Sarah Stephen
Asylum seekers in Australian detention centres and the refugee-rights movement have for years tried to convey the awful human cost of the mandatory detention system. But it took the horrific experience of Cornelia Rau, a mentally ill Australian resident who was held in detention for 10 months as an illegal immigrant, lays bare the reality of what happens in these centres to hundreds of vulnerable and traumatised people every day.
Rau's experience raises many different issues, among them the identification and treatment of people with a mental illness and the lack of national coordination in identifying missing persons. But the issue that has the federal government most nervous is the way Rau's case has refocused attention on the appalling policy of mandatory detention.
Cornelia's sister, Chris Rau, and brother-in-law, John MacDonald, were spot-on when they wrote in the February 7 Sydney Morning Herald about the government's "shameful double standard". They pointed out that while Cornelia Rau was regarded as an "illegal immigrant, the only treatment she received for mental illness was longer periods in lock-up as punishment for bad behaviour. From the information coming out of Baxter, the lock-ups led to a worsening of her condition and worse behaviour.
"Yet, magic! As soon as she became an Australian resident she was whisked away to a teaching hospital, seen by consultant psychiatrists and medicated. During which leg of her flight from Baxter to Adelaide did she suddenly gain the basic human right to medical treatment?
"Over the years we have heard of immigration detainees being denied access to psychiatric care, some with horrific mental illnesses and suicidal tendencies. How many cases like Cornelia's will it take until they receive the care they deserve, or more importantly, are taken out of conditions which in themselves lead to mental illnesses?
Secrecy
One of the central reasons why Rau was detained for so long is the federal government's determination to keep the public in the dark about what happens inside Australia's detention centres. The federal government has total control over the lives of people in immigration detention and is able to operate with a level of secrecy and exemption from legal protections that no Australian prison is allowed.
There is no media access. There is no judicial review of detention. If the law required that every detainee had to appear before a magistrate after one month for an independent assessment of whether or not detention should continue, Rau's wrongful detention might have been discovered.
A range of supporters and health professionals contacted the immigration department with their concerns about Rau's mental condition. Immigration officials refused two expert psychiatrists permission to make an independent assessment of her mental condition because she was unable to give written permission.
Dr Louise Newman, chairperson of the Royal Australian and New Zealand College of Psychiatrists, told the February 6 Melbourne Age: "I was deeply concerned about her welfare and the inappropriate treatment she was receiving at Baxter, but because she was incapable of giving us written permission to see her, we were prevented from doing so... This is a truly shocking state of affairs.
"You have staff at Baxter ignoring medical advice and clear evidence before them of this woman's deeply psychotic state. They are clearly not equipped or capable of making the appropriate judgement. This woman appears to have been in Baxter for three months, the issue is how can we allow the mentally ill to be treated in this way."
Pamela Curr, from Melbourne's Asylum Seeker Resource Centre, circulated a report on January 19 that revealed the concern many asylum seekers had expressed as soon as Rau arrived in Baxter: "Other detainees have repeatedly expressed concern about this young girl. They believe that she is mentally ill. Her unpredictable and bizarre behaviour, lack of communication and distress continue to worry fellow detainees. She exhibits psychotic symptoms, screaming and talking to herself at times and screams in terror often for long periods especially when locked in the cell."
Eventually succumbing to pressure to launch an inquiry into how Rau ended up in immigration detention, the government is determined to minimise the fallout and keep the terms of the inquiry as narrow as possible.
The government is already lying about potential evidence of Rau's treatment in Baxter, denying that there are security cameras in "management unit" rooms where she was held for 18-20 hours a day. In fact, the National Library website has photographs of one of these rooms, clearly showing a CCTV unit in one corner.
South Australia's public advocate, John Harley, told ABC radio's The World Today on February 7 that "if there is a good side to any of this: It has now highlighted the gross inadequacy of mental health services for people in detention".
Detention and mental illness
Detention centres create mental illness. Symptoms include severe depression, despair, hopelessness, paranoia, chronic rage, persecutory delusions, psychosis, character change, stereotypic movements, and persistent self-harming behaviour.
Research published in the Australian and New Zealand Journal of Public Health in December revealed that among a group of 10 families (14 adults and 20 children) held in immigration detention for more than two years, adults displayed a threefold and children a tenfold increase in psychiatric disorders subsequent to detention.
There is story after story of asylum seekers going inside with no history of mental illness, but two, three, four years later, coming out with sometimes irreversible psychological problems.
Curr recounted a case in March 2003 when a man was brought from the Woomera detention centre to the Royal Adelaide Hospital in a suicidal state, diagnosed with post-traumatic stress disorder following torture in Iran. This young man is on a United Nations list as having been one of the youngest-ever political prisoners in Iran's notorious Evin Prison, having been held there from the age of 15 until he was 22, subjected to torture, and witnessing torture and executions. His sister and cousins were executed.
While at the RAH, the young man was seen by a consultant psychiatrist who recommended hospitalisation and treatment and stated that under no circumstances should he be "housed in closed cell". Within 12 hours, the immigration department intervened and the young man was transferred back to Woomera and placed in solitary confinement for 18 days until the local doctor was so concerned for his life that he transferred the young man to the Woomera town hospital.
The young man's post-traumatic stress disorder was confirmed by a second consultant psychiatrist, who recommended similar treatment as the first consultant psychiatrist. But this was not implemented by detention centre staff. Curr spoke to the second psychiatrist who told her: "He's a broken man — he wants to die."
Prompted by the Rau affair, on February 9 federal Liberal MP Petro Georgiou declared that he thought it was time to get rid of mandatory detention. He told federal parliament that asylum seekers in some cases were locked up longer than people convicted of serious crimes such as rape and kidnapping. Georgiou also called for some 7000 refugees on temporary visas to be allowed to stay in Australia through a one-off amnesty.
Georgiou's call was backed by Professor Harry Minas, a member of the government's immigration detention advisory group and director of the Victorian transcultural psychiatry unit at St Vincent's Hospital. Minas said that it had been clear for years that the government's policy goals did not justify the harm done by mandatory detention.
The February 5 Melbourne Age editorialised that the Rau affair illustrated the need to abandon mandatory detention: "The case illustrates what those who have been campaigning against Australia's mandatory detention policies have been arguing for years: that the system is inhumane, strips people of their dignity and ought to be abandoned."
From Green Left Weekly, February 16, 2005.
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