Mental illness twice as common among refugees and migrants in detention, compared to those not in detention

Rates for depression, anxiety and PTSD in refugees and migrants in detention are around twice as high as rates for those not in detention, according to a new systematic review published in the Royal College of Psychiatrists’ BJPsych Open.

The authors interpret this as evidence of the harmful effect of immigration detention on the mental health of refugees and migrants, who are already at higher risk of mental illness. Looking at adults, they found that two in three (68%) detained refugees and migrants have depression, more than half (54%) have anxiety and almost half (42%) have PTSD.

Dr Marc Molendijk and Irina Verhülsdonk, lead authors of the paper from Leiden University, The Netherlands, said: “Immigrant detention seems to have an unacceptable negative effect on the mental health of refugees.”

23,075 refugees and migrants were detained in the UK between April 2019 and March 2020. Many will have endured terrible experiences in their country of origin and during their often difficult and dangerous journeys to the UK, including bereavement, separation from loved ones and loss of home, status and identity.

The Royal College of Psychiatrists published a Position Statement in April outlining its concerns about the lack of mental health care within the context of immigration detention.

Professor Cornelius Katona, lead author of the Royal College of Psychiatrists’ Position Statement on immigration detention, said: “This research provides further evidence of the harm caused by detention which is exacerbating and triggering mental illness in already very vulnerable and traumatised people.

“Detainees experiencing mental illness should receive the same standard of care as anyone else, but the very fact of detention makes this impossible. The reality is that being detained in these centres is very distressing and harmful if you have a mental illness, because of the environment itself and the lack of access to specialist treatment.

Dr Adrian James, President of the Royal College of Psychiatrists, said: “Refugees and migrants with existing mental illness should only be detained in very exceptional circumstances. It is also crucial that staff are given proper training to identify mental illness when it arises or deteriorates significantly, so that this can be managed appropriately by linking with local mental health services.

“The Nationality and Borders Bill must be scrapped, as this harmful legislation will worsen the mental health of refugees and migrants. The Bill stands to leave thousands in limbo by focusing on how they arrived in the UK, rather than their need for help.”

To produce their findings the authors searched the existing literature for relevant studies, applied eligibility criteria and assessed methodological quality. Nine independent studies were then identified for joint statistical analysis.

‘Prevalence of psychiatric disorders among refugees and migrants in immigration detention: systematic review with meta-analysis' is published in BJPsych Open.