The Australian Human Rights Commission’s report on the use of force in immigration detention is the latest chapter in a now familiar story of excessively harsh, punitive and degrading conditions in Australian immigration detention centres.

Once again, we see a disregard for the rights and basic dignity of people who have sought our protection and committed no crime.

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The report lays bare the unnecessary handcuffing of women, children, people in wheelchairs, people with mental illness and no history of violent behaviour, and other people needing medical care. It confirms what our clients have been telling us: that handcuffing has become a routine practice for transfers between centres and, alarmingly, for off-site medical appointments. This includes transfers for torture and trauma counselling, in private doctors’ waiting rooms and at consultations where the very purpose of the appointment is to investigate issues such as wrist and arm injuries.

But the report goes much further than the overuse of handcuffs. It highlights demeaning breaches of privacy. It exposes violence inflicted by officers in the name of compliance when other options were available. It details the use of guards in balaclavas and heavy armour to move family groups, including babies and young children, from a family compound in a pre-dawn paramilitary-style operation.

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This takes place in the context of the prison-like conditions in which people are being held. In May the Australian Human Rights Commission reported that it was especially concerned about harsh, restrictive and prison-like conditions in high-security accommodation compounds, inaccurate risk assessments resulting in unwarranted restrictions, the routine use of restraints during escort and excessive restrictions on excursions, personal items and external visits.

Concerns have also been raised in recent weeks about the arbitrary use of transfers, often without warning, between immigration detention centres. This not only compounds the anxiety and insecurity already faced by people living in detention, but prevents people from developing supportive and protective relationships with service providers, advocates, other people in detention and in the community.

Our work at the Public Interest Advocacy Centre has also exposed the lack of access to medical care for people in our immigration detention centres. We have seen people with serious chronic diseases, such as hepatitis C, suffering without access to treatment that is freely available to prisoners and people in the community. We have seen recommendations by doctors for necessary medical treatment ignored.

One of our clients, Tomas*, had already read the commission’s most recent report when we contacted him about it. It came as no surprise to him. Tomas is an asylum seeker who has been held in immigration detention for more than six years. He is forced to wear handcuffs every time he is moved between facilities.

Tomas is a survivor of severe torture and trauma. He has complex mental health needs. The detention environment is particularly triggering for him. His medical issues are well known to authorities and extensively documented. Throughout his time in detention, mental health professionals have repeatedly highlighted the damaging effect that handcuffing has on him, to no avail.

Opaque policies such as enhanced escort procedures and security risk assessment checks exist, but still we see vulnerable, sick and otherwise low-risk asylum seekers with no history of violence subjected to cruel and arbitrary practices.

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It is welcome news that the Department of Home Affairs has amended some of its internal policies in the course of the commission’s investigation. But we need to confront the truth at the heart of this. We have a system that causes deep and irreparable harm to people, many of whom have already suffered significant trauma.

We lock people up in onshore immigration detention for over 400 days on average (compare that to Canada – an average of one month). Unlike prisoners, immigration detainees don’t know when they will be getting out. They can be held indefinitely. We know this is deeply damaging to physical and mental health.

In the coming months, the UN’s torture prevention body, the subcommittee on prevention of torture, will be in Australia looking into all places of detention, including immigration detention. This visit comes at a crucial time, as Australia continues to consider how to implement our obligations under the optional protocol to the convention against torture and other cruel, inhuman or degrading treatment or punishment.

We should hope that all of this scrutiny will see improvements in the way we treat asylum seekers and others in immigration detention. But we must also recognise that harm is an inescapable part of our system of immigration detention. It is how we choose to treat people seeking asylum in our country.

* Not his real name

• Jonathon Hunyor is CEO of the Public Interest Advocacy Centre