Care in Captivity?

Mental healthcare provision for detainees is often fragmented and hampered by a severe lack of resources, in spite of the best efforts of many professionals working in this extremely challenging environment.

This is the main conclusion of ‘Care in Captivity?’, a JRS Malta report aimed at understanding how the mental health needs of detainees are met and evaluating the extent to which they receive the care and protection they need.

Our work in detention has made us acutely aware of the psychological difficulties detainees face, and of the many, often severe, adverse mental health consequences they suffer. We have witnessed first-hand the efforts made by mental healthcare professionals to provide appropriate and dignified care. However, having also witnessed the acute levels of distress experienced by detainees with mental ill-health, we cannot but be concerned about the overall efficacy of mental health services for this population. It is for this reason that we undertook this study, with a view to documenting the current situation and making recommendations for improved care and support,” said Ms Kristina Zammit, JRS Malta Assistant Director, who runs the organization’s Psychosocial Service.

The report highlights various gaps in how the mental health needs of detained asylum seekers are met including: the physical conditions in the Asylum Seekers Unit at Mount Carmel Hospital, which fail to foster a therapeutic environment; the irregular availability of interpreters; problems ensuring continuity of care in detention; and lengthy procedures for release from detention on vulnerability grounds.

It calls upon the Government to address fragmentation in service provision and improve the treatment and care currently provided by:

  • Integrating the provision of health care services in detention centres within the governmental primary health care system, thus ensuring proper follow up in detention and beyond;
  • Upgrading the existing psychiatric inpatient facilities, which are completely sub-standard, in order to create a therapeutic environment;
  • Imposing only those restrictions on individual movement within the ward that are strictly necessary, and ensuring that the focus is on providing therapy rather than on security;
  • Guaranteeing the availability of trained interpreters to allow mental healthcare professionals to work unhindered;
  • Ensuring that the system is subjected to regular review by the Mental Health Commissioner to ensure compliance with national standards of care in the field.

 The full report is available for download here.

This report is part of PATHS, a project aimed at ‘Promoting Access To Health and Social services for migrants and asylum seekers in Malta’, through provision of services, capacity-building and advocacy. The publication is funded by the European Commission Representation in Malta.


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