholar
  7. 7.
    Summerfield D, Gorst-Unsworth C, Bracken P, Tonge V, Forrest D, Hinshelwood G. Detention in the UK of tortured refugees. Lancet. 1991;338(8758):58.CrossRefPubMedGoogle Scholar
  8. 8.
    Silove D, McIntosh P, Becker R. Risk of retraumatisation of asylum-seekers in Australia. Aust N Z J Psychiatry. 1993;27(4):606–12.CrossRefPubMedGoogle Scholar
  9. 9.
    Silove D, Steel Z, Watters C. Policies of deterrence and the mental health of asylum seekers. JAMA. 2000;284(5):604–11.CrossRefPubMedGoogle Scholar
  10. 10.
    Silove D, Steel Z, Mollica R. Detention of asylum seekers: assault on health, human rights, and social development. Lancet. 2001;357(9266):1436–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Steel Z, Silove DM. The mental health implications of detaining asylum seekers. Med J Aust. 2001;175(11–12):596–9.PubMedGoogle Scholar
  12. 12.
    Williams B, Cassar C, Siggers G, Taylor S. Medical and social issues of child refugees in Europe. Arch Dis Child. 2016;101(9):839–42.CrossRefPubMedGoogle Scholar
  13. 13.
    Mannion M. Behind the wire: nursing in a detention centre. Aust Nurses J. 1992;21(10):22–4.PubMedGoogle Scholar
  14. 14.
    Pregnant asylum seekers in detention. Pract Midwife. 2002;5(11):7.Google Scholar
  15. 15.
    Woodhead M. Australian doctor challenges government over child detention “torture”. BMJ. 2016;352:i550.CrossRefPubMedGoogle Scholar
  16. 16.
    Mok A, Nelson EA, Murphy J, Hampson A, Hendriks JH. Children on hunger strike: child abuse or legitimate protest? BMJ. 1996;312(7029):501–4.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Zwi KJ, Herzberg B, Dossetor D, Field J. A child in detention: dilemmas faced by health professionals. Med J Aust. 2003;179(6):319–22.PubMedGoogle Scholar
  18. 18.
    Shields L, Stathis S, Mohay H, van Haeringen A, Williams H, Wood D, et al. The health of children in immigration detention: how does Australia compare? Aust N Z J Public Health. 2004;28(6):513–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Steel Z, Momartin S, Bateman C, Hafshejani A, Silove DM, Everson N, et al. Psychiatric status of asylum seeker families held for a protracted period in a remote detention centre in Australia. Aust N Z J Public Health. 2004;28(6):527–36.CrossRefPubMedGoogle Scholar
  20. 20.
    Newman LK, Steel Z. The child asylum seeker: psychological and developmental impact of immigration detention. Child Adolesc Psychiatr Clin N Am. 2008;17(3):665–83.CrossRefPubMedGoogle Scholar
  21. 21.
    Hodes M. The mental health of detained asylum seeking children. Eur Child Adolesc Psychiatry. 2010;19(7):621–3.CrossRefPubMedGoogle Scholar
  22. 22.
    Dudley M, Steel Z, Mares S, Newman L. Children and young people in immigration detention. Curr Opin Psychiatry. 2012;25(4):285–92.CrossRefPubMedGoogle Scholar
  23. 23.
    Isaacs D. Nauru and detention of children. J Paediatr Child Health. 2015;51(4):353–4.CrossRefPubMedGoogle Scholar
  24. 24.
    McGorry P. Asylum seeking and mandatory detention. The psychological consequences. Aust Fam Physician. 2002;31(3):275–8.PubMedGoogle Scholar
  25. 25.
    Koopowitz LF, Abhary S. Psychiatric aspects of detention: illustrative case studies. Aust N Z J Psychiatry. 2004;38(7):495–500.CrossRefPubMedGoogle Scholar
  26. 26.
    Keller AS, Ford D, Sachs E, Rosenfeld B, Trinh-Shevrin C, Meserve C, et al. The impact of detention on the health of asylum seekers. J Ambul Care Manage. 2003;26(4):383–5.CrossRefPubMedGoogle Scholar
  27. 27.
