Ineffective ‘safeguards’ include ;

A Detention Gatekeeper (prior to the decision to detain) – often fail to effectively review the suitability of individuals for detention

Screening – often fails to identify vulnerability once the person arrives in detention

Regular detention reviews – often fail to properly review continued detention

Case Progression Panels (supposed to review detention and evaluate case progression) – often fail to consider whether detention remains appropriate

Rule 35 of the Detention Centre Rules (see below) – often fails to ensure that particularly vulnerable people in detention are brought to the attention of those with responsibility for reviewing detention

Adults at Risk policy (see below) – often fails to identify adults at risk, and where it does succeed it often does not lead to their release

Assessment Care in Detention and Teamwork (ACDT) (process for monitoring and supporting those identified as at risk of self-harm or suicide) – often does not lead to appropriate treatment of detained people at risk of self-harm and suicide or the process fails to take place at all

Rule 35 of the Detention Centre Rules

Rule 35 is a mechanism which aims to ensure that particularly vulnerable detainees are brought to the attention of those with direct responsibility for reviewing their detention.

Without an effective Rule 35 process, the Home Office may not be aware of a detained person’s vulnerabilities (either because safeguards earlier in the process have failed or the person’s health has deteriorated whilst in detention) and continue detention even though to do so breaches its own policy.

Rule 35 requires a report to be written by the GP working inside Immigration Removal Centres in three circumstances:

(1) if a detained person’s health is likely to be injuriously affected by continued detention or any conditions of detention

(2) if a detained person is suspected of having suicidal intentions

(3) if there are concerns that the detained person may have been the victim of torture

Rule 35 reporting obligations are not being met by GPs working inside Immigration Removal Centres, particularly in relation to rule 35(1) and (2) reports which are rarely completed. Where there are reports, the Home Office often does not consider Rule 35 reports in accordance with its own policy, so vulnerable people languish in detention.

Adults at Risk

The ‘Adults at Risk’ guidance came into effect in 2016. It recognises that vulnerable individuals may be at increased risk of harm from detention and states that vulnerable individuals (‘adults at risk’) should not normally be detained and can only be detained when ‘immigration factors’ outweigh their indicators of risk.

Individuals will be regarded as ‘adults at risk’ if they declare or there is evidence that they “are suffering from a condition, or have experienced a traumatic event (such as trafficking, torture or sexual violence), that would be likely to render them particularly vulnerable to harm if they are placed in detention or remain in detention.”

Indicators of risk include:

  • suffering from a mental health condition or impairment
  • having been a victim of torture
  • having been a victim of sexual or gender based violence
  • having been a victim of human trafficking or modern slavery
  • suffering from post traumatic stress disorder
  • being pregnant
  • suffering from a serious physical disability
  • suffering from other serious physical health conditions or illnesses
  • being aged 70 or over
  • being a transsexual or intersex person.

In the Adults at Risk policy evidence of vulnerability is classified in three levels, with level 1 being effectively self-reporting, level 2 being professional evidence of a category of vulnerability, and level 3 being bespoke professional evidence that a period of detention is likely to cause harm. Once the category of vulnerability and evidence level has been identified and assessed, this is balanced against immigration and public protection factors in deciding whether someone should be detained.

Medical Justice has serious concerns about the effectiveness of this guidance and has repeatedly raised these concerns with the Home Office.

On 21 October 2021 the Home Office published the Independent Chief Inspector of Borders and Immigration’s (ICIBI) second annual inspection of the Adults at Risk policy – themes that emerge are depressingly familiar: poorly functioning systems for identifying vulnerable people in immigration detention; poor quality casework; insufficient independent oversight of decisions to detain; and a pervasive culture of scepticism and disbelief amongst decision-makers.