Mental health and immigration detention: Difference between revisions

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Under typical circumstances of family separation, the parent(s) are criminally detained and investigated while the children are held separately. In US detention centers, parents may be forcibly removed from holding cells with their children without warning or a chance to say goodbye, and no knowledge of if or when they will be reunited. Because of the already adverse effects of immigration detention, separating parents from children causes even greater trauma to parents, and disrupting their ability to care for their children even after reunification.<blockquote>"Lidia expressed difficulty connecting with her son out of fear that, if immigration authorities separate them again via detention or deportation, being attached would potentially contribute to re-traumatization. This reflects the great impact the trauma of separation continues to have on Lidia and her ability to provide secure attachment to her son." – personal accounts from staff at the Terra Firma Program in New York <ref name=":1" /></blockquote>Furthermore, family separation has profound impact on the psychological health of children, which will be discussed in a later section in greater detail.
Under typical circumstances of family separation, the parent(s) are criminally detained and investigated while the children are held separately. In US detention centers, parents may be forcibly removed from holding cells with their children without warning or a chance to say goodbye, and no knowledge of if or when they will be reunited. Because of the already adverse effects of immigration detention, separating parents from children causes even greater trauma to parents, and disrupting their ability to care for their children even after reunification.<blockquote>"Lidia expressed difficulty connecting with her son out of fear that, if immigration authorities separate them again via detention or deportation, being attached would potentially contribute to re-traumatization. This reflects the great impact the trauma of separation continues to have on Lidia and her ability to provide secure attachment to her son." – personal accounts from staff at the Terra Firma Program in New York <ref name=":1" /></blockquote>Furthermore, family separation has profound impact on the psychological health of children, which will be discussed in a later section in greater detail.


== Special populations ==
⚫
== Children and adolescents in the US ==

=== Women ===
The specific experiences of detained migrant women are often overlooked. Interviews with detention officers in Greece revealed that detained women are often culturally stereotyped and sexualized while in detention.<ref>{{Citation|last=Bosworth|first=Mary|title=Women’s Immigration Detention in Greece: Gender, Control and Capacity|date=2016|url=http://dx.doi.org/10.1007/978-3-319-24690-1_9|work=Immigration Detention, Risk and Human Rights|pages=157–170|place=Cham|publisher=Springer International Publishing|isbn=978-3-319-24688-8|access-date=2021-04-12|last2=Fili|first2=Andriani|last3=Pickering|first3=Sharon}}</ref> In the United States, thousands of instances of sexual violence against detained women have been reported, many of the cases being perpetrated by [[U.S. Immigration and Customs Enforcement|Immigration and Customs Enforcement]] (ICE) officers. While women are not the only targets of sexual violence, there have been systemic issues with women detainees being raped, filmed in the shower, and otherwise assaulted while in detention.<ref>{{Cite web|last=Speri|first=Alice|last2=|first2=|date=April 11 2018|title=1,224 Complaints Reveal a Staggering Pattern of Sexual Abuse in Immigration Detention. Half of Those Accused Worked for ICE.|url=https://theintercept.com/2018/04/11/immigration-detention-sexual-abuse-ice-dhs/|url-status=live|access-date=2021-04-12|website=The Intercept|language=en}}</ref>

⚫
=== Children and adolescents in the US ===
Among detained immigrants, children and adolescents––those under 18 years of age––are especially vulnerable, partly due to the overlap of traumatic experiences with critical developmental stages. After examining 425 immigrant children that were detained in the US, a study has found that 17% had a probable PTSD diagnosis, more than triple of the lifetime prevalence of PTSD among adolescents, i.e., those who have had PTSD at some point in their lives.<ref name="McLaughlin_2013">{{cite journal | vauthors = McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM, Kessler RC | title = Trauma exposure and posttraumatic stress disorder in a national sample of adolescents | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 52 | issue = 8 | pages = 815–830.e14 | date = August 2013 | pmid = 23880492 | pmc = 3724231 | doi = 10.1016/j.jaac.2013.05.011 }}</ref> Traumatic events have a significant affect on young children (ages 4–8), harming their emotional and behavioral development. This results in conduct issues or hyperactivity. Additionally, children who were forced to separate from their mothers have demonstrated even more distress.<ref name="McLaughlin_2013" />
Among detained immigrants, children and adolescents––those under 18 years of age––are especially vulnerable, partly due to the overlap of traumatic experiences with critical developmental stages. After examining 425 immigrant children that were detained in the US, a study has found that 17% had a probable PTSD diagnosis, more than triple of the lifetime prevalence of PTSD among adolescents, i.e., those who have had PTSD at some point in their lives.<ref name="McLaughlin_2013">{{cite journal | vauthors = McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM, Kessler RC | title = Trauma exposure and posttraumatic stress disorder in a national sample of adolescents | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 52 | issue = 8 | pages = 815–830.e14 | date = August 2013 | pmid = 23880492 | pmc = 3724231 | doi = 10.1016/j.jaac.2013.05.011 }}</ref> Traumatic events have a significant affect on young children (ages 4–8), harming their emotional and behavioral development. This results in conduct issues or hyperactivity. Additionally, children who were forced to separate from their mothers have demonstrated even more distress.<ref name="McLaughlin_2013" />


