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Holding people indefinitely causes mental health problems

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7482.60 (Published 06 January 2005) Cite this as: BMJ 2005;330:60
  1. Susan Mayor
  1. London

Detainees held under current UK anti-terrorism laws have serious mental health problems that should be considered in the development of new legislation, warned a recent statement from the Royal College of Psychiatrists.

The college—the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland—issued the statement after the House of Lords ruled on 16 December 2004 that the current legislation under which detainees are held (the 2001 Anti-terrorism Crime and Security Act) was unlawful because indefinite detention without trial was incompatible with the Human Rights Act 1998.

After reviewing psychiatrists' reports on the detainees currently held under the 2001 anti-terrorism act, the college suggested that there was evidence that detainees, as a group, had serious mental health problems. The particular circumstances of their detention were considered to contribute significantly to their mental health problems. The statement warned: “Despite limitations to available evidence, our best estimate is that indeterminate detention, lack of normal due legal process, and the resultant sense of powerlessness, is likely to cause significant deterioration to detainees' mental health.”

The college considered that these aspects of detainees' circumstances, rather than the lack of access to mental health services, were responsible for their mental health problems. It was satisfied that the access detainees had to mental health services in prison was similar to that of other prisoners.

Psychiatric treatment, however sophisticated it may be, cannot neutralise the deleterious impact on mental health of the particular nature of this group's detention, the statement suggested. “We are therefore particularly concerned that the home secretary should not suggest that provision of psychiatric treatment from high quality mental health services can in itself prevent a decline in detainees' mental health that may come about as a result of their detention,” the college said.

The Medical Foundation for the Care of Victims of Torture, a human rights organisation that helps survivors of torture and organised violence, supported the call for any changes to legislation to take account of the impact on detainees' mental health. Dr Charlotte Chapman, health and human rights adviser with the foundation, said: “We have long been concerned about the damaging mental health consequences of indefinite detention without trial.

“The nature of detention under the post-9/11 Anti-terrorism, Crime and Security Act 2001 is particularly likely to cause long term psychological problems. Detention without proper trial can increase feelings of injustice, frustration, and despair, which will all lead to deteriorating mental health.”

In the expectation that the UK government will soon review anti-terrorism legislation, the Royal College of Psychiatrists said: “We consider that the impact on mental health is an important factor that should be taken into account when reviewing present legislation or contemplating future such legislation.”

Dr Chapman suggested: “All prisoners held under anti-terrorism legislation should either be released or brought to trial.” She argued that any suggestion that detaining people without trial might be for the greater good of society—in this case, reducing the risk of terrorism—had been shown in the past to be ineffective. “Reducing civil liberty and justice for individuals does not secure safety for society,” she concluded.

The Statement by the Royal College of Psychiatrists in respect of the psychiatric problems of detainees held under the 2001 Anti-terrorism Crime and Security Act can be found at http://www.rcpsych.ac.uk/press/preleases/pr/pr_633.htm

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