Detained and Discarded

Home Office failings led to unsafe release of extremely vulnerable, unwell people without adequate support

New research published today by Medical Justice shows that Home Office failings have led to the unsafe release of extremely vulnerable and unwell people into the community, without adequate support.

One woman whose delay in treatment “could potentially have life or limb threatening consequences”, struggled to re-arrange an orthopaedic oncology appointment that she missed because she had been detained. One released Medical Justice client described how he ended up a number of times in Accident & Emergency, having been unable to secure a recommended cardiology appointment.

Some released from immigration detention had pre-existing vulnerabilities and medical conditions exacerbated by their time in detention, whilst other had attempted suicide, self-harmed or suicidal thoughts in detention.

Dr Rachel Bingham, Clinical Advisor at Medical Justice said :“These unsafe practices lead to greater unmet health needs, and to more serious health consequences, requiring more and longer treatments once people are able to access care. In the year reported on, over seventeen thousand people were released, despite the stated purpose of their detention being to remove them, indicating the senselessness of exposing people to these negative health consequences”

Ms A said : “I was getting prepped for major surgery when I was detained for 6 months. The healthcare at the Immigration Removal Centre was appalling. They failed to manage my condition and in the end had no choice but to release me. Although my health had deteriorated rapidly and the surgery was more urgent than ever, I was discharged without so much as a referral or medication. It was as if the centre was more concerned about washing their hands of me so they would not be held liable than they were about my aftercare. It was an awful experience and the whole time I was afraid for my health, and very, very anxious and emotionally distressed. I felt like nobody cared if I lived or died. It is unacceptable and inhuman in a first world country to treat people like this and it has to stop. Thankfully for me, my GP was very supportive and referred me back to the surgical team – I eventually had the surgery 7 months later.”

Thousands of people are released from detention into the community every year. Between 1 October 2020 and 30 September 2021, 81% of the 21,362 people detained were released back into the community.[1] 2,239 were considered to be ‘Adults at Risk’ whilst in detention by the Home Office,[2] however Medical Justice believes there to be far more vulnerable people in detention due to the systematic failures of the Adults at Risk policy to identify vulnerable people. With thousands released into the community every year, the impact of releasing those individuals in a medically unsafe release cannot be overstated.

The report Detained and Discarded: Vulnerable people released from immigration detention in medically unsafe way found that release from detention is often unplanned, chaotic and medically unsafe.

Medical Justice sees repeated cases of vulnerable people released into the community without adequate care plans, with little or no information and support about entitlement and how to access a GP, and rarely with referrals to community support services such as local mental health teams. This has included people who had very recently attempted suicide in detention.

One client said: “When I was told I was being released, no clinician or nurse gave me advice, my medication or any help with healthcare outside.”

Mohamed,[3] who was prescribed medication due to severe stomach pain and vomiting, was not provided with an adequate supply of his prescribed medication upon release and was not given his full medical records. As he did not have information or support about seeing a doctor in the community, he explained: “I experienced a long wait to see a doctor, meanwhile I was suffering during that time and I had no attention from anyone”.

Many experienced several of these issues at the same time, with a domino effect of one barrier leading to another. Additional difficulties were experienced with navigating the healthcare system in the community, as a result of their unstable immigration status and language barriers.

Abbas,[4] who suffers from physical health issues, including with his heart, and from depression and PTSD, struggled to see a cardiologist upon release. Despite having been recommended to see a cardiologist whilst in detention and by an A&E doctor in London after being released, it took over a year and a half for him to see a cardiologist. Abbas described multiple barriers he faced. For example, after being dispersed to outside of London, he explained: “Because of the language barrier and I had difficulty to go to London, I couldn’t go to the appointment.”

The report raises concerns about the Home Office’s application of its own policies on the safe release of vulnerable detainees as the unsafe release of people from detention persists.

Information obtained through Freedom of Information (FOI) requests suggests that the experiences of Medical Justice clients may be illustrative of a wider problem in the immigration detainee population. Shockingly, the Home Office revealed that only three people recorded as ‘Adult at risk’ had onward care plans arranged upon their release across three IRCs between January 2019 and June 2021.

The Home Office has further confirmed, in response to another FOI request, that it does not have any guidance or template letters for Home Office staff in IRCs to “advise individuals with health problems or those at risk of self-harm and/or suicide” at the point of release how to access health services in the community.

Immigration detention causes severe harm to those held there and can cause rapid deterioration over time. This is particularly true for those who have a history of mental health issues or a history of trauma. The Home Office failed to deliver on their responsibilities in accordance with their duty of care towards vulnerable individuals leaving detention and continues to toy with the lives of vulnerable people by releasing them in such an unsafe and dangerous way.

Related media article ;

British Medical Journal, 4th March 2022 : “Release of vulnerable people from immigration detention is often medically unsafe and chaotic, says charity”

[1] For statistics for September 2020 to September 2021, see Home Office National Statistics. 2021. Immigration Statistics, year ending September 2021. [Last accessed on 18 January 2022] Available at: https://www.gov.uk/government/statistics/immigration-statistics-year-ending-september-2021/how-many-people-are-detained-or-returned and Home Office Detention Summary Tables. 2021. Immigration Statistics, year ending September 2021. [last accessed on 18 January 2022] Available here. Does not include those who were returned or those classed as ‘other’ which includes people who have returned to criminal detention, those released unconditionally, those sectioned under the Mental Health Act, deaths and absconds. It also does not include those held in Pre Departure Accommodation (PDA). See Home Office Detention Summary Tables. Immigration Statistics, year ending September 2021.

[2] Data extracted from statistics provided in Home Office response to FOIA 68200 received 22 February 2022. The number of Adults at Risk in PDA and those identified under column ‘other’ is not included. See Annex 1 for Home Office responses to Freedom of Information Access Requests.

[3] Mohamed’s name has been changed to protect his identity.

[4] Abbas’ name has been changed to protect his identity.