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Submission to the National

Inquiry into Children in Immigration Detention from

the South Australian Department

of Human Services


May 2002

Executive

summary

  1. Introduction

  2. Role and Responsibilities of the Department of Human Services

  3. The DHS policy context for the care and protection of children in immigration

    detention and upon their release into the South Australian community

  4. Child

    development and support for children in immigration detention

  5. Health

    aspects of care of children in immigration detention

  6. Children

    with disabilities in immigration detention

  7. Child

    protection arrangements between State child welfare agencies and the

    Department of Immigration and Multicultural and Indigenous Affairs

  8. Issues

    regarding standards of care for children in immigration detention

  9. Conclusion

Appendices

  1. Summary

    of DHS services to new arrivals and refugees

  2. Collaboration

    and liaison across government and non-government sector in supporting

    TPV and PPV holders

  3. Submissions

    by the Child and Youth Service and the Australian Association for Infant

    Mental Health (AAIMH)

  4. Child

    protection notifications - Woomera

  5. Guidelines

    for the public health management of communicable diseases in Australian

    detention environments

Executive Summary

This submission aims

to highlight a number of issues for children in immigration detention

arising from the Department of Human Services' (DHS) involvement in child

protection, health service provision to children and their families, settlement

support and care of unattached minors.

The DHS considers

that immigration detention has a significant impact on children and their

families. It is concerned that this form of detention may aggravate and

compound previous trauma with significant potential for adverse social,

developmental, physical and mental health outcomes.

Using a broad definition

of environment, the submission notes concerns about environmental conditions

that exist in immigration detention centres. It addresses issues of current

practices and standards of care arising primarily from employment and

service contracting practices by ACM as these practices may militate against

standards that apply in the Australian community for health and wellbeing

and particularly those that exist to meet the specific requirements arising

from refugee new settler status. However, the submission also highlights

standards and practices that should apply in immigration detention.

The submission indicates

that there are community based alternatives to detention that may be more

cost-effective and that may meet administrative detention requirements

without adversely affecting children's developmental, health and social

wellbeing.

The submission notes

that the interpretation of the Convention on the Rights of the Child

and other relevant conventions and protocols cannot be applied appropriately

within the context of the primacy of the Migration Act within Australian

law. There is a need to develop appropriate mechanisms that promote the

application of CROC in a way that conforms with its intent to give due

recognition to the rights of the child and guide community standards and

practice.

A summary of the

recommendations proposed in this submission are provided below:

Section 4. Child development

and support for children in immigration detention

Best interests

of the child and family is best served in the community based environment

The best interests of unattached minors and families with children should

be of primary consideration. Therefore children and their families/carers

should be accommodated in an environment that is least restrictive and

preferably community based and that fosters their wellbeing and development

as a family in a normalised community setting.

Restore normalcy

and predicability

Family members should be supported to fulfil their roles and responsibilities

within the family unit.

Parents should feel

empowered to parent. Consideration should be given to parent help services

that focus on dealing with child development, trauma/stress/aggression

and discipline. Implement service strategies that foster a safe environment

such as education and other activities, social services specialising in

addressing difficulties, personal support, mental and physical health

needs.

Play and stimulation

Children should be provided with opportunity to play in an environment

which enhances their development. Consideration should be given to providing

support to parents in the care of infants. Focus should be placed on health

care information, diet and feeding arrangements, facilities and programs

that provide interaction for the healthy development of infants to reduce

the risk potential of long-term developmental delay.

Preserving

family unit through family support

Special arrangements should be made for living quarters which are suitable

for children and their families. Stronger efforts should be made to have

families with young children released from detention and placed in other

appropriate accommodation. It is noted that the Woomera Residential Housing

Project is a positive step in this regard.

Families must be

kept together at all times, which includes their stay in detention as

well as being released together.

Intervention should

occur when care and protection issues arise. Such intervention should

stress prevention of further harm, supporting care-givers to more appropriately

meet the needs of their children, maintenance of extended family ties

and placement options as a last resort.

The needs of unaccompanied

young women, families headed by women or families with children who require

special support, male headed single parent families should be given priority

and consideration should be given to special accommodation.

Effort should be

placed on promoting family help networks, supporting parents as care-givers,

recognising parents' own needs and promoting physical and emotional security.

Parent support services

should be expanded such as pre-school, school, safe recreational activities.

Transition

into the community

Families should be prepared for leaving and an appropriate range of appointments

to assist transition should be developed. When parents and or children

have been separated for periods of time, counselling to ease the process

of reunification should be provided. Focus should be placed on family

reunification, improved visitation etc. Practical support and information

should be provided such as referral sources, increased life skills programmes

that focus on job search, banking, rental etc.

Environment

Consideration should be given to improving the privacy, adequacy of space,

spatial configuration and natural environment of immigration detention

centres. Overall Centre layout should reflect cultural norms and enable

normal daily family activity such as cooking, sharing meals, recreation

and other tasks.

Children require

shelter that provides space to crawl, play and foster their development

and wellbeing.

Education

Children should be provided with access to education which is at a standard

equivalent to that accessed by the general Australian population. Special

consideration should be given to the need for remedial action to increase

the competency of children in immigration detention especially given prior

issues of their limited access to education and the need for ESL and other

classes.

A greater focus should

be placed on vocational education, activities through which participants

gain knowledge and skills such as job search.

Extended culturally

appropriate recreation activities should be considered.

Strategies to facilitate

participation of adolescents in formal, vocational and special education

(eg life skills) should be implemented.

Health and

well-being

Focus should be placed on improved health care especially the assessment

and treatment of pregnant women including the development of case plans

that ensure appropriate pre and post natal care, pregnancy monitoring,

culturally appropriate confinement and visiting arrangements, diet, immunisation,

child development, etc.

Flexibility with

food rules will enable better childcare practices within immigration detention

environments.

Promote family health

and wellbeing through implementation of primary health care education

strategies that are culturally accountable and prevention focused.

Increase availability

of interpreter services within detention environments.

Improved management

of children in crisis should be provided through improved assessment,

case planning and treatment regimes. Treatment should be provided in partnership

with families with attention to language, culture and developmental stages

of children concerned. Increase individual and group sessions for children

and parents to manage:

  • depression;
  • stress;
  • loss and grief;

    and

  • anger, etc.

Where psychiatric

assessment is required, this should be recognised, obtained, and case

plans developed. Consideration should be given to broadening the range

of culturally appropriate support options such as Refugee Trauma Support.

When psychiatric services are not required, consideration should be given

to utilisation of other counselling and community support arrangements

to resolve family issues.

Operational

framework in immigration detention

To ensure the protection and wellbeing of children in detention, special

attention should be given to staffing and training, assessment and planning,

monitoring and reporting and evaluation of service provision.

Staff training should

be increased and place emphasis on cultural training and case management.

A better system of

case management should be devised where assessment especially of minors

is strengthened and case plans developed and followed through. Greater

emphasis should be placed on accountability and coordination.

Utilisation of independent

visiting staff from external agencies should be considered to:

  • expand the range

    of available services;

  • respond to emergencies/concerns;
  • make recommendations

    regarding services and activities to meet the changing needs of the

    population (especially disabilities and gender specific);

  • assist transition

    of families from the Centre into the community.

Section 5. Health of children

in immigration detention

Continued long term

detention of young children and their families is unjustifiable on developmental,

medical and mental health grounds. Provision must be made immediately

for child asylum seekers and their parents to be housed in the community

and not held in detention centres. Immigration detention is directly and

indirectly traumatizing for infants, children and their families. The

impact of living in this environment compounds existing problems experienced

by parents already compromised by past trauma, loss and continuing uncertainty

about their future. Mental health interventions and services will be ineffectual

in this context of ongoing trauma.

Children and their

parents must have access to the full range of health services available

in the community including adult and child and adolescent mental health,

early childhood and disability services and bicultural workers. These

are most likely to be available in urban or large regional centres.

Pregnant refugee

women must have access to high quality antenatal care which ensures they

are fully informed and consent to the type of child birth options available

to them. All efforts must be made to prevent prolonged separations from

pregnant mothers who have other young children. After delivery mothers

must have access to perinatal mental health services and mother-infant

services.

That State health

authorities be contracted by DIMIA to provide primary and other health

services that are consistent with standards prevailing in the wider community

as well as meet the specific needs of asylum seekers ensuring comprehensive,

systematic, holistic service delivery, continuity of care and State and

Commonwealth obligations for refugees and the wider community are appropriately

met in line with international Human Rights Conventions and protocols.

Optimally, the accommodation

of the children would be with their substantive family unit or within

a culturally aligned family structure and not involve detention or institutionalisation.

Mental health services

provided to this population should include the following components:

  • Initially consist

    of a screening and information provision process identifying persons

    at risk and the process for them to access services;

  • Be provided in

    a normalised social context with transparent access to mainstream social

    services, accommodation and education resources;

  • Focus on primary

    care provided through a collaborative model involving key service providers

    working with refugees and migrants to ensure adequate screening, early

    detection and primary health care continues to be provided to this population

    both in situ, during and following re-settlement . Key examples of service

    agencies in South Australia include Survivors of Torture and Trauma

    Assistance and Rehabilitation Services (STTARS), the Migrant Health

    Service counselling and support services with the Divisions of General

    Practice;

  • Follow on as required

    to further assessment and treatment of identified mental health needs

    provided from existing public mental health services (CAMHS) augmented

    by a culturally appropriate mental health resources.

In extreme and unusual

circumstances of the Commonwealth placing children in detention they should

be provided with:

  • On admission screening

    and assessment and information ensuring persons at risk are identified

    and they are aware of the process for them to access services;

  • Engagement with

    and liaison between detention centre based mental health staff, the

    child and their care-givers, community based mental health staff and

    general practitioners to ensure continuity of care on release from detention.

Community services

should consist of coordinated cross-agency services with a focus on the

mental health needs of minors provided by mainstream health services and

in particular:

  • Mental health

    screening and early detection process;

  • Culturally relevant

    primary health care;

  • Management of

    re-settlement issues for children including close examination of the

    consequences of the journey experience and detention including type

    and degree of services demands over:

    • Short term

      (0-1yr);

    • Medium term

      (1-5yrs); and

    • Long term

      (5+yrs).

Further consideration

of alternative options for care including:

  • Community home-based

    placement;

  • Identification

    of priorities for initial assistance;

  • Long term re-settlement

    assistance needs;

  • The impact of

    the unresolved citizenship status on individuals and families and particularly

    children of TPV holders born in Australia.

Section 6. Children with disabilities

in immigration detention

That HREOC investigate

whether the following audits have been undertaken in immigration detention

centres in line with community standards:

  • an access audit

    of all accommodation within the detention centres should occur to determine

    whether they comply with AS 1428 Parts 1 and 2;

  • a disability access

    audit within the population to determine what care support is required

    to enable persons with disabilities to remain there with appropriate

    levels of support;

  • an audit of equipment

    needs should take place to determine the full range of disability needs

    ie wheelchair appliances, shower chairs, transfer boards, crutches and

    sticks, hearing aid devices, visual aids and appliances.

Section 7. Child protection

arrangements between State child welfare agencies and the Department of

Immigration and Multicultural and Indigenous Affairs

That consideration

be given to the development of national legislation that puts mechanisms

in place that ensure the rights of all children, including child asylum

seekers, within Australia in accordance with the UN Convention on the

Rights of the Child and other relevant international covenants and

that also promote nationally consistent approaches to child protection

at both Commonwealth and State and Territory levels.

Section 8. Issues regarding

standards of care for children in immigration detention

That a national independent

authority be established for children, to assess, monitor and report on

child asylum seekers' care and protection, service quality and standards,

including reporting standards and report on community concerns about the

application of such care and protection services.

That the Commonwealth

develop in collaboration with States and Territories, a national policy

and action plan for promoting national directions and integrated and collaborative

responses to the needs of refugee asylum seekers irrespective of their

refugee status with a particular focus on the needs of child asylum seekers.

That a cost-benefit

analysis that incorporates research and a review of the literature and

cost analysis be undertaken of the range of community-based options that

might exist as alternatives to detention with a focus on the benefits

that these alternatives may have for asylum seeking children and their

families.


1. Introduction

The South Australian

Department of Human Services (DHS) is pleased to take the opportunity

provided by the Human Rights and Equal Opportunity Commission to make

a submission to its Inquiry into Children in Immigration Detention. The

Department, as the key State Government portfolio responsible for the

care and protection of children and for public health in South Australia,

has a significant relationship with children in immigration detention.

It also has a significant continuing relationship with children and their

families released from immigration detention into the South Australian

community.

In making this submission,

the Department notes the following broad issues that have implications

for the provision of a substantiated evidence-based submission:

  • It is difficult

    to comment on the quality and appropriateness of personal health care

    provided to individual asylum seeking children and pregnant women in

    detention without undertaking either extensive interviews of health

    and welfare personnel employed at Woomera or a randomised case review

    and follow through post detention for those women and children released

    to the community. Such interviews and reviews would highlight issues

    that relate to the quality and delivery of personal health care for

    children and pregnant women in relation to expected standards of care

    for pregnancy and for any medical conditions or nutritional deficiencies

    that exist for this community of asylum seekers. Much of what is therefore

    presented in this submission is based on informal and formal observations

    by service providers on the manner in which services are provided in

    immigration detention and conditions in detention and issues arising

    post-detention;

 

  • The Department

    of Human Services (Family and Youth Services) undertook an assessment

    of the social and environmental conditions at Woomera in April 2002

    and how these might impact on asylum seeking children;

 

  • Policies and

    practices of Australasian Correctional Management (ACM) and Department

    of Immigration and Multicultural and Indigenous Affairs (DIMIA) may

    have changed to some extent over time due to reviews and improved understanding

    of standards or clarification of interpretation of what standards should

    prevail or what the service contract requirements entail. However, such

    changes have not been as extensive as would be expected and the basic

    detention environment of Woomera remains unchanged. There will always

    be an issue with regards to the interpretation of contract requirements

    and standards if there is no independent body with the authority to

    make such assessments;

 

  • Asylum seeking

    children do form a special group whose development and health is already

    compromised as a result of deprivations during war, dislocation, months

    of travel and institutionalisation in immigration detention. In this

    context, the concept of equivalence of social, developmental and health

    care as per community standards needs to be realised at a higher level

    and specific standards should apply.

