Understanding suicide and self-harm
This post, written by AFFMA office volunteers, first appeared in https://affmablog.wordpress.com/2017/03/13/91/
Self-harm and suicide ideation are not foreign in our detention centres, although they have decreased considerably with the shrinking population in detention after management of the maritime arrivals in 2011, it remains a prevalent issue.
Detainees have demonstrated particular susceptibility to harm – especially of psychological sorts – due to a myriad of reasons; these include but are not limited to:
- their past trauma
- their displacement from family and community
- social isolation
- lack of autonomy and control
- uncertainty about the future.
Additionally, a lack of privacy and space, witnessing episodes of self-harm, monotony, and an extensive length of stay, intensify previous factors and cause health deterioration.
What is needed to curb incidents of self-harm and suicide in detention
In order to curb incidents of self-harm and suicide, it is necessary for the department of Immigration and Citizenship (the department) to neutralise risks which may adversely affect the mental and physical health of the detainees.
The NSW State Coroner’s 2011 report, regarding the 3 suicides at Villawood Detention Centre in 2010, sanctioned the view of the experienced consultant psychiatrist and Associate Professor, Suresh Sundram, who in his report to the inquiry, recognised the ‘frustration, resentment and feelings of powerlessness and helplessness…in immigration detention’.
He suggested the feelings ‘have a potent capacity to exacerbate depression disorders which in turn will exacerbate these feelings’.
Similarly, the Coroner claimed that,
it is surely stating the obvious to observe that persons detained in Immigration Detention Centres must, by the nature of their various situations, be at much greater risk of suicide than the general community.”
He pinpointed the reasons as, ‘loss of families, freedom, status, work and length of time’.
Evidently, some factors leading to self-harm cannot be controlled, however, further stimuli must be denied. Here, it falls upon the department to monitor for these stimuli.
The Commonwealth is responsible for detainees under common law duty of care
As the High Court declared in Behrooz v Secretary, Department of Immigration & Multicultural & Indigenous Affairs, the Commonwealth is responsible for detainees under common law duty of care, as detainees ‘[do] not stand outside the protection of the civil and criminal law.
If an officer in a detention centre assaults a detainee, the officer will be liable to prosecution, or damages. If those who manage a detention centre fail to comply with their duty of care, they may be liable in tort.’
Under s 19(2) of the Work Health and Safety Act 2011, it is the duty of the department to neutralise all feasible risks and guarantee the health and safety of the detainees.
Contagion or imitative behaviour
The necessity of curbing episodes of self-harm and suicide ideation lies not only in neutralising the risk for an individual but for the surrounding inmates as well. Exposure to episodes of self-harm and suicide ideation can lead to ‘imitative
Exposure to episodes of self-harm and suicide ideation can lead to ‘imitative behaviour’ or ‘contagion’, and can entice inmates to engage in similar activities. Identified by professionals as the contagion effect, and originating from social learning theory, it can bring about disastrous consequences.
Involvement and social engagement can create positive environment and helps to keep detainees mentally engaged
In order to tackle the issue, the department needs to facilitate and engross detainees any way it can.
There needs to be a variety of engaging and educational activities to keep the detainees occupied and mentally engaged. Involvement in activities, specifically group activities, is shown to heighten optimism.
Detainees with the lengthiest detainments must receive priority, as they are more likely to isolate themselves from the group and resist partaking in activities. The report found a shockingly high level of mental illness among detainees, especially those held for lengthy periods.
As statistics show, the indisputable correlation between length of stay and self-harm urges particular attention upon detainees who have been in detention the longest.
Incidents of self-harm remain prevalent
I myself have witnessed scars and stitches on a detainee, who attempted suicide after hearing news of his transfer to Christmas Island. There have been numerous acts of self-harm I have been told, though I personally was not aware of any other incidents whilst visiting Villawood Detention Centre every week over a span of six months.
Nonetheless, the feelings of helplessness, anxiety and despondency were painfully obvious. It did not seem that these people were much engrossed or facilitated, and it may be assumed that the department has still not managed to neutralise risks of self-harm and suicide.
Detention suicide statistics
The Report by the Commonwealth and Immigration Ombudsman states that from the 1st of July 2010 to the 31st of December 2012, all 11 deaths in detention were suicides, however, according to the Australian Border Deaths Database, only 5 of the deaths were suicides or suspected suicides.
Since then, 19 have died in onshore and offshore centres, 5 of these were suicides or suspected suicides, and a significant number of deaths were natural; usually caused by heart conditions, possibly attributed to the stress of living in the limbo that is detention.
The two deaths that occurred in community detention from 2010 to 2013 were not suicides or suspected suicides.
Read the full report
Countless accounts of self-harm have been included in the statistics covered in the report, ‘Suicide and Self-harm in the Immigration Detention Network’, and can be found online:
http://www.ombudsman.gov.au/__data/assets/pdf_file/0022/30298/December-2013-Suicide-and-self-harm-in-the-Immigration-Detention-Network.pdf
It is essential for the department to review and refine the process of data collection and frequent reporting, in order to supervise the health of detainees, and recognise and control the risk of self-harm and suicide.
Prevention of self-harm during immigration detention
Standard medical methodology needs to be applied, and correspondence with the Immigration Health Advisory Group and bodies with appropriate expertise, such as the Australian Institute of Health and Welfare, is vital.
Although there has been a phenomenal improvement over the years, as suggested in the report, there needs to be a continuous revision of policies, health standards, and occurrences to target and contain the risk of self-harm and suicide, thereby preventing future occurrences.
Proper Implementation, integration and review of the Psychological Support Program (PSP) is another focal point in the ‘Prevention of Self-Harm for People in Immigration Detention’.
Again, it is the duty of the department to monitor the use of the PSP under its service providers, and by extension, curb the incidents of self-harm and suicide ideation.
Posted by Shezza Khan
