This article is more than 6 years old

This article is more than 6 years old

Facebook Twitter Pinterest Dr Peter Young gives evidence.

The immigration department has attempted to cover up alarming rates of children’s mental health problems in detention, an Australian human rights commission inquiry has heard.



Former and current detention centre workers gave evidence to the inquiry into children in detention that conditions were substandard, unsafe and inappropriate.

Doctors who worked on Christmas Island recounted shocking details of medical neglect, including stripping asylum seekers of basic medication when they arrived, as documented in a letter of concern written by 15 doctors working on Christmas Island and reported by Guardian Australia.

Former workers in detention centres on Nauru also gave harrowing accounts of the conditions for children, including the case of sexual assault on a teenage boy, first reported by Guardian Australia in June.

A former departmental official described the purpose of immigration detention as “to remove hope” for asylum seekers.

The inquiry heard that the immigration minister, Scott Morrison, has agreed to appear before the panel, making the prospect of another public hearing likely.

Mental health statistics covered up, says senior doctor in immigration detention:

Dr Peter Young, the former medical director for mental health for IHMS – the private healthcare provider in immigration detention – was compelled to attend the hearing in Sydney, where he said data presented to the department within the past two weeks had received a “negative” response and that the department “asked us to withdraw the figures from our report”.

His evidence drew gasps from the gallery as a projected image of the statistics showed that 15% of children in detention on the mainland and on Christmas Island were scored three-four on the HoNOSCA (Health of the Nation Outcome Scales for Child and Adolescent mental health) for symptoms of emotional distress – Young said a score of two was “clinically significant”.

A Health of the Nation Outcome Scales for Child and Adolescent mental health assessment for children in detention on Christmas Island and the mainland presented to the inquiry. Photograph: AHRC

Young said statistics compiled by IHMS showed a third of people held in detention had mental health problems, and it was “clearly established” that such problems were caused by prolonged time in detention.

The inquiry has published statistics showing that between January 2013 and March 2014 there were 128 incidents of self-harm involving children in Australia, constituting of 62% actual self-harm within the detention centres where children are held.

Young told the commission he was aware of self-harm incidents involving asylum seeker children, including poison attempts. He told the inquiry that there was no full-time child psychiatrist on Christmas Island or on Nauru, but that staff rotated the role.

Later three representatives from the Department of Immigration and Border Protection – department secretary Martin Bowles, deputy secretary Mark Cormack and assistant secretary Katie Constantinou – told the inquiry they were unaware of the request to withdraw the figures.

Bowles said if any department staff had acted “inappropriately” he would “deal with that”.

The department conceded on a number of occasions that prolonged detention had adverse affects on asylum seekers’ mental health. Asked about the rate of self-harm, Cormack said the department was “not contesting” research that found prolonged detention produced a “whole range” of effects.

Immigration department overriding officials and delays in treatment:

Young said the immigration department often overrode medical advice for the treatment of asylum seekers in detention, which he described as “troubling”.

This experience was backed by two former Christmas Island doctors, John-Paul Sanggaran and Grant Ferguson, both of whom signed the Christmas Island letter of concern.

Sanggaran and Ferguson relayed a number of details documented in the letter, including issues with medical diagnosis on the island, shocking facilities and the inability to transfer patients needing urgent treatment.

An epileptic girl had her medication stripped on arrival at Christmas Island – as is standard practice – and doctors could provide only one of two necessary pieces of medication.

“She started having seizures,” Ferguson said. “She was left on that one medication. We eventually got supply of that medication she arrived with, but they only ordered a month’s worth, so in a few weeks’ time they ran out and she was back to one [medication] again, and this whole time she was having seizures.”

He said the girl was eventually transferred off the island after repeated requests by medical staff.

Sanggaran reiterated his criticism that IHMS had not adequately responded to criticisms articulated in the letter.

Ferguson described conditions on Christmas Island as a “disaster zone”.

Elizabeth Elliot, a paediatrician who accompanied the human rights commision on a three-day visit to Christmas Island earlier in the month, said she observed children unable to get treatment for conditions including an undescended testicle, abscesses and skin problems.