 

  • Administrative

    detention is the term used by DIMIA to describe the nature of detention

    in immigration detention. The term administrative detention implies

    detention that is not based on criminal grounds and may result in wider

    options involving less formal detention arrangements and requirements

    to assure rights in accordance with international law particularly those

    that apply to children. However, there appears to be no precise definition

    of administrative detention or application of one that reflects a human

    rights approach. In this context, the impact of detention. whether it

    be cited as 'correctional' or 'administrative', is likely to be the

    same in relation to the case of children.

 

  • The parameters

    of immigration detention create difficulties for States and Territories

    in meeting their obligations as State child protection and health care

    authorities. In the three years since immigration detention commenced

    and with purchaser/provider arrangements in place between DIMIA and

    ACM, the State of South Australia has been required to renegotiate a

    number of memoranda of understanding on child protection, child welfare

    and care of unattached humanitarian minors. The Department of Human

    Services is now also negotiating the development of a health service

    memorandum for asylum seekers who require forms of health care and treatment

    that ACM is not expected or is unable to provide under its contract.

 

  • The primacy of

    the contract between the Commonwealth and ACM and the requirements that

    ACM meet all basic health care, educational and other special requirements

    of both adult and child asylum seekers has resulted in minimalist practices

    that appear to not meet current standards of health care and social

    support as discussed in this submission. The contract is framed primarily

    as a detention service rather than as a settlement service with a protective

    service component. The primacy of the detention service contract over

    and above other service components means that ACM needs to examine its

    bottom line in terms of ensuring profitability and the costs of providing

    quality care that meets children's health and developmental needs in

    line with current understandings of the care needs of child asylum seekers

    and their families has to be considered carefully.

The Department also

wishes to note its support for the submission made by Child and Youth

Health in South Australia and by Dr Rosalind Powrie on behalf of the Australasian

Association for Infant Mental Health (AAIMH). This submission will not

restate what has been already outlined in those submissions but seeks

to support those statements of recommendations that have been put forward

in them.


2. Role and Responsibilities

of the South Australian Department of Human Services

The key outcomes

the Human Services Portfolio aims to achieve are to:

  • enhance the quality

    of life for South Australians through government and community partnerships

    promoting health and wellbeing, the development of a sustainable community

    and quality living standards;

  • provide the care

    and support necessary for people to maintain and improve their health

    and wellbeing at a cost the community is willing to bear.

The Human Services

Portfolio is committed to the following goals:

  • ensuring community

    access to high quality, responsive and timely services;

  • ensuring adequate

    health and physical protection balanced with appropriate use of support

    services;

  • ensuring the protection

    of children and support for families;

  • providing housing

    services and assistance;

  • developing supportive

    communities;

  • maximising value

    for money and effectiveness of service delivery;

  • reflecting state

    priorities in Commonwealth-State relations;

  • minimising government

    regulation while maintaining adequate service standards;

  • communicating

    government policy clearly to the community;

  • setting performance

    requirements for public and private providers.

The Department aims

to coordinate planning across the whole of the state, create opportunities

to develop and maintain partnership with the community and delivers services

to people in an integrated, effective and productive way. This philosophy

has underpinned the delivery of services to new arrivals including asylum

seekers.

The two key strategic

directions of the Department of Human Services (DHS) most relevant to

this submission are:

  • Improving services

    for better outcomes; and

  • Increasing the

    State's capacity to promote quality of life.


3. The DHS policy context

for the care and protection of children in immigration detention and upon

their release into the South Australian community

International human

rights conventions are not law unless incorporated into legislation. They

do however influence decision making. Human rights are recognised as fundamental

to the functioning of a democratic society. Governments, such as Australia,

in signing the United Nations Convention on the Rights of the Child

(CROC), have indicated their support for the rights of children (up to

the age of 18) to have access to resources providing them with best possible

outcomes.

The principles of

the CROC state that every child has the right to survival, protection

and development, and to participate in decisions affecting his or her

future. CROC does not set children and young people in immigration detention

apart from those who are citizens or residents of a country. CROC clearly

states that it is for every human being under 18 with Article 22 of the

CROC clarifying the position for children seeking refugee status or who

are considered as refugees.

Parties shall

take appropriate measures to ensure that a child who is seeking refugee

status or who is considered a refugee in accordance with applicable

international or domestic law and procedures shall, whether unaccompanied

or accompanied by his or her parents or by any other person, receive

appropriate protection and humanitarian assistance in the enjoyment

of applicable rights set forth in the present Convention and in other

international human rights or humanitarian instruments to which the

said States are Parties.

This means that all

children and young people in a country whatever their background or status

should be awarded what the CROC outlines is needed to achieve best outcomes

for the child. This includes:

  • Not separating

    children from their parents;

  • Ensuring children

    have the right to protection from all forms of abuse;

  • Ensuring children

    not living with their parents have the right to special protection;

  • Ensuring children

    having rights to the highest attainable status of health;

  • Ensuring children

    having the right to a adequate standard of living; and

  • Ensuring children

    having the right to play and recreation.

As stated above,

CROC awards children rights including those of special protection. This

is particularly so for the protection of children affected by armed conflict

(Article 38) and rehabilitation of child victims (Article 39). The life

experience of refugee children has potentially seen them encounter armed

conflict, neglect and abuse, forms of cruel, inhuman or degrading treatment

or punishment and exploitation.

The rights of children

are complementary to other agreements that set down basic human rights

ie the Universal Declaration of Human Rights and International Covenant

on Civil and Political Rights. Other significant United Nations human

rights documents provide perspectives that will be considered in this

submission. These documents include the directions set in the United Nations

High Commission for Refugees (UNHCR) publication: Refugee Children

- Guidelines on Protection and Care (1994). This document recommends

that children seeking asylum should not be kept in detention, particularly

in the case of unaccompanied children. It states that if children are

kept in detention then it must only be as a last resort and for the shortest

appropriate time (also in CROC Article 37).

For children and

young people in detention the United Nations Rules for the Protection

of Juveniles (under 18) Deprived of Their Liberty (UN General Assembly

Resolution 45/113, 14 December 1990) states:

Juveniles…should

be guaranteed the benefit of meaningful activities and programmes which

would serve to promote and sustain their health and self-respect, to

foster their sense of responsibility and skills which will assist in

developing their potential as members of society.

Australia played

a significant role in the development of the CROC and has, through its

ratification, given support to its principles. This support has been further

amplified by the inclusion, as a Schedule, in the Human Rights and Equal

Opportunity Commission Act 1986. Australia has used CROC to inform policy,

planning and decision making, including legislation.

Australian reports

on CROC outline their response to children and young people seeking refugee

status in Australia. These reports indicate that while not enshrined in

legislation, the articles of the UNCROC do inform decisions that are made

including: keeping children and young people, wherever possible, with

their families; the provision of basic health and welfare; access to education

and recreation and special protection.

In Australia's responses

to the implementation of CROC, it is evident that Australia is working

towards meeting the principles of the convention for refugee children

and young people. Although children and young people are in detention,

which is not in keeping with the principles of CROC, Australia is committed

to processing the special needs children and young people. giving the

processing of their visa applications high priority.

The Commonwealth

Migration Act 1958 sets the legislative framework for responding

to all people, including children and young people, seeking refugee status.

Children and young people are in immigration detention whilst their visas

are being processed.

The effect of Commonwealth

legislation on State legislation is a fact of consequence which impacts

on the promotion of the best interest of the children and young people.

Within South Australia the legislation that is most significant to the

rights of the child and the promotion of their health and wellbeing are

the Family and Community Services Act and Children's Protection Act.

Both of these Acts form part of the business of the Department of Human

Services (DHS). Both of these Acts advocate for children's rights and

emphasise the importance of families and keeping families together. The

Commonwealth Migration Act takes precedence over both of these Acts. As

such, despite residing in the State of South Australia, the health and

wellbeing of the children and young people under immigration detention

remain the absolute responsibility of the Commonwealth.

The States and Commonwealth

have established Memoranda of Understanding to promote the best interests

of the children and young people in immigration detention. In doing so

they have set up ways in which to work within the existing Commonwealth

legislation and the limitations imposed by this overriding legislation

whilst enacting responses guided by State legislation and policy.

Within South Australia,

children and young people's wellbeing, including child protection, is

extensively directed through the Department of Human Services with collaboration

from other Departments such as the Department of Education, Training and

Employment.

The DHS Strategic

Plan clearly states the Human Services Portfolio commitment to ensuring

the protection of children and support for families. The philosophy underpinning

the Strategic Plan supports capacity building opportunities for individuals,

families and communities as well as the promotion of justice and equity.

The strategic directions of this document aim to improve planning and

services for population groups including children and young people at

risk and people from diverse cultural backgrounds.

In response to its

Strategic Directions, the DHS has recently endorsed a policy for

children and young people, a document for which young people wrote the

vision. The vision states:

The Department

of Human Services values and respects the rights, needs and views of

all children and young people as equal and unique citizens, [1]

supporting and promoting their opportunities and choices to achieve

the most out of life.

The vision of the

Children and Young People's Policy is very much in keeping with

the principles of the CROC. The policy is a whole of Department document

and includes principles for planning and service provision as well as

priority areas and key understandings of what children and young people

need to achieve the most out of life.

Health and wellbeing

of children and young people both now and in the future is about an investment

in today. Whether the children and young people in detention remain in

Australia to become citizens or not they have rights. These rights as

stated earlier allow them to achieve best outcomes.

The key understandings

of the DHS Children and Young People's Policy draw on the evidence, which

locates the health and wellbeing of children and young people in the following:

  • Safe, supportive,

    respectful, participatory and non discriminatory environments;

  • Positive perceptions

    of children and young people;

  • Investment in

    the early years;

  • Negotiation of

    key transition periods;

  • Prevention, intervention

    and access to ongoing support;

  • Experiences of

    all forms of abuse, neglect and violence, trauma and loss have immediate

    and long term impact;

  • Access to support

    and development provided through family, peer groups, recreation and

    education;

  • Equity of access

    to use of safe public space and services;

  • Responsive and

    appropriate services for differing stages of development and social,

    cultural and economic backgrounds reflecting varying beliefs, needs

    and experiences.

It is in these key

understandings and the key strategic direction of promoting a supportive,

enabling and inclusive environment that recommendations for strategies

that work toward best outcomes can be located.

Children and young

people from a multicultural background are identified in the DHS Children

and Young People's Policy as a priority population group. Particular

reference is made to children and young people who are newly arrived and

those that are unaccompanied minors. It recognises their life experiences

including the trauma that has impacted on their development. This population

group will be a priority population group in the development of implementation

frameworks, one for children, and one for young people, which will aim

to improve service provision to children and young people.

Further to these

policy directions are those operationalised through Family and Youth Services,

a service provider of DHS. Of specific relevance is the policy related

to child protection. This policy does not single out any specific groups

of children and young people. Rather child protection is considered a

fundamental right of all children and young people. The philosophical

framework of this policy, that gives recognition to the CROC, places child

protection in the context of structural and social factors. It supports

the role of the family and the need to support them as well as the child

or young person. As such it advocates for a position that maintains the

family environment, keeping the child or young person with their family

wherever possible. This is reflected in the Department's dealings with

the Commonwealth Family Law Act 1975. The DHS Family and Youth

Services (FAYS) Child Protection Manual also advocates for expeditious

dealings when managing situations of child safety. In these expeditious

dealings, the policy states that the family should be kept fully updated

on the process of which their child becomes the point of concern. All

assessments of children require consideration of cultural background at

the same time as putting the child's safety first.

The policies of DHS

are of significance for children and young people in immigration detention

as they provide the principles and strategies through which DHS provides

its business. Through memoranda of understanding between the State and

Commonwealth DHS has been and may be given further responsibility to promote

the health and wellbeing of the children and young people in immigration

detention in the State. Currently a memorandum of understanding exists

for child protection and unaccompanied minors, but not for all aspects

of health and wellbeing.

While the Human Services

Portfolio would advocate for the expediting of processing of visas for

children and young people and if present their families, it acknowledges

that the management of this process remains with Commonwealth jurisdiction.

As such, this submission focus on core DHS business which includes the

planning and provision of health, housing and community services that

promote health and wellbeing. This submission will remain in keeping with

the directions set out in the above conventions and guidelines as well

as the Department of Human Services commitment to the health and wellbeing

of children and young people.

This submission will

cover aspects of children and young people's health and wellbeing, which

are business of DHS including:

  • Health, psychological

    and social wellbeing and nutrition;

  • Legal issues;
  • Prevention, treatment

    and accommodation of disabilities; and

  • Detention and

    alternatives to detention.


4. Child development and support

for children in immigration detention

The Department of

Human Services through its Family and Youth Services has responsibility

for child protection statutory intervention in South Australia. While

the Child Protection legislation in its totality does not apply within

Woomera Detention Centre, assessments conducted by DHS within the Centre

are guided by the legislation. The aim of the child protection assessment

model utilised by DHS is to ensure greatest possible safety for children

reported for abuse or neglect. Focuses are on children in danger and the

greatest risk in order to minimise ongoing risk.

Delegated authority

Refugee minors who

arrive in Australia unaccompanied by their parents fall within the provisions

of the Commonwealth Immigration Guardianship of Children Act 1946.

Under this Act, the Minister of Immigration may take on partial or full

legal guardianship of the minor. The Minister has the power to delegate

a range of administrative responsibilities. In South Australia, the Department

of Human Services Chief Executive has been delegated responsibility for

support and assistance to those experiencing disadvantage, those who are

in need of care and protection, and the placement of children detained

pursuant to the Migration Act 1958 into community-based care. Key

South Australian legislation underpinning the role of the DHS is the Family

and Community Services Act 1972 and the Children's Protection Act

1993.