Revision as of 21:21, 12 April 2021

Mental health consequences of immigration detention include higher rates of depression, anxiety, PTSD, conduct issues, hyperactivity, compared to the general population. These harmful impacts exist regardless of past traumatic experiences (e.g., near-death experiences, physical, emotional, or sexual abuse, etc.), age, or nationality, or even time elapsed. Immigration detention may take place at country or state borders, in certain international jurisdiction zones, on offshore islands, boats, camps, or could even be in the form of house arrest.[1] The use of immigration detention around the world has increased recently, leading to greater concerns about the health and wellbeing of detained migrants. A 2018 scoping review from BMC Psychiatry gathered information showing that immigration detention consistently results in negative impacts on detainees.[2]

Overview

The number of refugees globally has increased substantially since 2014. The United Nations High Commissioner for Refugees estimates that at the end of 2019,[3] the number of forcibly displaced persons is at 79.5 million, including internally displaced people (IDP; 45.7 million), refugees (26 million), asylum seekers (4.2 million), and Venezuelans displaced abroad (3.6 million), compared to the 51 million of forcibly displaced persons in 2013, which was already the largest number since World War II.[4]

Many countries detain undocumented immigrants, including asylum seekers and non-citizens. In 2017 and 2018, there were 160,504 detained immigrants in the European Union and the United Kingdom.[5] In 2017 the number went rose to 323,591 in the United States in 2017.[6]

Refugees and asylum seekers are already more vulnerable to mental health consequences, given the physical and mental burden of fleeing one's own country. Detention exacerbates immigrants’ psychological condition, especially depression and post-traumatic stress disorder (PTSD). Numerous studies have examined and pointed out acute and long-term psychological distress among detained immigrants, especially children, making them particularly vulnerable.[7]

Immigration detainees commonly report anxiety, depression, and PTSD during and after detention.[2] Pre-detention stressors include exposure to torture, human trafficking, and other kinds of human rights violations,[4] already putting immigrants at risk for mental health issues. During detention, immigrants have to cope with the loss of liberty, the risk of being forced to return to their country of origin, social isolation, and possible abuse from staff, which may resemble their country of origin, triggering their traumatic experiences.[2]

A meta-analysis examined 17 studies on 1168 participants of immigration detainees,[2] including host countries such as the US, the UK, Canada, Australia, Israel, Japan, Switzerland, and Sweden, and countries of origin ranging from Iran, Iraq, Afghanistan, Palestine, Mexico, Cuba, to other countries in Central America. The wide range of countries suggests a universality in the negative mental health impact of immigration detention. Findings suggest that detention adds additional stressors to immigrants and is associated with greater symptom severity. Additionally, detained refugees suffer from greater symptom severity than non-detained refugees.  The duration of detention is linked, the severity of  adverse mental health outcomes . It is stated that “the experience of detention may act as a new stressor, which adds to the cumulative effect of exposure to trauma, leading to an increased likelihood of developing mental health difficulties such as PTSD” (p. 2).[2]