She said many children were suffering serious mental health issues. One girl had withdrawn to her room, stopped eating and told Elliot “it would be better to be dead than living here”.

“Almost every child we spoke to, that could articulate their feelings, expressed distress,” Elliot said.

Elliot confirmed that unaccompanied minors had recently been transferred from Manus island – highlighting, as Guardian Australia revealed, that children were on Manus during the violent unrest that left one asylum seeker dead in February.

Elliot said 15 women had been placed on self-harm or suicide watch on Christmas Island and rejected claims by Tony Abbott that those who self harmed were attempting to hold the government over a “moral barrel”.

“Take a step back – what woman would self-harm unless they were absolutely desperate?” Elliot said.

Bowles rejected claims about the conditions on Christmas Island and said the characterisation presented was “quite disturbing”.

Asked how many children and infants were among the 157 Tamil asylum seekers now held at Curtin detention centre he said the department was still addressing the “biodata”. The response drew derisive laughs from the gallery.

Bowles was asked if detention conditions were designed to “break people”. Visibly frustrated, he said: “I’m actually quite offended by these statements.” He suggested they prevented detention centre staff doing their jobs properly.

Shocking conditions for children on Nauru:

Kirsty Diallo, a former social worker employed by Save the Children on Nauru, recounted numerous examples of the poor state of care for children.

She told the inquiry children had begged her for shoes with no holes in, for books and for clean clothes. Diallo said one mother had become so desperate for clothes for her daughter that she stitched a dress from a mosquito net for her.

Diallo also documented cases of abuse, including the sexual assault of a teenage boy by a detention centre cleaner on Nauru. She said she had observed teenage asylum seeker girls in the centre engaging in “flirtatious behaviour with adult guards”, of guards stroking girls’ hair and of guards holding a three-year-old on their lap. She said an asylum seeker child had been threatened by a detention centre staff member with a cricket bat.

“You can’t do trauma recovery work when children remain unsafe,” Diallo said. Nauru was “completely inappropriate for children”.

Ai-Lene Chan, a doctor who practised on Nauru, said she encountered shortages of anti-depressants and antibiotics, meaning asylum seekers’ medications were often “abruptly stopped”.

She spoke of one child, a teenage boy who had a “complete loss of hope”.

“He had no appetite or will to live. He lost over 10kg of weight, about a quarter of his body weight,” Chan said.

Chan said the doctor employed in the Royal Nauru Hospital as an antenatal specialist did not hold the correct qualification and was trained in PNG. He eventually lost his job.

“I believe that Nauru is absolutely not a safe environment for children to be detained. I believe the detention environment creates the overwhelming majority of physical and psychological ailments,” Chan said.

She knew of unaccompanied minors and teenagers on Nauru who had been placed on suicide and self-harm watch.

A former immigration department official, Greg Lake, who worked as the centre manager on Nauru until the middle of 2013, said the purpose of detention, as he understood it, was to “construct an environment where people are used as examples … to remove hope”.

Lake, who also served as the director of offshore processing and transfers when the centres on Manus and Nauru were reopened by Julia Gillard in 2012, said he was instructed by the government to pick “children who looked the youngest” to be on the first flight to Manus. This, Lake said, reflected the government’s desire to send a strong message to people smugglers.

Outside the hearing:

At a break in proceedings, the human rights commission president, Gillian Triggs, said: “The inhumanity, the cruelty of these processes is very apparent and when it’s repeated without any conditions attached by all of these medical experts, as Australians we have to ask: have we gone too far?

“The minister [Morrison] has a responsibility to be much more transparent about what is happening.

“We’re trying to get facts right when frankly it would be much simpler for the minister to provide the Australian public with this information in the first instance.”

Abbott told reporters in Hobart no one wanted children to be held in detention, but the best thing the government could do was stop the people-smuggling business.

“What could be more horrific than the idea of children perishing at sea because their parents have fallen for the false promises of the people smugglers?” the prime minister said.