This delegation is

operationalised by a number of Memoranda of Understanding between the

DIMIA and the DHS ie:

  • Refugee Minors

    without parents in Australia and their caregivers 1995 and 2002 (draft);

  • Child Protection

    Notification and Child Welfare issues pertaining to children in immigration

    detention in SA 2001; and

  • Agreement for

    the care of some detainee minors in alternative detention arrangements

    2002 (draft).

Although the new

Memoranda of Understanding on Refugee Minors in Australia without parents

in Australia and their caregivers 2002 and the Agreement for the

care of some detainee minors in alternative detention arrangements 2002

are still in draft form, agreement has been reached about the scope of

care for minors who have been granted TPV status as well as those minors

in community based detention. Within these agreements, it is recognised

that refugee minors have developmental needs that require age-specific

services that provide care and protection in socially, culturally and

religiously appropriate ways. Appendix 1 provides detail on the support

provided to minors placed in the Department's care.

DIMIA reimburses

DHS for expenses accrued by DHS in the provision of care to this group

of children and young people through delegation of limited guardianship.

Guardianship and overarching duty of care is retained by the Minister

of Immigration. Notwithstanding this, the DHS has a duty of care to ensure

the wellbeing of children and young people in home and community care.

Additionally, the DHS has a duty of care to investigate child protection

concerns for children in immigration detention in South Australia and

to make recommendations to DIMIA on the best interests of the child or

young person.

DHS service provision

The Department of

Human Services, Family and Youth Services, has been involved in providing

services to refugee minors since the displacement of people arriving through

unauthorised means eg boats in Indo China, but the current bulk of activity

relates directly to the arrival of the "boat people" and their

detention by DIMIA. Currently support for unaccompanied refugee minors

is the main work undertaken by the Department with regards to asylum seeking

children.

DHS has assessed

the general wellbeing of children and families detained in the Woomera

Immigration Reception and Processing Centre (WIRPC). Specific recommendations

have been forwarded to DIMIA in relation to a number of cases in which

significant risks of abuse and neglect have been assessed and require

ongoing monitoring.

The following component

of this submission examines issues related to the environment of immigration

detention within the context of South Australian child protection practice

standards in the following areas:

1. Rights of the

child - best interest of the child;

2. Psychological and social well-being;

3. Education; and

4. Legal and administrative framework for dealing with children.

1. Rights of the

child - Best interests

Design and

location of detention facilities

Detention is often represented as a "place", and as such, a

passive concept. However, such a concept greatly underplays the impact

of detention facilities on the physical, psychological and emotional wellbeing

of children, young people and their families. In reality, detention is

best viewed as a "process" and an active concept that poses

many specific challenges for the system and the people within it, ie:

  • Immigration Detention

    is an artificial environment in which both the detainees and staff alike

    are restricted in freedom of movement and interaction. Many of the centres

    are located in sparsely populated areas in Australia. For example, the

    geographic location of Woomera in South Australia is characterised by

    a featureless landscape with limited vegetation and pervasive red soil.

    The area is impacted by extreme climatic changes - a feature of the

    arid environment. Razor wire topped fences surround the facility;

  • Most detainees

    have no direct knowledge of Australian life and cities. Some children

    within the facility have known no other life environment and others

    have been detained in the environment for twelve months or more;

  • The detention

    processes can especially impact upon parents. The effects of institutionalised

    living undermine and significantly compromise their capacity to nurture

    and protect children. The process of detention impacts on the ability

    of families to build normal family life environments. Factors such as

    small living quarters, no access to basic cooking, gardening and other

    facilities, institutionalisation of living arrangements and separation

    of family compromise quality of family life;

  • Children and young

    people have a range of developmental needs including physical activity,

    competence and achievement, self-definition, creative expression, positive

    social interactions, structures and clear limits, and meaningful participation.

    The ability to meet the developmental needs of children is greatly compromised

    in the artificial and restricted environment of a detention centre.

2. Psychological

and social wellbeing

Minors in immigration

detention are an extremely vulnerable group given their age, stages of

development, wellbeing and social support needs and none are more vulnerable

than the unaccompanied minors who have been among the group.

Any child or young

person moving from one culture to another may be challenged by the adjustment

required to settle into new surrounds, especially if those new surrounds

are significantly different from country and culture of origin. Detention

adds a significant dimension of stress to such adjustment. This impact

must be clearly understood and guide the design of immigration detention

facilities, policy and practice processes.

For many refugee

minors, a range of factors may further compound difficulties with adjustment

to settlement in Australia. The previous degree of trauma witnessed or

suffered, prior living conditions in the country of origin, the circumstances

experienced during the journey to Australia and, especially for unaccompanied

minors, disconnection or loss of family of origin and community may impact

significantly on their psychological wellbeing.

The following is

evident in both practice experience and research:

  • The health and

    wellbeing of children and young people placed in stressful and alien

    environments is greater when they retain a continuous relationship with

    parents or family/community systems. Healthy psychological, physical

    and intellectual development of children is dependent on environments

    that are predictable, nurturing, stimulating and provide opportunity

    to learn and master new skills that aid healthy development.

 

  • Nonetheless, it

    is also recognised that parents can also compromise the care and protection

    of children. Parents in detention may be too stressed or traumatised

    to provide adequate care. They may suffer mental or physical illness

    or experience difficulty coping with life in a new environment. It is

    recognised that in general, refugees experience very high rates of mental

    ill health and psychological distress (RANZCP College Statement #46).

    Prevention of the breakdown of the care of children through provision

    of practical support is required. The best interests of the child and

    a primary focus on safety should be the priority of all intervention.

 

  • The social and

    emotional development of children and young people in institutional

    environments can be impacted by a number of factors. Within stressful,

    regimented and artificial institutional regimes children and young people

    can become characterised by:

    • No cause and

      effect thinking;

    • Inability

      to persist at problem solving;

    • Limited impulse

      control;

    • Aggression;
    • Attention

      seeking behaviours;

    • Detachment

      and withdrawal;

    • Poor social

      skills;

    • Limited individual

      or creative thought;

    • No concept

      of time (past, present, future);

    • Lack of purposeful

      existence;

    • Inability

      to concentrate;

    • Unwillingness

      to participate in activities;

    • Unwillingness

      to learn;

    • Poor self

      image and desire to care for their physical health needs;

    • Lack of affect;

      and

    • Hyper-vigilance.
  • Physical environments

    with limited education/work, spiritual development and recreation opportunities,

    limited trauma support services, and which are geographically and socially

    isolating and limiting social interaction, impact on the health and

    well being of children and young people. The longer children and young

    person reside in detention the greater the potential for detrimental

    effect on their social, emotional wellbeing and physical health.

3. Education

Children and young

people require education appropriate to their age and abilities, which

is respectful of their culture and promotes their development. Education

in immigration detention should be multifaceted and encompass formal (academic)

instruction such as English and maths, as well as informal (non-academic)

instruction such as life skills, pre-vocational and vocational training.

The primary purpose

of providing an education to children and young people in immigration

detention should be to keep them current with their studies and provide

remedial instruction for those whose education has been interrupted. A

comprehensive education program is also an important way of providing

meaningful activity during the day. Participation in education can improve

problem solving abilities, act to reduce disciplinary problems, focus

young people's attention on activities of interest, build self esteem

and confidence and distract from the stressors of life in secure detention.

4. Legal and administrative

framework for children

Principles

to guide administration

The relationship between liability and the condition of detention for

minors is close. To guide service provision in the immigration detention

environment and mitigate its impact on detainees. the United Nations

High Commission for Refugee policy for staff should be applied, especially

the following principles:

  • In all actions

    taken concerning refugee children, the human rights of the child, in

    particular his or her best interests are to be given primary consideration;

  • Preserving or

    restoring family unity is of fundamental concern;

  • Actions to benefit

    refugee children should be directed primarily at enabling their primary

    care givers to fulfil their principal responsibility to meet their children's

    needs.

The Convention

on the Rights of the Child to which Australia is signatory contends

the "best interest" of the child should be of primary consideration.

The rule requires States to analyse how each course of action may affect

children. The Convention also articulates that detention be "used

only as a measure of last resort and for the shortest period of time"(CROC

Art.37 (b)). As education is vital to human development, it is recognised

as a universal human right (CROC Art. 22). The Convention articulates

the rights of the child to a variety of standards of treatment especially

protection from violence (CROC Arts 19 and 34), opportunity for recovery

from the effects of neglect, exploitation, abuse, torture or ill-treatment,

or armed conflict (CROC Art 39), a standard of living adequate for physical,

mental, spiritual, moral and social development (CROC Art 27), to be detained

in a manner which takes into account their age (CROC Art 37), rest and

play (CROC Art 16) and privacy (CROC Art 16).

The Department of

Human Services concurs with these principles and supports them as a sound

basis for the treatment of child asylum seekers.

Impact of current

immigration detention practices on detainees

Centre staff control all detainee contact with the outside world, movements,

social engagement, religious practice, access to health care, and recreation

within and outside the facility. The constraints of security procedures

appear to be consistent with those operating for a maximum security prison.

These constraints result in significant day to day control of detainee

behaviour residing with Centre staff, including that of children and young

people within the facility. Detainees report they feel like "criminals"

and have their ability to live autonomous and self-directed lives compromised.

It is acknowledged

that some detainees may need to be held in secure detention due to the

risk posed to the general Australian population. However, to foster healthy

child development and strengthen parent's capacity to care for their children,

"family friendly" accommodation should be provided to refugee

families. Such accommodation is best provided in the community where access

to schooling, social, cultural and religious support and activity can

be assured.

Communication practices

also impact on detainees and thus attention needs to be placed on improving

communication strategies. Detainees have expressed a need for improved

explanation of Visa application processes, Australian Migration Law and

Government policy and have indicated this would assist in addressing apparent

levels of confusion, misunderstanding, frustration and subsequently reduce

the sense of powerlessness experienced by many. Finding ways to reduce

and or explain delays in processing would also assist to build a sense

of trust in the current system. Identified factors impacting on detainees

include:

  • indeterminate

    length of incarceration

  • cycles of raised

    hope and disappointment (eg Monday and Wednesday visas notification,

    Tuesday and Thursday disappointment when visas not granted)

  • lack of understanding

    and certainty about the mechanisms/decision making process for visa

  • rise in mythology

    about what might speed visas processing (eg self-harm)

Whilst some of these

factors are more difficult to ameliorate, others can be affected by improved

communication processes.

Recommendations

Best interest

of the child and family is best served in the community based environment

The best interests of unattached minors and families with children should

be of primary consideration. Therefore children and their families/carers

should be accommodated in an environment that is least restrictive and

preferably community based and that fosters their wellbeing and development

as a family in a normalised community setting.

Restore normalcy

and predicability

Family members should be supported to fulfil their roles and responsibilities

within the family unit.

Parents should feel

empowered to parent. Consideration should be given to parent help services

that focus on dealing with child development, trauma/stress/aggression

and discipline. Implement service strategies that foster a safe environment

such as education and other activities, social services specialising in

addressing difficulties, personal support, mental and physical health

needs.

Play and stimulation

Children should be provided with opportunity to play in an environment

which enhances their development. Consideration should be given to providing

support with the care of infants to parents. Focus should be placed on

health care information, diet and feeding arrangements, facilities and

programs that provide interaction for the healthy development of infants

to reduce the risk potential of long-term developmental delay.

Preserving

family unit through family support

Special arrangements should be made for living quarters which are suitable

for children and their families. Stronger efforts should be made to have

families with young children released from detention and placed in other

appropriate accommodation. It is noted that the Woomera Residential Housing

Project is a positive step in this regard.

Families must be

kept together at all times, which includes their stay in detention as

well as being released together.

Intervention should

occur when care and protection issues arise. Such intervention should

stress prevention of further harm, supporting care-givers to more appropriately

meet the needs of their children, maintenance of extended family ties

and placement options as a last resort.

The needs of unaccompanied

young women, families headed by women or families with children who require

special support, male headed single parent families should be given priority

and consideration should be given special accommodation.

Effort should be

placed on promoting family help networks, supporting parents as care-givers,

recognising parents' own needs and promoting physical and emotional security.

Parent support services

should be expanded such as pre-school, school, safe recreational activities.

Transition

into the community

Families should be prepared for leaving and an appropriate range of appointments

to assist transition should be developed. When parents and or children

have been separated for periods of time, counselling to ease the process

of reunification should be provided. Focus should be placed on family

reunification, improved visitation etc. Practical support and information

should be provided such as referral sources and increased life skills

programs that focus on job search, banking, rental etc.

Environment

Consideration should be given to improving the privacy, adequacy of space,

spatial configuration and natural environment of the Centre. Overall Centre

layout should reflect cultural norms and enable normal daily family activity

such as cooking, sharing meals, recreation and other tasks.

Children require

shelter that provides space to crawl, play and foster their development

and wellbeing.

Education

Children should be provided with access to education which is at a standard

equivalent to that accessed by the general Australian population. Special

consideration should be given to the need for remedial action to increase

the competency of children in immigration detention especially given prior

issues of their limited access to education and the need for English as

a second language (ESL) and other classes.

A greater focus should

be placed on vocational education, activities through which participants

gain knowledge and skills such as job search.

Extended culturally

appropriate recreation activities should be considered.

Strategies to facilitate

participation of adolescents in formal, vocational and special education

(eg life skills) should be implemented.

Health and

well-being

Focus should be placed on improved health care especially the assessment

and treatment of pregnant women including the development of case plans

that ensure appropriate pre and post natal care, pregnancy monitoring,

culturally appropriate confinement and visiting arrangements, diet, immunisation,

child development, etc.

Flexibility with

food rules will enable better childcare practices within immigration detention

environments.