Historical context

The institutionalized use of detention centers began during the 1980s. Before this point, detention was used only in extenuating circumstances, when the state deemed it absolutely necessary. In this context, detainees were held in more improvised locations such as prisons, warehouses, or even hotel rooms.[8] Within the United States, immigration control has been a prominent aspect of national policy since the days of the Chinese Exclusion Act, and even Ellis Island housed a detention center, showing that detention has almost always been part of the US immigration process.[8] In fact, Ellis Island was known as "The Island of Tears" to immigrants.[9] Under Reagan in the 1980s, the Immigration and Naturalization Service (INS) began to earnestly detain migrants from the Caribbean, and built numerous detention centers within the US and in Puerto Rico.[8] A major turning point followed, with the passage of the Immigration Control and Reform Act (IRCA) in 1986. The passage of this legislation ensured that immigration control would stay a high priority in policy, and increased the funding for enforcement and detention activities.[8]

As countries such as the United States have put increasing funding and importance towards immigration detention, private prisons have entered the fold. The first private immigration detention center in the US was also established in the mid-1980s, and many other countries in the global north followed suit. For example, the use of Guantanamo Bay as an offshore detention center served as a precedent for Australia to establish offshore immigrant detention centers in Nauru and Papua New Guinea.[8] Overall, using immigrant detention centers, border patrols, and other control measures is an established practice around the world in order to maintain political and social borders created by dominant social groups.[10]

Common mental health outcomes

Post-Traumatic Stress Disorder (PTSD)

A study from the International Journal of Public Health interviewed asylum seekers detained in Canada. The results revealed that "being treated like criminals" and being forced to wait for "indeterminate periods of time" during which they had little control was detrimental to their mental health. In addition, the study revealed that the violence and lack of control resulted in retraumatization for asylum seekers who had previously endured trauma.[11]

Depression

Similarly, a UNHCR team observed the mental health of detained asylum seekers on Manus Island and found that 90% of them could have been diagnosed with major depressive disorder, generalized anxiety disorder, or PTSD.[12] Detained refugees in Australia and offshore detention centers said that "life in detention was meaningless” and talked about feelings of extreme hopelessness and loneliness. Even after being released from detention, depression seemed to be the most prominent mental health related issue for the refugees interviewed.[13]

Anxiety

During detention, asylum seekers and refugees both experienced symptoms of anxiety related to the uncertainty and lack of control while in detention. Fear of violence within the center and perceived lack of justice in relation to visa processing only added to these feelings. Furthermore, many refugees interviewed after release in Australia reported extreme symptoms of anxiety and intrusive thoughts related to their time in detention.[13]

Suicidality

A case study focusing on Australia's Nauru Regional Processing Center identifies suicidal ideations and suicide attempts by one detainee, and highlights the gap in suicide prevention in the detention center. According to this study, the factors behind this detainee's suicide attempts included long periods of detention, no knowledge of when they would be released, and the endlessly delayed and unjust legal process.[14]

A case study working with limited data from the UK found the rate of self-harm requiring medical attention to be around 13% – at a conservative estimate. Among this population, 72% of detained asylees were already living with depression, However, this particular study showed that there is an extreme lack of information on self-harm and suicide within detention centers.[15]

"'There is a big possibility that I kill myself here. Everyday I am dying slowly. What have I brought my family to?'" – a detainee in an Australian immigration detention center[16]

Family separation

Particularly over the past few decades in the United States, family separation has been used as policy of deterrence against migrants. Policies such as expedited removal and the general criminalization of immigrants crossing the border without proper documentation, as well as Trump's Zero Tolerance Policy, have effectively created the conditions under which family separation occurs in the United States.[17]

Through recent research, family separation has been strongly linked to negative mental health outcomes, particularly for migrants who have experienced prior trauma such as refugees or asylum seekers. Interviews with several refugee families after their resettlement in the United States showed that family separation was a major stressor. In this case, family separation concerns include fearing for family members that may still be in danger, feeling powerless to help separated family members, and lacking important social, emotional, and cultural connections through family. The same study applied several established measures of mental health and quality of life to the families they interviewed and found that those who were experiencing family separation had higher anxiety, depression, and PTSD levels, and lower quality of life measures compared to those not separated from family members.[18] Psychological recovery after being released from detention hinges heavily upon the stability of the detainee's family, meaning that family separation can have long-term effects even after detention ends.[17]

Under typical circumstances of family separation, the parent(s) are criminally detained and investigated while the children are held separately. In US detention centers, parents may be forcibly removed from holding cells with their children without warning or a chance to say goodbye, and no knowledge of if or when they will be reunited. Because of the already adverse effects of immigration detention, separating parents from children causes even greater trauma to parents, and disrupting their ability to care for their children even after reunification.

