Jane McCredie: Feeling the shame

PSYCHIATRIST Dr Peter Young last week defined torture as “the deliberate harming of people in order to coerce them into a desired outcome”.

That, he said, is what is happening in Australian-run detention centres — intentional creation of suffering with the aim of coercing asylum seekers to abandon their hopes of living in Australia.

We have been hearing about the psychological harms inflicted on asylum seekers in detention for more than a decade now, but Dr Young’s public statements to the media and to the Human Rights Commission inquiry into children in immigration detention take this to a new level.

Until recently, Dr Young was director of mental health for International Health and Medical Services (IHMS), the private contractor providing medical services to Australia’s onshore and offshore detention centres.

It takes courage to stand against a system that you have been part of, and the Royal Australian and New Zealand College of Psychiatrists has commended Dr Young for doing it.

Here is how he describes the camp on Papua New Guinea’s Manus Island to The Guardian: “When you go to Manus Island and you walk down what is called the ‘walk of shame’ between the compounds and you see the men there at the fences it’s an awful experience.

“You have to feel shame. You have to understand what that feeling is about in order to be able to be compassionate. By feeling the shame you stay on the right side of the line.”

IHMS figures cited by the company’s regional medical director, Dr Mark Parrish, when he appeared before the Human Rights Commission inquiry show the prevalence of mental illness in adult asylum seekers in detention is around 30%, a rate that increases in line with length of detention. Overseas research has also suggested prolonged immigration detention has a negative effect on mental health.

This puts doctors working within the system in an impossible position. How do you provide effective treatment for mental illness when the patient cannot be removed from the environment that is making them ill?

A decade ago, I was a regular visitor to Sydney’s Villawood Detention Centre, a place that was by all accounts relatively benign compared with today’s offshore camps.

Despite that, I watched the people I visited deteriorate as their detention dragged on with no end in sight. I am far from equipped to make a clinical diagnosis, but it was not hard to recognise the abandonment of hope in long-term detainees, or their growing loss of confidence in their ability to function in the outside world.

I saw them struggle to maintain a welcoming smile for visitors like me, and I never quite came to grips with the fact that these people we had imprisoned, in some cases for 5 years or more, tried so hard to be good hosts.

That was then. Over the intervening years, governments from both sides of politics have done their best to hide what goes on in immigration detention from public view.

Now, the desperate people who try to come here on boats are imprisoned in remote island hellholes that are largely inaccessible to the media, let alone the average Australian citizen who might want to know what is being done in their name.

Whatever you think about issues of border control, or of how immigration should be managed more generally, as a community we need to ask just how far we are prepared to go.

Do we accept the deliberate infliction of harm on children, for example, whether as a means of forcing their parents to accept repatriation or of deterring other families from attempting to get here?

There are around 1000 children in closed immigration detention, according to the Human Rights Commission, which has also heard evidence of 128 incidents of self-harm by children in detention in the past 14 months.

Is this really who we want to be?

Perhaps we need to follow Dr Young in “feeling the shame” — and then insist to politicians of all persuasions that all people in our care, however they come to be there, must be treated with compassion and humanity.

Jane McCredie is a Sydney-based science and medicine writer.