Promote family health

and wellbeing through implementation of primary health care education

strategies that are culturally accountable and prevention focused.

Increased availability

of interpreter services especially when detainees are hospitalised outside

immigration detention environments.

Improved management

of children in crisis should be provided through improved assessment,

case planning and treatment regimes. Treatment should be provided in partnership

with families with attention to language, culture and developmental stages

of children concerned. Increase individual and group sessions for children

and parents to manage:

  • depression;
  • stress;
  • loss and grief;

    and

  • anger, etc.

Where psychiatric

assessment is required, this should be recognised, obtained, and case

plans developed. Consideration should be given to broadening the range

of culturally appropriate support options such as Refugee Trauma Support.

When psychiatric services are not required, consideration should be given

to utilisation of other counselling and community support arrangements

to resolve family issues.

Operational

framework

To ensure the protection and wellbeing of children in detention, special

attention should be given to staffing and training, assessment and planning,

monitoring and reporting and evaluation of service provision.

Staff training should

be increased and place emphasis on cultural training and case management.

A better system of

case management should be devised where assessment especially of minors

is strengthened and case plans developed and followed through. Greater

emphasis should be placed on accountability and coordination.

Utilisation of independent

visiting staff from external agencies should be considered to:

  • expand the range

    of available services;

  • respond to emergencies/concerns;
  • make recommendations

    regarding services and activities to meet the changing needs of the

    population (especially disabilities and gender specific);

  • assist transition

    of families from immigration detention into the community.


 

5. Health of children in immigration

detention

The Department of

Human Services acknowledges that a child's early years are of critical

importance and provide the basis for physical, mental and social success

in their adult life. The evidence and knowledge that is now available

highlight the importance of giving children a better chance in life particularly

those who have experienced significant deprivation, disadvantage and stress.

Within this context, The Department acknowledges its support for the submission

made by Child and Youth Health in South Australia and by Dr Rosalind Powrie

on behalf of the Australasian Association for Infant Mental Health (AAIMH)

and the recommendations made within these submissions (see Appendix 3).

The Department, however,

wishes to highlight the major role stress plays in child development.

Studies of brain, particularly the biological pathways involved in the

reaction to stress to which individuals are exposed early in life, show

that this exposure may modify their ability to moderate and control responses

to stress later in life (Cynader and Frost, 1999). The quality of sensory

stimulation in early life helps shape the brain's endocrine and immune

pathways; and that adults who were poorly nurtured in early life tend

to retain sustained levels of stress that influence life outcomes for

health and social wellbeing.

On this basis, asylum

seeking children are clearly a group of children who require special attention

to provide them with a better chance of improving their health and social

wellbeing whether they remain in Australia or not. This knowledge highlights

the need for high quality continuous programs for children with staff

that are well-trained and provide continuity of services. These are the

special conditions that need to apply to all programs if children in immigration

detention are to achieve successful life long outcomes.

The following case

discussing immunisation aims to highlight the complexities of the issues

that confront service providers in immigration detention environment in

seeking to establish access to fundamental primary health care.

The case of immunisation

The Department of

Human Services is concerned with ensuring and promoting public health

to the greatest extent possible. It needs to be recognised that, in an

increasingly globalized world, public health is an issue that needs to

be managed at all levels from the global to the local level adopting prevention

standards that apply to the whole community. It also needs to be acknowledged

that publicly transmittable diseases are not circumscribed by contractual

boundaries or by remoteness of physical locations. Therefore, the concept

of public health needs to be acknowledged as an obligation to protect

the wider community not just a specified community.

The Department of

Human Services believes that child asylum seekers and children in the

rest of the Australian community have a right to be protected from vaccine

preventable diseases to the fullest extent possible. In accordance with

its contract, ACM management has to comply with a Statement of service

requirements Care needs: Health care. This statement focuses on service

expectations for health care within the confines of the immigration detention

centre environment and not beyond. For example, the statement reads at

the start:

7.1.1 The Department

expects that detainees should be able to access either in a facility

or externally, a level and standard of health services broadly consistent

with that available in the Australian community, taking into account

the special needs of the detainee population. The Services provider

should not provide for elective surgery or elective or cosmetic dental

treatment.

and

7.1.8 The duty of care with regard to health also encompasses public

health risks and, in these circumstances, may extend beyond detainees

to the safety and welfare of others at a facility, such as staff, visitors

and sub-contractors.

The document does

not mention any specific standards but regularly makes reference to the

norms of care available to members of the Australian community.

The Department of

Human Services is concerned, that despite overtures made by various health

services ie Communicable Disease Control Branch, Child and Youth Health

and the Migrant Health Service to ACM about provision of basic health

services such as immunisation, there has been no formal agreements ensuring

these external public health service providers are able to provide ongoing

services that:

  • would result in

    ensuring a systematic approach to immunisation and to promoting a standard

    of care;

  • would meet the

    community norms in ensuring individual and public health; and

  • would meet ACM's

    contractual obligations to DIMIA and duty of care to detainees and the

    Australian population.

The case of immunisation

reveals the extent of capriciousness and arbitrariness about what constitutes

a standard of care in immigration detention centres, particularly given

what is known ie that asylum seeking people including children have been

and will continue to be released into the South Australian and Australian

community. The case for vaccinating against measles and poliomyelitis

are highlighted especially below:

Measles

South Australia has been free of measles for the last 18 months. Most

of the cases of measles that have occurred in the recent past have been

the result of importation from Indonesia. This is significant because

most asylum seekers arriving by boat have generally arrived from Indonesia.

The potential for measles to enter into the South Australian community

is significant given this situation and therefore the failure to institute

appropriate immunisation schedules for asylum seekers and particularly

asylum seeking children remains a major concern for the Department of

Human Services.

Poliomyelitis

South Australia has been free of poliomyelitis since 1978. The Western

Pacific region has been officially free of poliomyelitis since 2000

(this region has been actually free of poliomyelitis for since 1997

but the formal declaration was made in 2000). There are two places through

which poliomyelitis is now being transmitted ie Pakistan/Afghanistan

and Central Africa. There is therefore a potential to break Australia's

and the Western Pacific region's polio free status.

It can be inferred

from the Statement of service requirements Care needs: Health care.

that the concept of public health used primarily applies to the detention

centre environment with a proviso that it extends to people who may come

to the Centre to provide goods and services ie sub-contractors, staff

and visitors at the Centre. In other words, it is focused on place and

not on meeting public and primary health care principles. It presumes

that:

  • staff, contracted

    service providers and visitors do not have wider community contact;

    and

  • asylum seekers

    held in detention stay in the detention environment until their release

    into the community when they are no longer a client of ACM or until

    they are deported and therefore the wider community public health is

    not a concern.

It does not give

due recognition to the movement of asylum seekers in the wider community

under detention arrangements for schooling, for inpatient hospital based

care or for other services or for minors under detention arrangements

living in the community. It does not give due recognition to ensuring

wider community standards for public health are met given that a significant

majority of asylum seekers are being or have been released into the community.

The requirements are therefore sufficient within this context only and

do not go beyond this.

The failure to establish

a systematic approach to something as straightforward as immunisation

indicates a breach in the standards of care, particularly to children,

a breach of children's human rights to health care of the standard prevailing

in the wider community and a failure to fully comprehend the importance

of the need to provide this fundamental primary health care service for

the wider community. This breach is unjust for children in immigration

detention and also unjust for all Australian children as well as for those

people with compromised health in the community. Furthermore, it requires

significant effort by State health authorities to urgently review immunisation

status as soon as refugee children and adults are released into the community

in order to ensure preventive measures are in place.

The case of immunisation

is of acute importance in demonstrating that ACM has not necessarily adopted

well-known prevailing health standards for immunisation based on what

is well-known about the epidemiology of certain vaccine preventable diseases.

There has been significant effort undertaken by communicable disease experts

in Australia to provide ACM management with guidelines on what standards

need to be implemented for vaccine preventable diseases. This effort has

resulted in the development of a document entitled Guidelines for the

public health management of communicable diseases in Australian detention

environments by the Communicable Diseases Network Australia to outline

expected standards. Whilst there is not absolute agreement on what is

necessary for each State/Territory, there has been broad acceptance that

this should form a standard for people in immigration detention.

The story of immunisation

highlights the inherent difficulties of meeting appropriate standards

for health care for children in immigration detention in something as

straightforward as the application of the Australian immunisation schedule.

It is of concern because it tends to highlight the level of understanding

about Australian health care standards within immigration detention, the

inability to establish appropriate systems of care and poses concern about

standards where care is more complex given the likely health profile of

this population.

Health service providers

who have provided health care to refugees in South Australia following

their release into the community have noted that children's behavioural

and emotional issues tend to come to the fore sometime after release.

Physical health issues tend to be the main focus for immediate attention

post-release by parents and health workers. There have been over 160 new

contacts with children released from immigration detention centres for

Child and Youth Health. The health worker reports that there are often

significant physical health issues that appear to be undiagnosed or formal

communication not provided on these conditions, if previously diagnosed

in detention. Conditions such as poliomyelitis, haemiplegia, ricketts,

blood and infectious disorders have been diagnosed in children following

their release into the community. The health workers indicated that many

of these children would have benefited from earlier interventions or the

communication of medical information if such interventions had been in

place. They have also indicated that there are a few instances where babies

and children have not had a full medical assessment including one 6 month

old baby born in transit.

Nutritional issues

for babies and toddlers remains an area of significant concern in immigration

detention centres. Health workers have reported in the past that they

have seen 24 month and 18 month toddlers being breastfed totally due to

the lack of provision of appropriate foods for this age group.

One of the significant

issues raised is the extent to which babies and toddlers receive the stimulation

required to promote their social, emotional, physical and intellectual

development in immigration detention centres. The provisions made for

promoting enriching environments for children in detention through access

to toys, formal child care and play groups need further investigation.

The availability of such programs, particularly for parents who may have

either physical or mental health conditions that compromise their capacity

to care or poor parenting knowledge and skills, needs consideration.

Concerns about parenting

knowledge and skills have arisen in the past. These concerns have been

noted in two reviews undertaken by Parliamentary Committees on detention

centre facilities and conditions. Discussions have been held on the provision

of parenting advice and information for residents between the Department

of Human Services Family and Youth Services and the Woomera Immigration

Reception and Processing Centre management in response to these concerns.

The Migrant Health Service has conducted a program for parents about understanding

the behaviour of their children in the community because many parents

fail to understand that many of the emotional and behavioural problems

are due to trauma, not naughtiness or wilfulness.

One of the points

that needs greater emphasis regarding health care in immigration detention

is the right to independent health and medical treatment whilst in detention.

International standards have been developed that highlight the requirements

for independent health care within detention environments (primarily correctional

services) and for confidentiality of health records. The extent to which

detention is distinguished from imprisonment is unclear. However, clarification

of this distinction is required because it provides a further basis for

determining rights to health care and the manner in which this health

care should be provided with regard to issues such s confidentiality of

records.

Dental care

The standard that

applies to South Australian children is the provision of access to routine

free screening and treatment for primary school-aged children through

a booked system of dental care through the South Australian Dental Service.

Parents may or may not take the offer up of screening and care with some

opting to see private dental care providers. Young people attending secondary

schooling may continue to be a part of this system of dental care through

payment of a small co-payment.

Mental health

The following information

provides a general context to the mental health issues that may be experienced

by refugees and asylum seekers. Discussions have been held with individual

workers who have provided services to refugee children to see if there

are significant manifestations of mental health issues among this population

group on their release into the community. It is not possible to ascertain

with any degree of certainty whether detention has resulted in or exacerbated

a pre-existing mental health issue without baseline health assessments

on entry and on exit from immigration detention. Some behavioural problems

do emerge as a result of settling in a new community and culture. These

behavioural problems may possibly reflect a mental health issue. They

may also be indicative of inadequate information and understanding of

the different cultural context in Australia.

The Psychiatry Research

and Teaching Unit of the School of Psychiatry at the University of New

South Wales produced a report in 1998 on the mental health and well being

of on-shore asylum seekers. This report stated that mental health, legal

and welfare workers had witnessed high levels of despair amongst asylum

seekers. Additionally, it reported that post migration stresses appeared

to exacerbate disturbances in those who had suffered trauma in their homelands.

Depression was common and attributed to fear of repatriation, stresses

of stringent refugee determination procedures, worry for family left behind

and difficulties in accessing basic services such as specialist medical

care and other social services.

The same authors

reported in a survey by the Asylum Seekers Centre in Sydney (1994) that

among asylum seekers:

  • 80% reported

    exposure to serious trauma in their homeland;

  • 50% lived with

    constant fear - of being sent home, of being unable to go home in an

    emergency, of inadvertently violating visa conditions, of police, of

    government departments and 'official organisations' and as a result

    of not being able to work;

  • 30% reported stress

    due to delays, worry about family at home, medical and dental treatment,

    separation from loved ones;

  • 10% reported concern

    about their continued well being as a result of communication difficulties,

    loneliness, boredom, poverty, isolation, bad jobs and interviews with

    DIMIA officials.

Furthermore, asylum

seekers asked to rate their state of mental health responded with the

following:

  • over 50%: severe

    distress;

  • 33%: depressed;
  • 23%: anxious;
  • 38%: suffering

    a post traumatic stress disorder; and

  • 20%: chronic physical

    problems (often a result of depression and poor mental health).

The report also states

that all asylum seekers and refugees should be regarded as a high risk

group for persisting mental health problems. Moreover, that detained asylum

seekers showed extremely high rates of mental illness and that some evidence

exists that detention itself may be a powerful contributor to ongoing

psychological disorders. This pattern has also been observed by South

Australian Migrant Health Service health workers. They recently reported

that people released from immigration detention after a short stay were

generally brighter in their outlook and showed less evidence of somatisation

than people who had been detained for long periods.