"Lidia expressed difficulty connecting with her son out of fear that, if immigration authorities separate them again via detention or deportation, being attached would potentially contribute to re-traumatization. This reflects the great impact the trauma of separation continues to have on Lidia and her ability to provide secure attachment to her son." – personal accounts from staff at the Terra Firma Program in New York [17]

Furthermore, family separation has profound impact on the psychological health of children, which will be discussed in a later section in greater detail.

Special populations

Women

The specific experiences of detained migrant women are often overlooked. Interviews with detention officers in Greece revealed that detained women are often culturally stereotyped and sexualized while in detention.[19] In the United States, thousands of instances of sexual violence against detained women have been reported, many of the cases being perpetrated by Immigration and Customs Enforcement (ICE) officers. While women are not the only targets of sexual violence, there have been systemic issues with women detainees being raped, filmed in the shower, and otherwise assaulted while in detention.[20]

Children and adolescents in the US

Among detained immigrants, children and adolescents––those under 18 years of age––are especially vulnerable, partly due to the overlap of traumatic experiences with critical developmental stages. After examining 425 immigrant children that were detained in the US, a study has found that 17% had a probable PTSD diagnosis, more than triple of the lifetime prevalence of PTSD among adolescents, i.e., those who have had PTSD at some point in their lives.[21] Traumatic events have a significant affect on young children (ages 4–8), harming their emotional and behavioral development. This results in conduct issues or hyperactivity. Additionally, children who were forced to separate from their mothers have demonstrated even more distress.[21]

Long term consequences

Long term stressors that may affect refugees and immigrants include acculturation difficulties, isolation, discrimination, poor living conditions, poor healthcare, etc. However, deleterious effects of detention, compounded by the length of detention, may continue to exist long after release from centers. Even if detention is temporary, its consequences are not. It is important to note that not all immigrants develop depression, anxiety, PTSD, or other psychological disorders. An Australian study examining 241 Arabic-speaking immigrants have found that after a mean of 3 years following release from detention centers, more than half of those who were detained for more than 6 months still show clinical depression, nearly doubling the percentage of those who were detained for 1–5 months. This is independent of past traumatic experiences.[22] Future studies are needed to determine more substantial long-term effects of immigration detention

