End Isolation Cells: Dutch NGOs

New research from the Netherlands questions the use of isolation in immigration detention, entitled ‘If someone is suffering, does he have to be kept in an isolation cell?

The research, published in March 2015, was produced by the Working Group on Health and Care Provision in Immigration Detention (a collaboration between Amnesty International the Netherlands, the LOS Foundation / Immigration Detention Hotline and Médecins du Monde the Netherlands).

The research addresses the use of isolation in immigration detention, its underlying policy and discrepancies between the practice of enforcing isolation and international human rights standards.

Among the negative consequences onto the health of the detainee, the authors mention ” suicidal thoughts and behaviour, emotional breakdown, chronic depression, uncontrollable anger, hallucinations and high blood pressure”.

Although medical research has shown that the use of isolation is detrimental to the mental health of detainees, changes to legislation, policy and practice have not yet been undertaken in the Netherlands to prevent its use. Upcoming revisions to Dutch legislation present a timely opportunity to reduce the use of isolation in immigration detention.

In the Netherlands, immigrants awaiting removal are detained. The European Committee for the Prevention of Torture (CPT) specifically states that immigration detention must ‘avoid as far as possible any impression’ of a prison environment, and that detention may not have a ‘punitive character’. Despite this, many organisations have gathered evidence that Dutch immigration detention centres are often the same as prisons, and in some aspects even stricter, including thier use of  isolation as a disciplinary measure.

According to the CPT, the grounds for isolation and the power to impose it must be clearly established in law. In addition, isolation may only be used when strictly necessary, if no less intrusive means are available to ensure safety or order in the detention centre. Moreover, the use of isolation must be proportional, considering the potentially harmful effects of isolation in relation to the objective. Isolation may also not be used in a discriminatory fashion and its use must be accounted for, which includes recording decisions to put people in isolation.

According to Dutch Law and Policy, immigrants, who are in administrative detention, are subject to the same conditions for the use of isolation as people who are imprisoned because they have committed a criminal offence. Isolation can be used as a disciplinary measure or as a measure to maintain order.

When isolation is imposed, the detainee has to spend a defined amount of time in an isolation cell. Beforehand, he has to hand in his clothes and belongings and is subjected to a full body search. This practice has a humiliating and occasionally traumatising effect on the person. The contact to the guards is limited, as is the amount of time one can spend in fresh air. Among the negative consequences onto the health of the detainee, the authors mention ” suicidal thoughts and behaviour, emotional breakdown, chronic depression, uncontrollable anger, hallucinations and high blood pressure”. Furthermore, the immigrants who suffer from psychiatric disorders are at greater risk of ending up in isolation since it is used as a management tool to maintain order. Isolation can result in further deterioration of the detained immigrants’ mental health.

One of the findings of the research is that the most cases of isolation are on medical grounds (threatening suicide, confusion, attempted suicide, self-harm, refusal of medication among others). The research team also conducted an expert meeting – the importance of sufficient expertise and good training of (healthcare) staff dealing with psychiatric patients in immigration detention was highlighted, stressing that making contact – and not severing it due to isolation – is a critical part of care provision.

The authors make suggestions on how the situation can be improved. In the area of mental health care and forensic psychiatry, they promote a more preventive approach

The authors make suggestions on how the situation can be improved. In the area of mental health care and forensic psychiatry, they promote a more preventive approach – identifying a crisis ahead of time, taking remedial action, maintaining close contact with the patient. Since punishment (e.g. isolation) was leading to further escalations, the solution was to create a more open living environment, with increased contact with staff and as little repression as possible.

Immigration detention centres in Sweden are being given as an example of positive practices:

“The immigrants are not kept in cells, but in rooms to which they have a key. This open living environment also results in greater stability and safety here and therefore in fewer incidents. This prevents escalation, and with it the need for isolation.”

Some of the recommendations made, include:

  • revoking the legal power to impose isolation as a disciplinary measure in immigration detention centres.
  • taking concrete steps, formulated in an action plan, to work on the reduction and eventual elimination of the use of isolation as an order measure; (framework established by the GGZ – the Dutch Association of Mental Health and Addiction Care)
  • making the GGZ guidelines an integral part of the supervisory framework of the Netherlands Healthcare Inspectorate and the Inspectorate of Safety and Justice in immigration detention

For more information, the complete report can be downloaded in Dutch here.