A Mental Health Review

conducted by NSW Health reported the following regarding people from a

refugee background:

  • depression, once

    crisis period of initial settlement is over, is common;

  • children and adolescents

    felt severely dislocated from the rest of their family;

  • children and adolescents

    experienced significant stress as a result of seeing their parents unable

    to cope with settlement issues and cultural adjustment and

  • a higher rate

    of suicide among older refugees than in the general population.

Moreover, refugee

populations were over-represented among crisis presentations, admissions

to hospital as involuntary patients and among those placed on temporary

orders and community orders. In conclusion the review stated that prevention

and early intervention in the case of mental illness for this population

was far more cost effective than crisis management.

The Department of

Immigration and Multicultural and Indigenous Affairs' Refugee Resettlement

Advisory Council reported that successful settlement (and subsequent mental

health and well being) was dependent on a number of things including:

  • level of English

    language ability (English language instruction is denied to TPV holders);

  • ability to obtain

    some form of stable income;

  • the establishment

    of a stable home/household;

  • access to health,

    education and other community services;

  • a secure understanding

    of their rights and responsibilities as Australian residents (information

    not provided to TPV holders in any formal fashion); and

  • the ability to

    establish social networks that allow them to become fully participating

    members of the community.

All existing literature

and studies on refugees and mental health point to the importance of the

use of staff trained in refugee issues. Synergy, the newsletter of the

Australian Transcultural Mental Health Network, reported in its Spring

1999 issue the following topic requests for specific training from clinicians

in Melbourne's eastern suburbs:

  • beliefs about

    causation and treatment of mental illness across cultures (78.3%);

  • cultural issues

    in working with families (75.1%);

  • cultural issues

    in clinical assessment and mental state examination (70.5%);

  • information about

    ethnic agencies (65.9%);

  • cultural issues

    in acute/crisis management (64.5%);

  • culturally sensitive

    history-taking and case formulation (61.8) and

  • approaches to

    understanding how cultural values differ (61.8%).

These training requests

came from clinicians whose practice was largely comprised of refugee patients.

A similar survey in South Australia would likely find far lower representation

of clinicians with significant experience of dealing with refugee clients.

There is a great

deal of anecdotal evidence emerging regarding the mental health issues

of refugees, asylum seekers and Temporary Protection Visa holders in South

Australia. Minutes of meetings and discussions with Migrant Health Service,

STTARS, the South Australian Housing Trust Inner Adelaide Office and community

volunteers indicate the following:

  • almost all TPV

    holders require attention for mental health issues, which, if left untreated

    or unattended, are resulting in somataform disorders;

  • psychologist services

    and STTARS counsellors are presently unable to respond to the level

    of need among TPV holders, resulting in mental health crisis response

    services being approached for assistance outside their brief;

  • many mental health

    issues among TPV holders and former refugees in general respond well

    to community based activities such as support groups, discussion groups

    and activity groups that provide routine and order as well as a release

    from tedium, loneliness and worry;

  • at least 4 TPV

    holders have presented with severe mental health issues, that have not

    required immediate hospitalisation but have required police intervention

    and the need for community supported housing options. One TPV holder

    has presented with severe schizophrenia undiagnosed in detention;

  • depression and

    anger following the elation of release from detention is increasing

    and people are reporting feelings of hopelessness and dislocation as

    a result of family separation more frequently;

  • inability to cope

    with culture shock and feelings of helplessness are reported;

  • anger management

    problems are becoming increasingly apparent among TPV holders;

  • sleep disorders

    and people expressing a lack of care about what happens to them are

    being increasingly reported; and that

  • the number of

    late night calls to community volunteers from people in mental distress

    are increasing.

Some representatives

of the groups mentioned above have expressed grave fears of an epidemic

of mental health issues unless some intervention and preventative programs

and processes are put in place and that the findings of studies highlighted

above are representative of refugee mental health in South Australia.

Potential mental

health issues arising as a result of detention for children

This section includes anecdotal information obtained from health workers

working with refugee children and their families and reflects their observations

as well as issues in relation to refugee children's rights in detention

centres. It may not reflect recent changes that may have occurred in detention

centre practices for children.

Children will experience

detention differently from adults. Their age, responsibilities and previous

experiences are likely to affect their mental health status. Many children

have experienced significant trauma, many have been raised in refugee

camps and experienced extreme hardship in travelling to Australia. Many

feel powerless and dependent on decisions of their parents, other people

or authorities. Placement in a detention centre may serve to further compound

feelings of powerlessness.

Children are less

likely to have things explained to them in ways that they can understand.

Very young children are likely to be most disadvantaged in this way. Children's

capacity to understand the reasons for detention and to exercise their

rights as refugees and special rights as children and particularly as

unaccompanied minors will depend on their level of maturity. It will also

depend on the extent to which this is facilitated by agencies such as

DIMIA and the detention provider.

The extent of level

and type of information and involvement of children on residential committees

and so on has not been made clear in any of the reports that have been

published to date in Australia ie Not the Hilton, the Joint Standing

Committee on Foreign Affairs, Defence and Trade Completed Inquiry:

Visits to immigration detention centres and the Flood Report.

Indeed one of the issues that arises form the draft document A world

fit for children being developed by the Preparatory Committee for

the Special Sessions of the General Assembly on Children is that children

should be a primary focus and be given the best possible support and care

to achieve physical, mental and emotional health and social competence.

One particular requirement for refugee children is building and strengthening

their abilities to protect themselves. Systems that have been designed

with adults in mind may tend to exclude children and not provide sufficient

emphasis on their rights of participation or social and developmental

needs.

One of the major

signs of emotional distress for children is bed-wetting and there is anecdotal

evidence indicating that this condition is prevalent among children post-release.

Other behavioural patterns indicating behavioural or emotional disturbance

that have been noted by health workers include: aggression, withdrawal,

poor or disturbed sleeping patterns. Often these children are accompanied

by one parent but remain separated from their other parent. Health workers

report that many of these children and young people have profound feelings

of loss and grief involving separation from parents, family, friends,

the communities they know and having to negotiate unknown communities

and environments. These children and young people are experiencing grief

and loss, dealing with the fact that they may not see their parents or

family again compounded by having to adjust to a new culture and society.

Clearly these children are highly at risk and have need of preventative

care and support in terms of their emotional well being.

Child and Youth Health

Service is currently undertaking a 12 month evaluation of the service

it has provided from the Migrant Health Service location and in asking

clients how they rated the importance of having their child access health

services. The attached Child and Youth Health submission discusses this

evaluation. On the first contact, clients are initially anxious and wary

but they want to know whether their child is healthy. They are often very

pleased and happy to see the service provider on the second and subsequent

contacts. One father emphasised the importance of providing health care

services for children comparing this care to the intensive care needed

for very young trees so that they grow strong, tall and straight.

The defining of the

mental health status for all people is the result of a dynamic and interactive

process involving social, environmental and life circumstances, as well

as biological factors. For children detained or in institutions, there

are significantly higher levels of stress and anxiety in their lives resulting

from the consequences of trauma and grief, which are inextricably linked

to mental health and disorder.

Evidence regarding

the impact of institution care/custodial care on children notes the forced

incarceration of children is considered to have a significant and detrimental

impact upon the child's psycho-emotional wellbeing and to limit the potential

for that child to develop appropriate interpersonal skills and adult capabilities.

In the interest of

promoting mental health and ensuring access to quality mental health services

children should be accommodated within their family and cultural context,

in as normalised social environment as practicable with access to peers,

age appropriate schooling and recreational services.

Unaccompanied adolescents

could more cost effectively be accommodated in community, group and/or

foster homes with consideration for culturally relevant mentoring and

support.

In relation to the

current situation at Woomera, overall mental health services are reported

by services providers as "compromised" in relation to:

  • Access to mental

    health services;

  • Coordination of

    health care;

  • Lack of appropriate

    screening and early detection of mental health needs; and

  • Detention release

    and resettlement needs.

The Department of

Human Services has no evidence that the mental health and development

needs of child asylum seekers in detention is being assessed appropriately.

There is no clear evidence for or against this from the perspective of

the information that is available for asylum seekers once released from

detention once their health care needs have been assessed by health service

providers in the community. For example, there are no copies of medical

records provided to clients so that this information can be provided by

them to community based health service providers to inform their decision-making

about treatment when seeing the person post-detention.

It is also of the

view that these assessments, to be carried appropriately, require specialist

health personnel:

  • who form part

    of State community based mental health care systems rather than health

    personnel who are employed directly by ACM; and

  • who are experienced

    in child mental health as well as in working with children from different

    cultural backgrounds, particularly those who have been asylum seekers,

    to assess mental health in the context of their family and determine

    appropriate treatment.

Recommendations

Continued long term

detention of young children and their families is unjustifiable on developmental,

medical and mental health grounds. Provision must be made immediately

for child asylum seekers and their parents to be housed in the community

and not held in detention centres. Immigration detention is directly and

indirectly traumatizing for infants, children and their families. The

impact of living in this environment compounds existing problems experienced

by parents already compromised by past trauma, loss and continuing uncertainty

about their future. Mental health interventions and services will be ineffectual

in this context of ongoing trauma.

Children and their

parents must have access to the full range of health services available

in the community including adult and child and adolescent mental health,

early childhood and disability services and bicultural workers. These

are most likely to be available in urban or large regional centres.

Pregnant refugee

women must have access to high quality antenatal care which ensures they

are fully informed and consent to the type of child birth options available

to them. All efforts must be made to prevent prolonged separations from

pregnant mothers who have other young children. After delivery mothers

must have access to perinatal mental health services and mother-infant

services.

That State health

authorities be contracted by DIMIA to provide primary and other health

services that are consistent with standards prevailing in the wider community

as well as meet the specific needs of asylum seekers ensuring comprehensive,

systematic, holistic service delivery, continuity of care and State and

Commonwealth obligations for refugees and the wider community are appropriately

met in line with international Human Rights Conventions and protocols.

Mental health services

provided to this population should include the following components:

  • Initially consist

    of a screening and information provision process identifying persons

    at risk and the process for them to access services;

  • Be provided in

    a normalised social context with transparent access to mainstream social

    services, accommodation and education resources;

  • Focus on primary

    care provided through a collaborative model involving key service providers

    working with refugee and migrants to ensure adequate screening, early

    detection and primary health care continues to be provided to this population

    both in situ, during and following re-settlement . Key examples of service

    agencies in South Australia include Survivors of Torture and Trauma

    Assistance and Rehabilitation Services (STTARS), the Migrant Health

    Service counselling and support services with the Divisions of General

    Practice;

  • Follow on as required

    to further assessment and treatment of identified mental health needs

    provided from existing public mental health services (CAMHS) augmented

    by a culturally appropriate mental health resources.

In extreme and unusual

circumstances of the Commonwealth placing children in detention they should

be provided with:

  • On admission screening

    and assessment and information ensuring persons at risk are identified

    and they are aware of the process for them to access services;

  • Engagement with

    and liaison between detention centre based mental health staff, the

    child and their care-givers, community based mental health staff and

    general practitioners to ensure continuity of care on release from detention.

Community services

should consist of coordinated cross-agency services with a focus on the

mental health needs of minors provided by mainstream health services and

in particular:

  • Mental health

    screening and early detection process;

  • Culturally relevant

    primary health care;

  • Management of

    re-settlement issues for children including close examination of the

    consequences of the journey experience and detention including type

    and degree of services demands over:

    • Short term

      (0-1yr);

    • Medium term

      (1-5yrs); and

    • Long term

      (5+yrs).

Further consideration

of alternative options for care including:

  • Community placement;
  • Identification

    of priorities for initial assistance;

  • Long term re-settlement

    assistance needs;

  • The impact of

    the unresolved citizenship status on individuals and families and particularly

    children of TPV holders born in Australia.

 

 


6. Children with disabilities

in detention

Legislative Framework

UN Standard

Rules

Australia is a signatory to the United Nations Standard Rules on the

Equalisation of Opportunities for Persons with Disabilities and as

such agrees to uphold the 22 rules stipulated within that annex. As a

signatory, Australia is also required to report regularly on how it is

meeting these Standard Rules. The Standard Rules make no distinction between

children with disabilities living in community settings or those in detention.

The following rules

within that agreement are relevant to the issue of children with disabilities

who are detained against their will in detention centres with people of

all ages:

Rule 1. Awareness

raising

'States should take action to raise awareness in society about persons

with disabilities, their rights, their needs, their potential and their

contribution.'

Rule 2. Medical

Care

'States should ensure the provision of effective medical care to persons

with disabilities.'

Rule 3. Rehabilitation

'States should ensure the provision of rehabilitation services to persons

with disabilities in order for them to reach their optimum level of independence

and functioning.'

Rule 4. Support

services

'States should ensure the development and supply of support services,

including assistive devices for persons with disabilities, to assist them

to increase their level of independence in their daily living and to exercise

their rights.'

Rule 5. Accessibility

'States should recognise the overall importance of accessibility in the

process of equalisation of opportunities in all spheres of society. For

persons with disabilities of any kind, States should (a) introduce programmes

of action to make the physical environment accessible; and (b) undertake

measures to provide access to information and communication.'

Section 3 of the

Commonwealth Disability Services Act (1986) highlights the three objects

of this Act ie

(1) The objects of this Act are:

(a) to replace

provisions of the Handicapped Persons Assistance Act 1974, and

of Part VIII of the Social Security Act 1947, with provisions

that are more flexible and more responsive to the needs and aspirations

of persons with disabilities;

(b) to assist persons

with disabilities to receive services necessary to enable them to work

towards full participation as members of the community;

(c) to promote

services provided to persons with disabilities that:

(i) assist persons

with disabilities to integrate in the community, and complement services

available generally to persons in the community;

(ii) assist persons with disabilities to achieve positive outcomes,

such as increased independence, employment opportunities and integration

in the community; and

(iii) are provided in ways that promote in the community a positive

image of persons with disabilities and enhance their self-esteem;

(e) to encourage

innovation in the provision of services for persons with disabilities;

and

(f) to assist in

achieving positive outcomes, such as increased independence, employment

opportunities and integration in the community, for persons with disabilities

who are of working age by the provision of comprehensive rehabilitation

services.