    Keller AS, Rosenfeld B, Trinh-Shevrin C, Meserve C, Sachs E, Leviss JA, et al. Mental health of detained asylum seekers. Lancet. 2003;362(9397):1721–3.CrossRefPubMedGoogle Scholar
  28. 28.
    Ishikawa E. Nihon no nanmin ukeire: sono keii to tenbou [Acceptance of refugees in Japan: history and prospects]. In: Komai H, editor. Koza guroubaruka suru nihon to imin mondai dai 1 kan: kokusaika no nakano imin seisaku no kadai [Lectures on globalizing Japan and problems of immigrants, vol. 1, problems of immigrant policy in globalization]. Tokyo: Akashi Shoten; 2002. p. 207–51.Google Scholar
  29. 29.
    Momartin S, Steel Z, Coello M, Aroche J, Silove DM, Brooks R. A comparison of the mental health of refugees with temporary versus permanent protection visas. Med J Aust. 2006;185(7):357–61.PubMedGoogle Scholar
  30. 30.
    Steel Z, Silove D, Brooks R, Momartin S, Alzuhairi B, Susljik I. Impact of immigration detention and temporary protection on the mental health of refugees. Br J Psychiatry. 2006;188:58–64.CrossRefPubMedGoogle Scholar
  31. 31.
    Lorek A, Ehntholt K, Nesbitt A, Wey E, Githinji C, Rossor E, et al. The mental and physical health difficulties of children held within a British immigration detention center: a pilot study. Child Abuse Negl. 2009;33(9):573–85.CrossRefPubMedGoogle Scholar
  32. 32.
    Robjant K, Robbins I, Senior V. Psychological distress amongst immigration detainees: a cross-sectional questionnaire study. Br J Clin Psychol. 2009;48(Pt 3):275–86.CrossRefPubMedGoogle Scholar
  33. 33.
    Robjant K, Hassan R, Katona C. Mental health implications of detaining asylum seekers: systematic review. Br J Psychiatry. 2009;194(4):306–12.CrossRefPubMedGoogle Scholar
  34. 34.
    Steel Z, Momartin S, Silove D, Coello M, Aroche J, Tay KW. Two year psychosocial and mental health outcomes for refugees subjected to restrictive or supportive immigration policies. Soc Sci Med. 2011;72(7):1149–56.CrossRefPubMedGoogle Scholar
  35. 35.
    Cleveland J, Rousseau C. Psychiatric symptoms associated with brief detention of adult asylum seekers in Canada. Can J Psychiatr. 2013;58(7):409–16.CrossRefGoogle Scholar
  36. 36.
    Graf M, Wermuth P, Hafeli D, Weisert A, Reagu S, Pfluger M, et al. Prevalence of mental disorders among detained asylum seekers in deportation arrest in Switzerland and validation of the Brief Jail Mental Health Screen BJMHS. Int J Law Psychiatry. 2013;36(3-4):201–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Young P, Gordon MS. Mental health screening in immigration detention: a fresh look at Australian government data. Australas Psychiatry. 2016;24(1):19–22.CrossRefPubMedGoogle Scholar
  38. 38.
    Green JP, Eagar K. The health of people in Australian immigration detention centres. Med J Aust. 2010;192(2):65–70.PubMedGoogle Scholar
  39. 39.
    Gatherer A, Enggist S, Møller L. The essentials about prisons and health. In: Enggist S, editor. Prisons and health. Copenhagen: WHO; 2014. p. 1–5.Google Scholar
  40. 40.
    Berger D. Australia‘s law to gag doctors with concerns about asylum seekers is a failure of democracy. BMJ. 2015;350:h3256.CrossRefPubMedGoogle Scholar
  41. 41.
    Smith P. Australia backs down over jail terms for doctors who speak out about abuse of asylum seekers. BMJ. 2016;355:i5681.CrossRefPubMedGoogle Scholar
  42. 42.
