07/09/2012 12:00 EDT | Updated 09/08/2012 05:12 EDT

Strict detention policies pose risk to mental health of refugees, doctors say

OTTAWA - Doctors are sounding more alarms about changes to Canada's refugee system.

An opinion piece in the Canadian Medical Association Journal says a new law could pose a serious danger to the mental health of refugees.

Bill C-31, the Protecting Canada’s Immigration System Act, includes provisions that allow the immediate detention of refugee claimants designated as part of irregular arrivals.

All those over the age of 16 will be held for a minimum of two weeks before their detention is reviewed, while those under 16 can be informally detained with their parents or released to child care authorities.

The bill became law at the end of June and the detention provisions are now in force.

The authors of the piece cite several studies suggesting high levels of psychiatric symptoms among detained refugee claimants, even after short periods.

"As health professionals, it is our responsibility to urge the government to minimize harm to children, pregnant women, trauma survivors and other vulnerable people," Dr. Janet Cleveland and Dr. Cécile Rousseau wrote in the article, released Monday.

"Children should not be incarcerated or separated from their parents. Detention of all refugee claimants should be limited to the shortest possible time required for identity and security checks and should generally be in noncarceral accommodation, especially for vulnerable individuals."

The article cites statistics from the U.S., the U.K. and Australia, all showing adverse mental health outcomes following detention.

In the United Kingdom, after a median 30 day detention, 76 per cent of detained refugee claimants were clinically depressed, compared with 26 per cent of a non detained comparison sample.

In the U.S., after a median detention of five months, 86 per cent of refugee claimants showed clinical levels of depression, 77 per cent had clinical anxiety and 50 per cent had clinical post-traumatic stress disorder.

In Australia, where there is mandatory detention for refugee claimants who arrive by boat, there were more than 1,100 incidents of self-harm and six suicides in a population of about 6,000 people detained for a median of 10 months, the article says.

The authors say that's roughly 10 times the suicide rate in the general population in both Australia and Canada.

"Yet, in Australia, close to 90 per cent of 'irregular' claimants are later accepted as refugees and settle there permanently," the authors write.

The new Canadian law was introduced following the arrival of a ship carrying almost 500 asylum claimants in 2010.

Six men among those passengers reportedly remain in detention.

In a 2010 evaluation of detentions and removals, the Canada Border Services Agency raised concerns about how they handled mental health issues among detained claimants.

"While individuals with mental health issues do get assistance, there is considerable variation in the time until services are received," the report said.

"The evaluation was unable to determine the scope or magnitude of this issue as detainees' health statistics are not tracked by the (agency)."

Earlier this year, the Mental Health Commission of Canada released a federally funded blueprint for overhauling mental-health care in Canada, which included the needs of immigrants and refugees as one of its priorities.

The opinion piece in the CMAJ follows weeks of protests by doctors over cutbacks to health benefits for some refugee claimants.

Included in the original interim federal health program had been coverage of counselling or psychiatric treatment for refugee claimants, as well as coverage of the cost medications.

But changes to the program — which took effect at the end of June — only provide those services to those resettled in Canada by the government.

Otherwise, treatment will only be given if the claimant poses a public health or safety risk.

In a letter to Immigration Minister Jason Kenney in June, the Canadian Psychiatrists Association voiced their concerns about the impact on mental health.

"This language, which deems patients worthy of care only if they are a potential harm to others, serves to further stigmatize our already stigmatized population, and does not address the dire need for medication and treatment for all patients who need them, whether or not they pose a risk to others," they wrote.

The government argues that refugee claimants should not receive benefits that aren't received by Canadian taxpayers, saying the changes were designed to discourage bogus refugee claims.