Section 6 of the

Act extends application of the Act to the Territory of Cocos (Keeling)

Islands and to the Territory of Christmas Island.

These objects form

the basis on which standards relating to people with disabilities should

apply irrespective of their status within Australia including immigration

detention centres.

Given the numbers

of people within detention centres, there is a high likelihood that there

would be significant numbers of people with disability with resultant

disability access and support needs. Twenty-two per cent or 330,000 people

within the general South Australian population has a disability. Of those,

approximately 97,000 people have a severe or profound disability. (The

ABS defines severe and profound as having a core activity restriction

in one or more daily living skills).

If these same percentages

of the population are applied within detention centres, a significant

number can be projected especially when past experiences of war and trauma

associated with their travels to seek refuge are factored in for this

group.

The National Ethnic

Disability Alliance (NEDA) has written to the Department of Immigration

and Multicultural and Indigenous Affairs (DIMIA) to obtain confirmation

of prevalence of children with disabilities and found the following:

  • As of the 1st

    February 2002, there was a total of 378 children residing in detention

    centres;

  • As of the 5th

    February 2002 there was a total of 16 children (or 4.2%) with a disability

    residing in detention centres (Port Hedland and Woomera); and

  • The types of disability

    included: cerebral palsy, hearing impairment, vision impairment, acute

    dwarfism, trauma, Perthes disease, cardiac, asthmatic and genetic disabilities.

The DIMIA has advised

NEDA that all necessary steps are taken to ensure that the needs of these

children are met.

NEDA has expressed

its complete opposition to any child with a disability (who will more

than likely come from a NESB) being detained in detention centres.

The standards and

processes of determining application of standards that are expected to

be applied in the general community should apply in immigration detention

centres. Therefore the following actions that would need to be undertaken

to ensure compliance with community standards:

  • an access audit

    of all accommodation within the detention centres should occur to determine

    whether they comply with AS 1428 Parts 1 and 2;

  • a disability access

    audit within the population to determine what care support is required

    to enable persons with disabilities to remain there with appropriate

    levels of support;

  • an audit of equipment

    needs should take place to determine the full range of disability needs

    ie wheelchair appliances, shower chairs, transfer boards, crutches and

    sticks, hearing aid devices, visual aids and appliances.

Recommendation

That HREOC investigate

whether the following audits have been undertaken in immigration detention

centres in line with community standards:

  • an access audit

    of all accommodation within the detention centres should occur to determine

    whether they comply with AS 1428 Parts 1 and 2;

  • a disability access

    audit within the population to determine what care support is required

    to enable persons with disabilities to remain there with appropriate

    levels of support;

  • an audit of equipment

    needs should take place to determine the full range of disability needs

    ie wheelchair appliances, shower chairs, transfer boards, crutches and

    sticks, hearing aid devices, visual aids and appliances.


7. Child Protection arrangements

between State child welfare agencies and the Department of Immigration

and Multicultural and Indigenous Affairs (DIMIA)

The Memorandum of

Understanding developed between South Australia and DIMIA acknowledges

the State's statutory responsibility to investigate and resolve allegations

of child abuse and neglect in Commonwealth detention centres and refugee

camps. This MOU enables appropriate access to detention centres to conduct

necessary investigations and care proceedings.

Detention of children

in immigration detention centres exposes children to risks of child abuse

and neglect due to the nature of these environments and the extreme emotional

and psychological states of people held within them. Under the UN Convention

on the Rights of the Child, the special vulnerability of children,

the requirement for special measures of protection as well for ensuring

the best interests of the child are a primary consideration require clarification

for children within immigration detention. The Convention stipulates that

children should not be separated from their parents (Article 9.1) and

should only be held in detention as a measure of last resort and for the

shortest appropriate period of time (Article 37 (b)). These articles pose

a dilemma in the treatment of children in terms of the application of

rights, and more so, if accompanied by parents. This dilemma has been

particularly acute where refugee status has not been granted to the family

and where a child is deemed at risk.

The Department of

Human Services has established a Memorandum of Understanding on Child

Protection and Child Welfare in Immigration Detention. This particular

Memorandum serves to ensure child protection authorities can arrange to

undertake assessments of children where child abuse allegations have been

made. When a notification is received, arrangements are made with DIMIA

and ACM to undertake investigations at Woomera IRPC. The capacity to make

child protection orders that seek the removal of children who have not

been granted refugee status has been limited given the overriding primacy

of the Migration Act. Recommendations on child protection matters

are made within the constraints of the Commonwealth Migration Act

and are forwarded to DIMIA for response.

Mandatory notification

under Section 11 of the South Australian Children's Protection Act,

1993 is deemed to apply at Woomera Immigration Reception and Processing

Centre (WIRPC).

State/Territory child

protection authorities have the power to investigate notifications received

regarding child protection concerns for children/young people detained.

However, if such investigations result in a determination that child abuse

has in fact occurred, child protection authorities cannot necessarily

exercise any powers to protect the child from further harm that are inconsistent

with the Commonwealth legislation, in particular, The Migration Act,

which provides for the mandatory detention of unlawful non-citizens.

Therefore, while

the State may have some authority to investigate matters relating to child

welfare, the steps that can be taken by the State, or the State Courts,

to protect the child are severely limited due to the operation of the

Migration Act. In particular, State child protection authorities

cannot exercise any powers that are inconsistent with the Commonwealth

legislation.

The following specific

powers under the South Australian Children's Protection Act, which

might be applied to ensure the safe resolution of child protection issues,

are directly inconsistent with the detention requirements of the Migration

Act and therefore cannot be applied:

  • The power of the

    Minister to enter into a voluntary custody agreement with the guardians

    of the child;

  • The power to remove

    a child from a place pursuant to Section 16 or 17;

  • The authority

    of the Youth Court to grant custody of a child to the Minister pursuant

    to section 21 (1) (c) and 23 (3) (a);

  • The authority

    of the Youth Court to direct a person who resides with a child to cease

    or refrain from residing in the same premises as the child subject to

    Section 21 (1) (d);

  • The ability of

    an employee of the Department to take a child to such persons or places

    as the Chief Executive Officer may authorise pursuant to Section 26

    (1);

  • Orders of the

    Youth Court may make granting Custody or Guardianship of the child to

    the Minister on a long term basis and associated ancillary orders, under

    Part 4 Division 4 and Part 5 Division 2.

However in relation

to the first power noted above, under the Migration Act and the Immigration

(Guardianship of Children) Act 1946, there is a capacity for the Federal

Minister of Immigration to enter into a voluntary custody arrangement

with the parents or guardians of the child. The Federal Minister then

may delegate custody to the State Minister on the limited basis as determined

by these Acts. So, whilst there is a legal capacity to delegate the first

power above, the relationship between State and Commonwealth laws leads

to a requirement for complex, unwieldy arrangements for both DIMIA and

the States' and Territories' child protection authorities to establish

the appropriate arrangements for guardianship of child detainees as well

as for child protection. Whilst children's protection legislation may

differ to some extent across States and Territories, it is likely that

similar limitations will apply to their respective legislation in relation

to the operation of the Migration Act.

Early in 2002, the

State's capacity to take into care, unattached minors deemed to be at

extreme vulnerability and risk because they were not protected by family

during the period of disturbances at Woomera, was enabled through specific

arrangements for these children to be place in community home-based places

of detention. The basis under which these arrangements were agreed was

through the enactment of Section 5 of the Migration Act 1958 under

which the Commonwealth Minister can approve certain locations as places

of detention. These places include the places where the detainee minor

resides (home) and/or spends significant period of time eg school. In

addition to approving certain locations, specified individuals are also

named as 'directed individuals' (by the Secretary of DIMIA under the Migration

Act). These persons are required to ensure immigration detention is

maintained by detaining the minor on behalf of an officer under the Migration

Act. In meeting this aspect of the legislation, the DHS has had to

name DHS staff, carers and school principals as 'directed individuals'

to fulfil these legal obligations. The new Memorandum of Understanding

between DIMIA and the DHS for the care of some detainees currently

under negotiation includes within its scope, the capacity to place both

unattached and attached minors in community-based detention arrangements.

In South Australia,

steps were taken to provide an improved capacity to respond to child protection

notifications. Agreement was reached that the South Australian child protection

authority would work in collaboration with DIMIA regarding investigations

through the MOU finalised in 2001. Any further interventions undertaken

in relation to each child protection matter will be the responsibility

of DIMIA. In practice, this means that the SA child protection authority

will investigate child protection allegations and advise DIMIA of the

outcome of these investigations. The SA child protection authority will

provide recommendations regarding the management of child protection issues

to DIMIA for their consideration. Liaison with DIMIA will ensure that

appropriate steps are taken to reduce the risks to which children/young

people in detention may be exposed.

Staff employed at

detention centres are required to sign a contract of employment that includes

a confidentiality clause. Prior to the drafting of the South Australian

MOU with DIMIA, there was some tension in determining whether staff employed

understood their obligations to make notifications under State law. Mandated

notifier training is now provided to all staff at the detention centre

and this has provided greater clarity about roles and responsibilities

in relation to child protection notification.

Whilst the MOU constitutes

an advancement, there are a number of issues that cannot be properly resolved

within this form of agreement. For example, closure of child protection

cases may be difficult to achieve. The South Australian draft MOU with

DIMIA provides for DIMIA making information available about the last known

address of the family where there has been a child protection notification

made. However, it is envisaged that it will be difficult to follow up

cases once children are released into the community with their parent

or guardian and where people move on to other States/Territories.

Investigation of

a child protection notification has particular significance for individuals

and families residing within the detention centres. For example, disclosure

is more difficult given that one of the consequences may be the immediate

return to country of origin. Children are also reluctant to disclose and

are aware that their vulnerability and risk is likely to increase in an

environment where their safety has already been compromised. Children

do not necessarily trust interviewers and have been known to retract allegations.

Interviews with any detainee in detention centres had in the past required

the presence of a detention centre officer. The MOU stipulates that all

interviews with children will be conducted in the presence of counselling

staff and not detention personnel. Even this measure does not necessarily

ensure an environment for safe disclosure.

The issue of child

protection has been an ongoing matter of some concern to the Department

and has required considerable resourcing in order to follow up all notifications

that have been made. The following data indicates the extent of concern.

Whilst this data pertains to the entire Woomera postcode region, the historic

pattern of reporting in this region indicates that the growth in reports

primarily can be accounted for by notifications from the Woomera Immigration

Reception and Processing Centre.

Since October 1999

to March 2002:

  • 163 notifications

    have been received. Of these notifications, 113 were regarded as child

    protection matters and 50 were regarded as notifier concern (See Appendix

    4, Table 1 and Chart 1). Notifications since October 1999 have risen

    steadily with the greatest incidence in increase occurring from November

    2001 with a further surge in increase in reports occurring in January

    2002 and March 2002. The rates of reporting were fairly even for the

    months of November 2001, December 2001 and February 2002. Notifications

    have clearly escalated during periods of unrest;

 

  • The gender breakdown

    was 103 males and 60 females (See Appendix 4, Table 1 and Chart 2);

 

  • Age breakdown

    was as follows:

Table

1: Number of notifications for each age group (April 2001-March 2002)

Age
Number
00-01
11
02-04
33
05-09

38
10-14
52
15-17
28
Other
1
TOTAL
163
  • Woomera has a

    higher notification rate but lower substantiation rate compared with

    the rest of the State for the period April 2001 to March 2002 (see Appendix

    4, Charts 7(a) and 7(b) and 8(a) and 8(b));

  • Notifications

    made by source of notification were as follows:

Table

2: Source of notifications x number of children notified (April 2001-March

2002)

Source

of notification

Number
Child
0
Parent/guardian
0
Other

- relative

0
Friend/neighbour
3
Doctor
8
Hospital

CPS

0
Other

medical

8
School
0
Family

Daycare

0
Other

social/health/welfare

9
Police
3
FAYS

worker

6
Anonymous
1
Others
105
TOTAL
143
  • The number of

    notifications made per individual child were as follows:

Table

3: Number of notifications per child (April 2001-March 2002)

Number

of notifications

Number

of children

1
70
2
26
3
4
5
1
7
1
Total

notifications - 146

Total

number of children - 102

Appendix 4 provides

data breakdowns for child protection notifications in the Woomera postcode

area.

However, further

analysis is required of child protection notifications and investigations

to draw any specific conclusions about issues around child protection

for child asylum seekers given the way that such investigations are required

to be carried out. Nevertheless, the notification rates indicate that

there is a high and continuing concern for children in immigration detention

within South Australia.

Recommendations

That

consideration be given to the development of national legislation that

puts mechanisms in place that ensure the rights of all children, including

child asylum seekers, within Australia in accordance with the UN Convention

on the Rights of the Child and other relevant international covenants

and that also promote nationally consistent approaches to child protection

at both Commonwealth and State and Territory levels.


8. Issues regarding standards

of care for children in immigration detention

There is a growing

body of policy that is providing clearer direction on the interpretation

that should apply in national laws, regulations and international standards

concerning immigration detention centre conditions for refugees who are

minors.

The underlying objective

of the international law relating to children is recognition of their

special vulnerability and their susceptibility to permanent damage as

a result of childhood events.

DIMIA has responsibility

for the WIRPC, but the day to day operations of the WIRPC is contracted

to ACM. DIMIA has a duty of care to all those in custody. DIMIA has a

set of Immigration Detention Standards that are referred to under the

contract between the DIMIA and the detention service provider ACM. This

contractual agreement specifies broad requirements in relation to the

needs of children in detention.

One of the major

issues of concern is the standards of care that should apply to the detention

of children vis a vis that which may apply to adults.