    Paxton GA, Cherian S, Zwi KJ. The royal Australasian college of physicians position statement on refugee and asylum seeker health. Med J Aust. 2015;203(4):176–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Kenny MA, Silove DM, Steel Z. Legal and ethical implications of medically enforced feeding of detained asylum seekers on hunger strike. Med J Aust. 2004;180(5):237–40.PubMedGoogle Scholar
  44. 44.
    Cohen J. Safe in our hands? A study of suicide and self-harm in asylum seekers. J Forensic Legal Med. 2008;15(4):235–44.CrossRefGoogle Scholar
  45. 45.
    Silove D, Curtis J, Mason C, Becker R. Ethical considerations in the management of asylum seekers on hunger strike. JAMA. 1996;276(5):410–5.CrossRefPubMedGoogle Scholar
  46. 46.
    Roggla G. Medically enforced feeding of detained asylum seekers on hunger strike. Wien Klin Wochenschr. 2005;117(11-12):436.CrossRefPubMedGoogle Scholar
  47. 47.
    Dahlberg J, Dahl V. Asylum seekers on hunger strike–how far does the patient‘s right to refuse treatment go? Tidsskr Nor Laegeforen. 2015;135(1):45–7.CrossRefPubMedGoogle Scholar
  48. 48.
    Lazarus JA. Physicians‘ ethical obligations to hunger strikers. BMJ. 2013;346:f3705.CrossRefPubMedGoogle Scholar
  49. 49.
    Irmak N. Professional ethics in extreme circumstances: responsibilities of attending physicians and healthcare providers in hunger strikes. Theor Med Bioeth. 2015;36(4):249–63.CrossRefPubMedGoogle Scholar
  50. 50.
    Karni T. Hunger striking inmates and detainees, and medical ethics. Isr Med Assoc J. 2015;17(3):179–81.PubMedGoogle Scholar
  51. 51.
    Caenazzo L, Tozzo P, Rodriguez D. Hospitalized hunger-striking prisoners: the role of ethics consultations. Med Health Care Philos. 2016;19(4):623–8.CrossRefPubMedGoogle Scholar
  52. 52.
    Druml C, Ballmer PE, Druml W, Oehmichen F, Shenkin A, Singer P, et al. ESPEN guideline on ethical aspects of artificial nutrition and hydration. Clin Nutr. 2016;35(3):545–56.CrossRefPubMedGoogle Scholar
  53. 53.
    Getaz L, Rieder JP, Nyffenegger L, Eytan A, Gaspoz JM, Wolff H. Hunger strike among detainees: guidance for good medical practice. Swiss Med Wkly. 2012;142:w13675.PubMedGoogle Scholar
  54. 54.
    Chalela JA, Lopez JI. Medical management of hunger strikers. Nutr Clin Pract. 2013;28(1):128–35.CrossRefPubMedGoogle Scholar
  55. 55.
    Eichelberger M, Joray ML, Perrig M, Bodmer M, Stanga Z. Management of patients during hunger strike and refeeding phase. Nutrition. 2014;30(11–12):1372–8.CrossRefPubMedGoogle Scholar
  56. 56.
    Kalk WJ. Guantanamo force feeding trial: the US is wrong to medicalize hunger striking. BMJ. 2015;350:h669.CrossRefPubMedGoogle Scholar
  57. 57.
    Hocking DC, Kennedy GA, Sundram S. Mental disorders in asylum seekers: the role of the refugee determination process and employment. J Nerv Ment Dis. 2015;203(1):28–32.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Joost Jan den Otter
    • 1
  • Thomas Wenzel
    • 2
  • Bernadette McGrath
    • 3
  • Andres Leal Osorio
    • 3
  • Boris Drožđek
    • 4
  1. 1.WPA Section on Psychological Consequences of Torture and PersecutionGenevaSwitzerland
  2. 2.World Psychiatric Association Scientific Section, Psychological Aspects of Persecution and TortureGenevaSwitzerland
  3. 3.Overseas Services to Survivors of Torture and TraumaAdelaideAustralia
  4. 4.PsyQ/Parnassia GroupRosmalen/EindhovenThe Netherlands

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