Assessment Care in Detention Team (ACDT) is the main process for monitoring those identified to be at risk of self-harm and/or suicide and their care needs. It is led by custodial staff (not healthcare). ACDT is a system of observations (the highest level being constant watch) and regular reviews in order to “manage” this risk in detention.
Neither processes are therapeutic, nor are they sufficient to address the needs of those who are actively suicidal or at risk of suicide or self-harm. These processes are not connected to the safeguards in the Rule 35 process. Those on ACDT for self-harm or suicide risk are not automatically assessed for the relevant Rule 35 report and therefore do not automatically have their detention reviewed by the Home Office.
Through its casework and research Medical Justice continues to find relatively high levels of self-harm and suicidality in immigration detention. Individuals can be put on and off ACDT on several occasions throughout their time in detention and/or in response to multiple self-harm episodes and/or suicide attempts. The fact that individuals who are so unwell in detention that they require long periods on high levels of observation on ACDT or are put on and off ACDT should indicate to IRC custodial and healthcare staff that the person requires urgent healthcare intervention as they may not be suitable for detention. This should be communicated to the Home Office through a Rule 35 (1) and/or Rule 35 (2) report triggering a review of detention. However, Medical Justice evidence and the Home Office’s own statistics show that this is rarely being done and ACDT and constant watch are being used to contain the episodes of self-harm and/or suicide attempts in detention, without consideration of the issues underlying the self-harm/suicide risk and the role continuing detention plays within this.
Medical Justice has also provided a comparison of the Home Office statistics on numbers of ACDTs and constant supervision opened, with the numbers of Rule 35 (1) and (2) reports, which is available to download.
Rule 35 v ACDT and Constant Watch statistics
The continuing contrast between the high levels of self-harm incidents, numbers of ACDTs and episodes of constant watch and the extremely low numbers of Rule 35 (1) and (2) reports suggests a failure to use the essential safeguarding mechanism provided by Rule 35.