Children who are

refugees are in need of special attention. Displacement has a profound

emotional, physical, and developmental impact on all refugees but children

are particularly affected and this increases their vulnerability. Those

children who are separated from parents and family are even more vulnerable

to these effects. Article 25 of the Universal Declaration of Human

Rights recognises that children are entitled to special care and assistance,

and that all children have the right to social protection.

Immigration detention

centres are required to be places of safety, offering protection and assistance

for children. Immigration detention centres should be particularly cognisant

of the cultural and social relationships within and between groups and

offer services that ensure the protection and safety of children.

The Immigration

Detention Centre Guidelines developed by the Human Rights and Equal

Opportunity Commission (HREOC) in March 2000 establish principles and

benchmarks that draw on relevant international minimum standards which

detail what is required for humane detention consistent with respect for

human dignity as required by the International Covenant on Civil and

Political Rights and the International Covenant on the Rights of

the Child. The minimum guidelines use the framework provided by the

international covenant applying in the juvenile justice area.

Under these guidelines,

there are specifications regarding the care of children. One of these

provisions is that all personnel should receive as part of their training,

instruction on their responsibilities towards civilians and particularly

towards children. These standards provide greater clarity about the special

needs of children in comparison with the current Immigration Detention

Standards that apply between DIMIA and the service provider. The extent

to which these standards have been applied in practice should be considered

by HREOC.

The development of

these standards raises the issue of the status of such documents and the

difficulty of making them standards when they require enactment by other

parties such as DIMIA. There is therefore a need to develop appropriate

enabling mechanisms that ensure the rights of the child, particularly

asylum seeking children, can be upheld appropriately at a national level

and that also ensure independence, fairness and public accountability.

The interpretation

of the Convention on the Rights of the Child and other relevant

conventions and protocols cannot be applied appropriately within the context

of the primacy of the Migration Act within Australian law. There is a

need to develop appropriate mechanisms that promote the application of

CROC in a way that conforms with its intent to give due recognition to

the rights of the child and guide community standards and practice. To

date, the CROC has been speciously applied within immigration detention

and the capacity to apply it effectively and appropriately will continue

to flounder whilst it remains outside Australian law. This is of fundamental

concern because it poses a continuing dilemma for the interpretation of

appropriate care and protection of child asylum seekers resulting in little

or no jurisdictional basis on which to assert the rights of these children.

The Commonwealth

owes a duty of care to those in its custody. In addition, the Commonwealth

has ratified international treaties relating to the rights and treatment

of children and in particular, children who are refugees. The Commonwealth

also funds health services and establishes broad standards of health care

in the community and in acute care services. However, standards of care

applying within Australia are also stated in State health services and

articulated by the medical colleges, by professional medical organisations

and allied health associations. All these standards need to be applied

in combination and require significant understanding of the Australian

health care system and the different levels of standards that apply. The

Statement of Service Requirements Care Needs: Health Care for ACM

does not sufficiently recognise this situation. In particular, the Statement

of Service does not highlight the extent of clinical governance required.

Ensuring that there

are proper governance arrangements in place for managing, monitoring and

improving health care and ensuring clear accountability and responsibility

for the overall clinical care provided within an organisation is an issue

for the provision of services within detention environments. The performance

measures do not require essential primary health care standards to be

met but focus primarily on complaints or incidents The absence of positive

reporting based on standards for service delivery especially for those

services that should apply to children and their families as basics ie

hearing, eye, assessments of physical health status, psychological health,

dental health and immunisation indicates the residual nature of the health

and medical services that are provided compared with those available in

the wider community Many of the performance measures require substantiation

but it is unclear what the process of substantiation entails.

Particular professional

employment practices by ACM in immigration detention centres also militate

against the establishment of appropriate standards of care across all

fields of care relating to social, developmental and health outcomes.

The six-week rotation of staff may reduce capacity to meet standards that

broadly apply in relation to child social, developmental and health outcomes

in line with best service management and delivery practices, ie:

  • Availability and

    accessibility of quality services;

  • Continuity of

    care;

  • Confidentiality;

    and

  • Active involvement

    of and participation of children and their parents in their care and

    development.

Recommendations

That a national independent

authority be established for children to assess, monitor and report on

child asylum seekers' care and protection, service quality and standards,

including reporting standards and report on community concerns about the

application of such care and protection services.

That the Commonwealth

develop in collaboration with States and Territories, a national policy

and action plan for promoting national directions and integrated and collaborative

responses to the needs of refugee asylum seekers irrespective of their

refugee status with a particular focus on the needs of child asylum seekers.

That a cost-benefit

analysis that incorporates research and a review of the literature and

cost analysis be undertaken of the range of community-based options that

might exist as alternatives to detention with a focus on the benefits

that these alternatives may have for asylum seeking children and their

families.


9. Conclusion

The Department of

Human Services considers that detention has a significant impact on children

and their families, aggravating and compounding previous trauma with significant

potential for adverse social, developmental, physical and mental health

outcomes given current practices and standards of care arising primarily

from employment and service contracting practices by ACM. These practices

militate against standards that apply in the Australian community for

health and wellbeing and particularly those that exist to meet the specific

requirements arising from refugee new settler status.

The Department of

Human Services is of the view that there are community based alternatives

to detention that are more cost-effective and that can meet the administrative

detention requirements in the truer sense of the meaning of such detention.

The interpretation

of the Convention on the Rights of the Child and other relevant

conventions and protocols cannot be applied appropriately within the context

of the primacy of the Migration Act within Australian law. The need to

develop appropriate mechanisms that promote the application of CROC in

a way that conforms with its intent to give due recognition to the rights

of the child and guide community standards and practice is reiterated.

Until such mechanisms are established, the dilemmas involved in interpreting

appropriate care and protection of child asylum seekers will continue

as a result of the absence of little or no jurisdictional basis on which

to assert the rights of these children.


Appendix 1

Summary of DHS services to

new arrivals and refugees

This section provides

summary information on all DHS services provided to all new arrivals and

refugees and allows comparison of those services that are available to

the different categories of newcomers. This summary highlights measures

that have been undertaken by the DHS to attempt to deal with issues raised

by immigration detention and by the inequity in settlement support between

PPV and TPV holders:

Housing - Permanent Residents

  • Up to three months

    On Arrival Accommodation (furnished flat or house according to family

    size) for visa subclasses 126 and 135 who arrive as part of Immigration

    SA program.

  • Bond guarantee

    plus first two weeks' rent (or equivalent) in private rental accommodation

    to all humanitarian arrivals who require it.

  • Provision for

    short-term leases (up to six months) on SAHT properties for some families

    with special needs. At discretion of Manager, Inner Adelaide Office

    after detailed assessment and after recommendation by medical practitioners

    and/or social workers and negotiation with IHSS accommodation provider.

  • Participation

    of a staff member from the SAHT Inner Adelaide Office in the Case Coordinating

    Committee for New Arrivals convened by the Migrant Resource Centre as

    IHSS provider. Delegate is currently the Service Delivery Manager.

  • Automatic classification

    of refugees to the Category 2 waiting list by recommendation of the

    Case Coordinating Committee convened by the Migrant Resource Centre

    as IHSS provider.

  • Classification

    to Category 1 with referral letters from medical practitioners, police,

    social worker etc.

Temporary Residents (holders

of Temporary Protection Visas, subclass 785)

  • Up to 1 month

    On Arrival Accommodation for holders of Temporary Protection Visas (subclass

    785) who have children for child protection reasons or who are elderly/infirm

    and to allow a normalisation of family relationships.

  • 'Bulk' processing

    of holders of Temporary Protection Visas (subclass 785) upon release

    from immigration detention for payment of one week's rent at a backpackers'

    hostel. This is generally in lieu of the first week's rent in long term,

    private rental accommodation. This provision applies only to recipients

    of Special Benefit.

  • Short term leases

    (up to six months) in SAHT properties for families with special needs

    such as illness, disability, size of family etc. At discretion of Regional

    Manager, Inner Adelaide Office with advice from Service Delivery Manager

    and/or medical practitioners or social workers.

  • Bond guarantee

    equal to four week's rent when a holder of a Temporary Protection Visa

    secures longer-term accommodation.

  • Ability to register

    for public housing waiting lists.

  • Support of families

    with children who are released from immigration detention on Temporary

    Protection Visas (subclass 785). For reasons of child protection, families

    with children are not accommodated in backpackers' hostels with single

    adults. The Housing Adviser with responsibility for processing TPV applications

    at the SAHT Inner Adelaide Office arranges their first night's accommodation

    after release in a self contained motel unit, with transport to the

    South Australian Housing Trust Inner Adelaide Office the next morning

    where they are assigned furnished accommodation if necessary.

Health (the South Australian

public health system provides services to temporary and permanent residents

who are all eligible for Medicare coverage)

  • Access to health

    briefings at Migrant Health Service that explain the workings of the

    Australian health care system where new immigrants arrive in groups.

  • Screening and

    assessment at Migrant Health Service before supported devolvement to

    local services such as Community Health Centres and general practitioners.

  • Referral by Migrant

    Health Service to specialists, (including mental health), Community

    Health Centres and other State and Commonwealth health services for

    integrated primary health care.

  • Provision of bilingual

    Health Liaison Workers.

  • Provision of interpreters

    in all DHS facilities, including public hospitals for people with poor

    English proficiency.

Community services - Permanent

Residents

  • Supervision of

    unattached Humanitarian Minors as per the Memorandum of Understanding

    with the Commonwealth.

  • Financial assistance.
  • Financial counselling.
  • Child Protection.
  • Issuing of Transport

    Concession Cards where applicant is a holder of a Health Care Card and

    recipient of Centrelink benefits.

  • Concessions on

    utilities (electricity) bill where applicant is a holder of a Health

    Care Card and recipient of Centrelink benefits.

  • All new arrivals

    have access to the Crisis Response and Child Abuse Service (CRACAS)

    on a needs basis.

Temporary Residents (holders

of Temporary Protection Visas, subclass 785)

  • Supervision of

    unattached Humanitarian Minors as per the Memorandum of Understanding

    with the Commonwealth.

  • Financial assistance.

    For holders of Temporary Protection Visas (subclass 785) this can come

    from a special fund from Treasury set aside to assist TPV holders. This

    money is essentially designed to reduce the strain on non-government

    organisations in providing household formation support and is generally

    limited to $200 per person.

  • Financial counselling,

    including budgeting advice, debt consolidation advice and shopping advice.

  • Child Protection

    (including investigations of child abuse in Woomera Immigration Reception

    and Processing Centre).

  • Crisis Response

    and Child Abuse Service response to reports.

  • Reimbursement

    of volunteers who assist in the early orientation and settlement of

    TPV Holders for out-of-pocket expenses.

  • Issue of basic

    bedding packages to holders of TPVs at their request, with the cost

    deducted from any future claims for special financial assistance packages

    paid through FAYS offices.

 

 

 

 

DHS/FAYS unaccompanied humanitarian

minors and community detention program

Services and functions profile

The following services

and functions outline the responsibilities of FAYS in responding the care

and protection needs of children placed in the care of the Department

by DIMIA.

Alternative

Care Program

  • Recruitment
    • Responding

      to potential carer inquiries.

    • Provision

      of information.

    • Follow up

      initial contact.

    • Marketing

      and Networking for recruitment.

    • Liasing with

      Muslim community and community leaders.

       

  • Assessment
    • Ensuring

      interviews and assessments are culturally relevant.

    • Capacity to

      conduct interviews in carers first language.

    • Conducting

      first stage interviews.

    • Conducting

      second stage interviews.

    • Police, CIS,

      medical and character checks.

       

  • Training
    • Provision

      of training module.

    • Development

      of a training package tailored to program.

    • Ensuring training

      package is culturally appropriate.

    • Ensuring package

      highlights cultural issues relevant to group.

    • Capacity to

      conduct training in carers first language.

    • Capacity to

      draw on the shared history and identity of group.

       

  • Support Services
    • Monthly carer

      meetings.

    • Home visit

      and telephone contact service.

    • Newsletter

      (proposed).

       

 

  • Monitoring
    • Conducting

      annual reviews.

    • Responding

      to complaints and issues.

       

 

  • Respite
    • Provision

      of a culturally appropriate respite service to carers across the

      complete range of alternative care service provision within the

      refugee program.

    • Liaison with

      staff and carers.

       

 

  • Transition

    Housing

    • Development

      and provision of transition housing services for refugee minors.

    • Facilitation

      of group norms and behaviour within the transition housing service.

       

 

  • Family based

    care

    • Matching

      and placement service.

    • Ensuring provision

      of a multicultural family based service.

       

 

  • Group Home
    • For UHMs not

      appropriate for family based care or independent living.

       

 

  • "On Arrival"

    Carer Service

    • Assessment,

      training, support and provision of On Arrival Care Supervision for

      UHMs under 16.

       

 

  • "Detention"

    Carer Service

    • Assessment,

      training, support and provision of Detention Care Supervision for

      designated UHMs released into detention care in Adelaide.

 

On Arrival

Program

  • Alternative care

    service for supervision of under 16 yo.

  • Meeting all UHMs

    released to Adelaide from Detention Centres.

  • Transport to accommodation.
  • Placement and

    support service.

  • Assistance with

    Centrelink for benefits.

  • Assistance with

    Medicare.

  • Assistance with

    Immigration for TPV application.

  • Provision of information

    and orientation including Halal shops.

  • Assistance with

    language.

  • Assistance with

    medical assessment.

  • School enrolment.
  • Assistance with

    clothing and school uniform.

  • Community connections.
  • Assistance with

    worship including prayer rug, provide Koran.

  • Facilitating arrangements

    special religious holy days and festivals.

  • Urgent psychological

    assessment where required.

Detention Program

  • Placement and

    support service.

  • Intensive supervision

    as required under by DIMIA, Migration Act applies.

  • Assistance and

    purchase of clothing.

  • Assistance with

    medical assessment and treatment.

  • Psychological

    assessment.

  • Liaison and referral

    for therapy.

  • Liaison with legal

    representatives.

