P-HSJCC Webinar Series: Immigration Detention and Mental Health

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P-HSJCC Webinar Series: Immigration Detention and Mental Health April 10, 2018 Moderator: Tasha Rennie Network Engagement and Communications Officer, HSJCC Secretariat

HSJCC Webinars We will have a Q&A period at the end of our webinar. To ask a question, please type your question in the chat box. This webinar will be recorded. The recording and power-point presentation will be emailed to you following the webinar. Please complete the brief evaluation survey following the webinar.

About the HSJCC Network HSJCC Network is comprised of: 40 Local HSJCCs 14 Regional HSJCCs Provincial HSJCC Each HSJCC is a voluntary collaboration between health and social service organizations, community mental health and addictions organizations and partners from the justice sector including crown attorneys, judges, police services and correctional service providers.

Presenter Michaela Beder, MD FRCPC, Psychiatrist, Lecturer, University of Toronto

CHALLENGING IMMIGRATION DETENTION Michaela Beder, BA, MD, FRCPC Psychiatrist, Toronto Provincial HJSCC Webinar, March 26, 2018 With thanks to Hanna Gros, Jordan Pachciarz Cohen and Rachel Kronick for their slides

My work Photo credit: bike citizens

Alpha

Outline Context: Immigration System What is Immigration Detention? Statistics Mental health in detention Child and Adult Advocacy Recommendations

CONTEXT

Trends in Canadian immigration More categories and numbers of temporary workers coming in to Canada More difficult for vulnerable groups to come to Canada: refugees, parents, grandparents, spouses Increased precarity of immigration status Especially under previous gov t, demonization of migrants: spouses, bogus refugee claimants, fair and generous immigration system, gold-plated healthcare

IMMIGRATION DETENTION

What are immigration holding centres? Slide credit: Rachel Kronick

Reasons for detention: Flight risk Unclear identity Danger to the public

Hurdles to release from detention Detention review hearings: 48hrs & 7 days after arrest, and every month until release Detainees may or may not be legally represented No limit to the length of detention

Detention Conditions IHCs: Medium security facilities Provincial jails: Maximum security facilities immigration detainees treated as all other inmates

Immigration Detention in ON Jails: diffusion of responsibility Toronto Star, May 28, 2016

Detention Statistics: Adults Fiscal Year Number of detainees Average length of detention Admissions to non-ihc (provincial jails) Detainees held in Ontario 2016-2017 6,251 19.5 days 2,047 (32.6%) 3,251 (52.0%) 439 2015-2016 6,596 23.1 days 2,909 (39.9%) 3,660 (55.5%) 623 2014-2015 6,768 24.5 days 2,889 (39.3%) 3,962 (58.5%) 694 2013-2014 7,722 23 days 3,115 (36.7%) 4,675 (60.5%) 706 2012-2013 8,739 20 days 3,487 (36.3%) 5,519 (63.2%) 678 Long-term detainees (held for 90+ days) Majority of long-term detainees in non-ihc facilities in Ontario are held at Central East Correctional Centre (Lindsay ON)

Detention Statistics: Children Fiscal Year Accompanied Minors Unaccompanied Minors Total Average length of detention 2016 2017 151 11 162 13.1 2015 2016 181 20 201 14.1 2014 2015 220 12 232 16 Includes foreign nationals, permanent residents, and Canadian citizens Includes children who are detained, and those housed in detention to accompany their detained parents Longest detention: 803 days Vast majority detained as flight risk

MENTAL HEALTH IN DETENTION

Clinical research: Impact of immigration detention on mental health Slide credit: Rachel Kronick

Clinical research: Impact of immigration detention on mental health - Canadian study - Brief detention (mean 31 days) - Does not have confounding factors of previous prospective studies Detention contributes significantly to post-traumatic stress, depression and anxiety symptoms over and above the impact of trauma exposure and demographic variables. Slide credit: Rachel Kronick

Clinical research: Impact of immigration detention on mental health Detained Non-Detained Post-Traumatic Stress 32% 18% Depression 78% 52% Anxiety 63% 47% Slide credit: Rachel Kronick

Clinical research: Child detention Qualitative, ethnographic investigation: What are the lived experiences of children and parents? What are the emotional and behavioural responses of children in detention? How can we understand the practises and functioning of the IHC itself? Rachel Kronick, Cécile Rousseau and Janet Cleveland, Asylum-Seeking Children s Experiences of Detention in Canada: A Qualitative Study (2015) 85:3 American Journal of Orthopsychiatry 287

Children s responses: Symptoms withdrawal food refusal anxiety (phobias, separation anxiety) sleep difficulties, including nightmares irritability and behavioral problems selective mutism depressed mood, anhedonia traumatic play or reenactments Slide credit: Rachel Kronick

Family separations Slide credit: Rachel Kronick

Lived Experiences: Suicide Lucia Vega Jimenez, 42

Lived Experiences: Death Abdurahman Ibrahim Hassan, 39

Lived Experiences: 11 years detained

16 people have died since 2000 in immigration detention

ADVOCACY

Community Advocacy

Legal-Health Advocacy

Provincial advocacy: OHRC

On Oct 4, 2016, a statement was released across Canada, signed by 46 medical, legal and human rights organizations, alongside 342 health and legal professionals endchildimmigrationdetention.wordpress.com

Government Response

Government Response

Solidarity with detainees

And to the streets!

RECOMMENDATIONS

Recommendations Detention should only be used as a last resort (Alternatives to Detention) End immigration detention in provincial jails Individuals with mental health conditions or psychosocial disabilities, suicidal ideation, serious medical issues, and persons who do not pose a danger to the public, should not be detained, and especially not in provincial jails. Provincial jails should ensure access to programs and supports Government should set legislative limits to the length of immigration detention (presumptive period)

Resources stoptransferstojails.wordpres s.com endchildimmigrationdetention.wordpress.com ihrp.law.utoronto.ca endimmigrationdetention.com

Thank you! mbeder@gmail.com

FOR PSYCHIATRISTS

Writing Refugee Reports Psychiatrists, family physicians, psychologists, counsellors Insufficient availability of clinicians Short time-lines Difficult to access detained clients Limited resources in jails Training resource: ask me!

In Advance of the Assessment Ask for: Reason for referral Diagnosis of a mental illness? Is the client vulnerable and do they need a designated representative? Difficulties in testifying? Need for an interpreter Any available information, including a BOC, psych records Lawyer s perception of the client What kind of hearing is the report for? Get a signed ROI Explain parameters, ex a one time assessment

Assessment locations office: lawyer s or clinician s immigration detention Get approved in advance Ask for hours you can meet/shift change Jail Get approved in advance Call the day of to ensure client is not on lockdown videoconference

Thank you for listening! For more information about the Provincial HSJCC and to join the mailing list, visit: www.hsjcc.on.ca