A damning report on healthcare and safeguarding in detention has concluded that the existing protocols for vulnerable detainees are “totally and utterly flawed”. 

The Medical Justice report Harmed not Heard focuses on the inadequacy of the Rule 35 safeguarding process, designed to identify vulnerable detainees for release. The research comes only a few weeks after the conclusion of the Brook House inquiry, which uncovered appalling abuse of detainees and exposed how ineffective the safeguarding processes designed to protect vulnerable individuals truly were.

Medical Justice’s research took data from five of the UK’s seven detention centres, concluding that failings exist across the detention estate.

Key findings

Medical Justice’s clinical staff began by identifying vulnerable detainees who met the Rule 35 criteria. By comparing their own assessments with those carried out by staff at IRCs, the report found striking failures of IRC healthcare, and identifies a culture of non-compliance where legal obligations to vulnerable detainees are concerned.

For instance, just half the people assessed by Medical Justice had seen a GP within 24 hours of arriving at an IRC, in flagrant breach of Detention Centre Rule 34. Early screening of detained people is essential to ensure that those at most risk of detention are released before their risk is aggravated. 

Suicide, PTSD and lacking capacity

Another 90% of individuals reported thoughts of self-harm and suicide to Medical Justice staff, but only in half of these cases had been recorded by IRC staff. This suggests a failure of safeguarding channels to effectively identify at-risk individuals. 

Similarly, around 75% of detainees assessed either had a diagnosis or presented with “clinically significant” symptoms of PTSD. Clinical literature cited by Medical Justice repeatedly points to the damage that detention can do to individuals with PTSD – detention conditions replicating the penal environments in which some asylum seekers have experienced state torture, for instance. 

However there was no evidence that detention staff had screened these individuals for PTSD or were aware of their illness, raising further concerns about at-risk individuals going totally unnoticed.

Two people met by Medical Justice appeared to lack capacity. While not unlawful to detain people who lack capacity, it is unlawful not to make any reasonable adjustments to accommodate a person’s disability. In any case it’s a chilling thought that the Home Office decided that depriving such vulnerable individuals of their liberty was appropriate.

Rule 35 should be “proactive”

As the primary mechanism operating in detention centres for safeguarding vulnerable detainees, the report asks us to bear in mind that the Rule 35 process is meant to be proactive, to ensure that vulnerable people are not detained. Rule 35 was not introduced for mere record keeping purposes. This is particularly important to bear in mind given the number of detainees on suicide watch during the pandemic.

The Home Office’s approach to safeguarding detainees again come under the spotlight last week after a Black British teenager was detained under immigration powers after being identified by Immigration Enforcement as Nigerian. The boy is non-verbal and was reported missing after receiving treatment for psychosis. It was assumed he must be a foreign national, presumably because of the colour of his skin, and it was assumed that it was appropriate to detain him. Hopefully it doesn’t take a more shocking example than this for the Home Office to take seriously its responsibilities to vulnerable people.