References

  1. ^ United Nations High Commissioner for Refugees. "Refworld | Guidelines on the Applicable Criteria and Standards relating to the Detention of Asylum-Seekers and Alternatives to Detention". Refworld. Retrieved 2021-03-13.
  2. ^ a b c d e von Werthern M, Robjant K, Chui Z, Schon R, Ottisova L, Mason C, Katona C (December 2018). "The impact of immigration detention on mental health: a systematic review". BMC Psychiatry. 18 (1): 382. doi:10.1186/s12888-018-1945-y. PMC 6282296. PMID 30522460.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  3. ^ "Refugee data finder". United Nations High Commissioner for Refugees. June 2020.
  4. ^ a b "Global trends 2013: UNHCR releases annual refugee statistics". United Nations High Commissioner for Refugees. June 2014.
  5. ^ "European Union: Organization & alliances countires grid". Global Detention Project. 2020.
  6. ^ "Americas". Global Detention Project. 2020.
  7. ^ Priebe S, Giacco D, El-Nagib R (2016). Public health aspects of mental health among migrants and refugees: A review of the evidence on mental health care for refugees, asylum seekers and irregular migrants in the WHO European Region. World Health Organization. PMID 27809423.
  8. ^ a b c d e Flynn M (September 2014). "There and Back Again: On the Diffusion of Immigration Detention". Journal on Migration and Human Security. 2 (3): 165–197. doi:10.1177/233150241400200302. S2CID 220065313.
  9. ^ Silverman SJ (2010-10-01). "Immigration Detention in America: A History of Its Expansion and a Study of Its Significance". Rochester, NY. SSRN 1867366. {{cite journal}}: Cite journal requires |journal= (help)
  10. ^ Nethery A (September 2009). 'A modern-day concentration camp': using history to make sense of Australian immigration detention centres. ANU Press. doi:10.22459/dhm.09.2009.04. ISBN 978-1-921536-94-6. {{cite book}}: |work= ignored (help)CS1 maint: unflagged free DOI (link)
  11. ^ Cleveland J, Kronick R, Gros H, Rousseau C (November 2018). "Symbolic violence and disempowerment as factors in the adverse impact of immigration detention on adult asylum seekers' mental health". International Journal of Public Health. 63 (8): 1001–1008. doi:10.1007/s00038-018-1121-7. PMID 29860657. S2CID 44180183.
  12. ^ Sundram S, Ventevogel P (December 2017). "The mental health of refugees and asylum seekers on Manus Island". Lancet. 390 (10112): 2534–2536. doi:10.1016/S0140-6736(17)33051-9. PMID 29191373. S2CID 205988654.
  13. ^ a b Coffey GJ, Kaplan I, Sampson RC, Tucci MM (June 2010). "The meaning and mental health consequences of long-term immigration detention for people seeking asylum". Social Science & Medicine. 70 (12): 2070–2079. doi:10.1016/j.socscimed.2010.02.042. PMID 20378223.
  14. ^ Rimkeviciene J, O'Gorman J, De Leo D (2017-01-01). "Suicidality in detention centres: a case study". International Journal of Migration, Health and Social Care. 13 (1): 106–118. doi:10.1108/IJMHSC-09-2015-0034. ISSN 1747-9894.
  15. ^ Cohen J (2008-05-01). "Safe in our hands?: A study of suicide and self-harm in asylum seekers". Journal of Forensic and Legal Medicine. 15 (4): 235–244. doi:10.1016/j.jflm.2007.11.001. ISSN 1752-928X. PMID 18423357.
  16. ^ Mares, Sarah; Newman, Louise; Dudley, Michael; Gale, Fran (2002-06-01). "Seeking Refuge, Losing Hope: Parents and Children in Immigration Detention". Australasian Psychiatry. 10 (2): 91–96. doi:10.1046/j.1440-1665.2002.00414.x. ISSN 1039-8562.
  17. ^ a b c de la Peña, Cristina Muñiz; Pineda, Lisa; Punsky, Brenda (2019-06-01). "Working with Parents and Children Separated at the Border: Examining the Impact of the Zero Tolerance Policy and beyond". Journal of Child & Adolescent Trauma. 12 (2): 153–164. doi:10.1007/s40653-019-00262-4. ISSN 1936-153X. PMC 7163859. PMID 32318188.{{cite journal}}: CS1 maint: PMC format (link)
  18. ^ Miller, Alexander; Hess, Julia Meredith; Bybee, Deborah; Goodkind, Jessica R. (2018). "UNDERSTANDING THE MENTAL HEALTH CONSEQUENCES OF FAMILY SEPARATION FOR REFUGEES: IMPLICATIONS FOR POLICY AND PRACTICE". The American journal of orthopsychiatry. 88 (1): 26–37. doi:10.1037/ort0000272. ISSN 0002-9432. PMC 5732089. PMID 28617002.
  19. ^ Bosworth, Mary; Fili, Andriani; Pickering, Sharon (2016), "Women's Immigration Detention in Greece: Gender, Control and Capacity", Immigration Detention, Risk and Human Rights, Cham: Springer International Publishing, pp. 157–170, ISBN 978-3-319-24688-8, retrieved 2021-04-12
  20. ^ Speri, Alice (April 11 2018). "1,224 Complaints Reveal a Staggering Pattern of Sexual Abuse in Immigration Detention. Half of Those Accused Worked for ICE". The Intercept. Retrieved 2021-04-12. {{cite web}}: Check date values in: |date= (help)CS1 maint: url-status (link)
  21. ^ a b McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM, Kessler RC (August 2013). "Trauma exposure and posttraumatic stress disorder in a national sample of adolescents". Journal of the American Academy of Child and Adolescent Psychiatry. 52 (8): 815–830.e14. doi:10.1016/j.jaac.2013.05.011. PMC 3724231. PMID 23880492.
  22. ^ Steel Z, Silove D, Brooks R, Momartin S, Alzuhairi B, Susljik I (January 2006). "Impact of immigration detention and temporary protection on the mental health of refugees". The British Journal of Psychiatry. 188: 58–64. doi:10.1192/bjp.bp.104.007864. PMID 16388071. S2CID 4694253.
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