Resource

People seeking asylum are frequently placed in immigration detention centres upon arrival in a new country. These centres are intended to temporarily hold individuals while identities are verified, claims are processed or deportations are arranged. 

However, being placed in detention centres has been consistently linked to an increase in poor mental health outcomes among people seeking asylum. This is particularly significant given people seeking asylum are already more likely to experience poor mental health, due to traumatic experiences endured pre-, during- and post- migration.  

The UN High commissioner for refugee states that detention should be used as a last resort and be proportionate. However, detention for immigration purposes is widely used worldwide. In the European Union alone, over 100,000 people are currently in held in immigration detention, with many remaining there for months or even years.  

Conditions in detention centres are often poor, with overcrowding, limited access to outdoor space, unsanitary environments, poor nutrition, and inadequate access to physical and mental healthcare. Individuals who have experienced immigration detention identified it as a dehumanising experience, involving deprivation, isolation and the fracturing of relationships. Children are especially vulnerable to the harmful effects of detention on both their physical and mental health. Despite the UNHCR's clear guidance that children should never be detained for immigration-related reasons, around 330,000 children are detained every year across at least 77 countries. 

A review published in 2018 suggested that detention may be associated with poorer mental health outcomes amongst people seeking asylum. Since then, the global number of people seeking asylum has more than doubled.   

We conducted an updated systematic review of the recent literature (since 2018) exploring the relationship between immigration centres and mental health outcomes for people seeking asylum.  

14 studies met the inclusion criteria, including participants detained in Mexico, Spain, the United States, the United Kingdom, Portugal, and Australia. 

Key findings included: 

Adults: 

• People seeking asylum who were detained had high prevalences of psychiatric morbidity, particularly PTSD, mood disorders and anxiety 

• Poor detention conditions were associated with mental illness among adults, including experiences of abuse, confinement, limited access to family visitation, and harassment. 

• All studies examining the impact of detention duration found that longer periods of detention were associated with increased mental health concerns. 

• Some studies also suggest a bidirectional relationship, where people seeking asylum who were experiencing mental health problems were more likely to experience longer detention and worse conditions in detention, including solitary confinement and reduced access to both mental and physical healthcare.  

Children: 

• Studies reported a high prevalence of mental health disorder symptoms among adolescent detainees. Up to four in five children showed symptoms of PTSD. 

• Evidence that children with neurodevelopmental disorders or symptoms of these are being held in immigration detention facilities 

• Mental illness among children in immigration detention was significantly associated with maternal factors, including separation from their mothers, maternal mental health problems, and mothers' exposure to violence during the migration journey. 

• Unlike adults, there was no relationship between duration of detention and mental illness among children – high rates of mental health symptoms were demonstrated in children regardless of length of length of detention.  

Implications of this study 

• Upper limits should be applied to adults' detention in countries without such restrictions 

• Conditions of detention environments should be improved, including eliminating harmful practices such as separation of families, verbal and physical abuse, poor access to health services 

• Mental health screening should be carried out prior to detention to identify those at risk of or with mental health disorders. Evidence based psychological support should be accessible to individual in detention. 

• Governments should consider alternatives to immigration detention, such as community-based arrangements 

• Detention of children should be abolished given the clear evidence of harm and existing UNHCR guidelines 

Read the full systematic review by clicking the arrow below.