Self-harm among asylum seekers in Australian onshore immigration detention: how incidence rates vary by held detention type

Abstract

Background: Detained asylum seekers are at increased risk of self-harm, and the type of detention in which they are held may further exacerbate this risk. In Australia, there are four types of closed (or held) immigration detention for people seeking asylum, with varying levels of security and supports: Immigration Detention Centres [IDCs], Immigration Transit Accommodation [ITAs], Immigration Residential Housing [IRH], and Alternative Places of Detention [APODs]. The objective of this study was to examine the variation in the incidence and method(s) of selfharm among asylum seekers in Australian onshore immigration detention, according to the type of detention in which they are held. Methods: We obtained data on all self-harm incidents reported among asylum seekers in Australian onshore immigration detention according to held detention type, as well as individual facility, between 1 August 2014 and 31 July 2015, by Freedom of Information. We calculated self-harm episode rates per 1000 asylum seekers using the average population figures for held detention type, as well as for each individual facility comprising the main types of held detention. Method(s) used to self-harm was also extracted for the main sub-populations. Results: The study included 560 episodes of self-harm. Individual facility rates of self-harm ranged from 91 per 1000 asylum seekers (95% CI 72-110) in Yongah Hill IDC to 533 per 1000 asylum seekers (95% CI 487-578) in Perth IDC. On average, calculated self-harm episode rates were highest among asylum seekers in: Immigration Transit Accommodation facilities, 452/1000 (95% CI 410-493); Alternative Places of Detention, 265/1000 (95% CI 233-296); and Immigration Detention Centres, 225/1000 (95% CI 195-254). The most frequently reported methods of self-harm across the main types of held detention were: cutting (35.2%), self-battery (34.8%), and attempted hanging (11.1%). Conclusions: Self-harm rates for asylum seekers in all types of closed immigration detention were many times higher than rates found in the general population. Average rates were not lower in facilities with lower security features.

Temporal variations in the distribution of self-harm episodes and methods across the Australian asylum seeker population: An observational study

“…Our own research has found that rates of self-harm among adult asylum seekers in onshore detention during the same study period-at 257 per 1,000 detained asylum seekers-were 214 times higher than hospital-treated rates of self-harm in the general Australian community [5]. Furthermore, our more recent study [26] has observed that self-harm episodes occur most frequently in types of onshore detention where populations are mixed (such as Immigration Transit Accommodation [ITA] and Alternative Places of Detention [APODs]). These types of detention house both single adult males and females, as well as families, for short-, medium-, and long-term stays.…”

“…These types of detention house both single adult males and females, as well as families, for short-, medium-, and long-term stays. Transfers between and within other facilities reportedly occur very frequently in such detention arrangements-including between onshore and offshore detention-often with little notice, resulting in family separation [26]. Such separations are known to occur between parents and children, couples, as well as extended family members.…”

“…There are a range of possible explanations worth considering for the observed pattern of self-harm: the state of the centres at this time of the evening, fear of transfer during the night, and lower levels of supervision. Furthermore, as both ITAs and APODs were used for housing families with children, it is likely that attempting to carry out parenting tasks in the late evening in such environments, with little autonomy or flexibility, was experienced as particularly challenging for both detained parents and children [26]. Indeed, research has found that held detention environments, including both APODs and ITAs, frequently contributed to feelings of parental disempowerment, with parents often stripped of control over their everyday routines, including organising mealtimes in the evenings to suit children's bedtimes or easy access to bottles and nappies, as needed, including late at night [27][28].…”

Addressing self‐harm among detained asylum seekers in Australia during the COVID‐19 pandemic

“…We recently examined self‐harm among asylum seekers in Australia over a 12‐month period according to the type of detention in which they were held: Immigration Detention Centres (IDCs), Immigration Transit Accommodation (ITAs), and Alternative Places of Detention (APODs) 5 . Rates of self‐harm among those detained in IDCs, APODs, and ITAs were calculated to be 187 times, 220 times, and 376 times higher than the hospital‐treated rates of self‐harm reported in the Australian general community, respectively 6 . Furthermore, across the entire immigration detention population, self‐harm rates were found to have increased by an average of 15% since an earlier investigation into self‐harm in the onshore detention network just three years earlier 7 …”

Prevalence, methods and characteristics of self-harm among asylum seekers in Australia: protocol for a systematic review

“…10 These studies reported self-harm prevalence rates in adults and children of between 31%-36% and 25%-80%, respectively over a 6-month period in 2002-2003. 10 However, a preliminary search conducted while developing the search strategy for this review identified several further salient studies in this area [26][27][28][29][30][31][32] that have been published both prior to and since the authors' 10 review was conducted in 2018. Some of these studies were likely excluded from von Werthern et al's explicit search strategy for various reasons (eg, studies examining multi-morbidity including both mental and physical health), meaning that they may have been missed.…”