  • Liaison with Refugee

    Review Tribunal and hearings.

  • Assistance with

    school enrolment.

  • Managing behavioural

    issues and needs.

  • Casework services

    respectful of language, culture and religious values.

  • Linking to recreation

    activities, groupwork.

  • Escort Detention
  • Establishing and

    supervising mentors to provide escort service to and from school and

    to other activities.

Recreation

Program

  • Consulting with

    UHMs and team.

  • Liaison with INEYS,

    ASSE, Street Level West.

  • Planning and development

    of activities with partners.

  • Preparation of

    submissions for funding.

  • Conducting activities

    (food, drinks, transport, equipment etc).

Case Management

Independent

Living Program

  • Advocacy, liaison

    and provision of report to Housing Trust.

  • Purchase of white

    goods and furnishings.

  • Independent skills

    training.

  • Casework service.

Education

  • Enrolment, school

    fees, uniforms.

  • Alternative curriculum

    planning for UHMs.

  • Liaison with school.
  • Assistance with

    career advice (linking).

  • Assistance with

    higher education choices.

  • CIRI tutoring.

Family

  • Family Liaison

    with Red Cross tracing and message home service.

  • Maintaining sibling

    or relationship groups together.

  • Health Arrange

    baseline medical, psychological.

  • Assistance with

    medical information, appointments, transport etc.

  • Interagency services

    development with Mental Health.

Relationships

with Carer

  • Home visiting,

    continuous assessment of circumstances.

  • Manage behaviour

    issues, conflict.

Independent

living

  • Skills development.
  • Housing assistance.
  • Purchase of household

    goods.

  • Information -

    orientation, safety, emergency numbers, behaviour, norms.

  • Casework contact

    - problem solving.

Emotional

  • Counselling services

    - post traumatic stress, torture and trauma.

Relationships

  • Facilitating networking,

    associations and relationships.

Casework

  • Case Planning

    and implementation.

  • Level of service

    and contact.

  • Assistance with

    visa.

  • Liaison with agencies

    including DIMIA.

  • Preparation of

    reports.

  • Referrals.

Religion

  • Linking with

    Iman.

  • Planning activities

    for religious ceremony and celebrations, eg Eid, Nawroz.

Supervisor

Role

  • Staff supervision

    and consultations.

  • Program development.
  • Crisis management.
  • Coordination of

    DHS and FAYS practice and policy requirements.

  • Interpretation

    and application of State and Federal legislation (includes Immigration

    Guardianship of Children Act, Migration Act).

  • Development of

    team practice and procedures.

  • Recruitment of

    culturally competent staff.

  • Development of

    programs to meet the needs of UHMs including cultural, recreational

    and religious.

  • Community response

    - responding to the community on issues, facilitation of community interest

    into capacity to contribute to services (participative services model).

  • Community development

    - facilitation of services and service integration with organisations

    such as Second Story, STTARS, Mental Health, Legal Service Commission.

  • Representing the

    department and liaison with senior and executive staff from a wide range

    of organisations (DIMIA - Adelaide, Canberra, DHS, Mental Health, STTARS,

    MRC, Woomera Lawyers, RRT, Centrelink, UNHCR, DEET, Red Cross, interstate

    counterparts etc.

  • Managing enquiries

    from various organisations on issues involving refugee minors.

  • Coordinating and

    responding to community interest and advocacy arising from community

    representative.

  • Developing relationships

    with the Middle Eastern Community to contribute to service improvements

    and to community building.


Appendix 2

Collaboration and liaison

across government and non-government sector in supporting TPV and PPV

holders

The Department of

Human Services liaises closely with many non-government organisations

involved in the provision of services to new arrivals and refugees. These

include:

  • Migrant Resource

    Centre as providers of orientation and information services under the

    IHSS;

  • Anglicare Housing

    as subcontracted provider of On Arrival Accommodation to the IHSS;

  • Australian Refugee

    Association as provider of household formation assistance and proposer

    support under the IHSS;

  • COPE (Centre of

    Personal Education) Multicultural Communicable Disease Program;

  • Council of Churches,

    particularly the Coalition for Justice for Refugees;

  • Interchurch Housing

    Office;

  • Multicultural

    Communities Council;

  • Australian Red

    Cross;

  • St Vincent de

    Paul Society;

  • Salvation Army;
  • STTARS (Survivors

    of Torture and Trauma Assistance and Rehabilitation Service), which

    is part funded by DHS Mental Health Services;

  • Wesley Uniting

    Mission.

Staff of the Department

of Human Services actively liaise and consult with national and local

councils and associations including: the Refugee Council of Australia;

the Muslim Women's Association and various associations formed by ethnic

and national groups within the South Australian community. Additionally,

grants through Community Benefits SA, the Supported Accommodation Assistance

Program and Gamblers Rehabilitation Fund have been awarded to these organisations

to assist them in supporting the successful settlement and promotion of

well being of immigrant populations.

Department of Human

Services staff are represented in several committees with input into service

provision for humanitarian arrivals. These include:

  • COSMIC (Commonwealth

    State Migration Committee);

  • IHSS Case Coordination

    Committee.

The Department of

Human Services also convenes an Interagency Strategy Group for Temporary

Protection Visa holders, comprised of representatives from the following

organisations:

  • Department of

    Premier and Cabinet;

  • Department of

    Education, Training and Employment;

  • Office of Employment

    and Youth;

  • TAFE Sector;
  • School sector;
  • SA Police;
  • Multicultural

    Communities Council of SA;

  • Australian Refugee

    Association;

  • Survivors of Torture

    and Trauma Assistance and Rehabilitation Service;

  • Migrant Resource

    Centre;

  • Australian Red

    Cross;

  • Coalition for

    Justice for Refugees;

  • Department of

    Immigration and Multicultural Affairs; and

  • Centrelink.

This group aims to

examine responses by all agencies and examine coordination issues and

ensure a consistent approach across all sectors.

The Division of Multicultural

Affairs convenes a Cross-portfolio Group on the Settlement of TPV holders.

This group comprises State Government portfolio representation only and

is convened to discuss and provide confidential policy, program and financial

responses on all Humanitarian settlers but with a focus on TPV holders

to the Minister for Multicultural Affairs.


Appendix 4

Child Protection Notifications

- Woomera

TABLE 1: Breakdown of notification by gender, age, family structure, notifier,

perpetrator and form of abuse

CHART 1: Notifications

by Month, postcode 5720

CHART 2: Child Protection

Notifications by Gender - Woomera, April 2001 to March 2002

CHART 3: Child Protection

Notifications by Family Structure - Woomera, April 2001 to March 2002

CHART 4: Child Protection

Notifications by Assessment Decision - Woomera, April 2001 to March 2002

CHART 5: Child Protection

Notifications by Age - Woomera, April 2001 to March 2002

CHART 6: Child Protection

Notifications by Notifier - Woomera, April 2001 to March 2002

CHART 7(a): Child

Protection Notifications by Race - State Total

CHART 7(b): Child

Protection Notifications by Race - Woomera

CHART 8(a): Child

Protection Notification Outcomes - State Total

CHART 8(b): Child

Protection Notification Outcomes - Woomera


Appendix 5

Guidelines for the public

health management of communicable diseases

in Australian detention environments

 

1. Introduction

These Guidelines

address the immediate public health management issues relevant to communicable

diseases in Australian detention centres accommodating asylum seekers

and illegal entrants. The Guidelines are not intended to cover all communicable

disease issues, but rather to identify the minimum requirements for the

protection of the health of detainees and the Australian public.

The Guidelines do not replace or override current legislation or regulations,

or supplant the essential role of public health staff from the relevant

jurisdictions in managing issues in accordance with local requirements.

Any suggestions for

alteration or addition to these Guidelines should be made to Communicable

Diseases Network Australia (CDNA).

2. Tuberculosis (TB)

All detainees, including

children, should be screened for active TB on arrival. For those aged

12 years and over, screening should be by history, physical examination

and chest x-ray (PA film initially).

Chest x-rays should

be taken as soon as possible, and within one week of arrival at the detention

centre. Chest x-ray films must be read by a radiologist or respiratory

physician and the report sighted by the relevant medical officer before

the examination is considered complete. Pregnant women who have not had

a chest x-ray should be monitored by medical staff and have a chest x-ray

performed after delivery.

Mantoux (tuberculin) testing is an appropriate screening instrument for

all children under 12 years of age. The Mantoux test must be administered

by clinical staff specifically trained in its administration and reading.

Interpretation of the Mantoux result should be consistent with the guidelines

of the relevant State based tuberculosis service.

All detainee neonates born in Australia and tuberculin negative children

up to 5 years of age should be offered BCG except for those previously

vaccinated or for TB contacts for whom preventive treatment is being considered.

BCG should not be given to an immunocompromised child, and must be administered

by clinical staff specifically trained in its use.

Regardless of screening

results, a person of any age with symptoms suggestive of TB on arrival,

or who develops symptoms of TB after initial screening, should be investigated

promptly and/or referred to the relevant State or Territory TB service.

If an active case of TB is confirmed or if TB is suspected in a child,

management should be undertaken by or in close consultation with the relevant

State or Territory TB service. To ensure proper case follow up occurs,

the detention service must always ensure that the local TB service is

advised prior to discharge or transfer of cases, and is provided with

post-discharge contact details.

The detention service provider and health staff working with it should

develop strong links with the State/Territory TB service to ensure staff

remain up to date on TB issues and to expedite diagnosis and management

of detainees with TB.

3. Hepatitis B

All adults should be offered testing for hepatitis B surface antigen.

Those found positive for hepatitis B should be counselled, and immediate

family contacts who are sero-negative should be offered hepatitis B vaccination

in accordance with the Austalian Standard Vaccination Schedule.

4. Hepatitis C

Testing for hepatitis C antibody should be offered to all individuals

for whom there are clinical and/or epidemiological indicators of disease

or infection. Those who test positive should be given appropriate counselling.

5. HIV antibody testing

HIV testing should be offered when there are clinical and/or epidemiological

indications of disease or infection. Pre- and post-test counselling is

required for all persons undergoing HIV testing and/or for the legal guardian

in the case of a symptomatic child.

Confirmed HIV positive persons should be advised of their rights and responsibilities

regarding HIV, and contact tracing should be undertaken in consultation

with the relevant State or Territory AIDS/STD service.

6. Malaria

Malaria screening by thick and thin film should be performed on persons

who have come from, or transited through, a malaria endemic country and

who present with a febrile illness, report fever in the previous week

and/or are pregnant.

7. Treponema serology

All those 15 years and over should be offered testing for treponemal serology

(and children also tested where epidemiologically indicated). Those with

evidence of infection (whether secondary or latent) should be treated,

with referral to an appropriate sexually transmitted infection service

considered.

8. Other infectious

diseases

Routine screening for other infectious diseases, including gastrointestinal

parasites and typhoid, should not be undertaken unless there are clinical

or epidemiological indicators of disease. Health care providers should

maintain a high level of suspicion of communicable diseases and investigate

accordingly.

9. Vaccination

All detainees should be offered (and encouraged to accept) vaccination

according to the Australian Standard Vaccination Schedule (see attached)

using accelerated schedules or minimum intervals for catch up where appropriate.

The importance and benefits of vaccinating children should be emphasised.

In particular, to minimise the possibility of measles outbreaks, MMR should

be administered as soon as possible after arrival in Australia (and no

more than three days after arrival) for all children up to 15 years of

age.

10. Food Hygiene

As kitchens at detention centres cater for a large number of people and

many individuals involved in food preparation are themselves detainees,

it is essential that strict hygiene is observed. Advice should be sought

from the State or Territory Health Authority or the local council Environmental

Health Officers to ensure that processes in place minimise the risk of

food-borne infections.

Any individual working in a centre kitchen who develops diarrhoea and/or

vomiting should not be allowed to continue to work in food-related jobs

until cleared by the local Medical Officer.

11. Sewage Disposal

Detention centres are often in remote parts of Australia where infrastructure

is relatively inadequate, and in these circumstances it is important to

ensure that all sewerage systems are able to cope with the numbers of

detainees in the area. Advice should be sought from State Health Authorities/Local

Government Environmental Health Officers as appropriate to ensure that

adequate systems are in place.

12. Vector Control

It should be recognised that vector-borne diseases pose risks both to

the Australian population (eg. malaria may be introduced into the country

through infected detainees) and to the detainees themselves (eg Murray

Valley Encephalitis could have a major impact on non-immune detainees).

Facilities therefore need to have appropriate vector-control systems,

particularly mosquito screening of buildings to prevent the transmission

of mosquito borne diseases.

13. Notification

to State Health Authorities

(a) In the event

of a notifiable disease or disease cluster

Where a notifiable disease is diagnosed in a detainee, it is a legislative

requirement that the case be notified to the relevant State or Territory

Health Authority. The detention service provider and associated medical

staff should be familiar with local notification requirements, including

the procedure for urgent notifications. Maintaining close liaison at all

times with the State or Territory health authority should be encouraged.

Any unusual increase

in the occurrence of a disease (cluster), even for diseases not usually

notified, must be reported to the relevant State or Territory Health Authority

as a matter of urgency, and all staff must cooperate with the disease

control measures required by that Authority.

Outbreaks likely

to occur in camps and institutions include measles, hepatitis A, influenza,

meningitis, chicken pox, pertussis, acute gastrointestinal disease and

skin infestations such as scabies.

(b) In the event

of discharge from detention

On discharge, detainees should be referred to the relevant Health Authority

for follow up of infectious diseases such as TB, and in order to facilitate

access to public health and clinical services, including completion of

vaccination schedules.

14. Medical records

In order to facilitate subsequent health care arrangements, a copy of

the medical discharge summary and vaccination record should be kept at

the detention centre and copies given to each detainee (or their legal

guardian) on discharge.

15. Occupational

Health and Safety

As a minimum, all detention centre staff should be fully vaccinated in

accordance with the Australian Standard Vaccination Schedule. Staff in

specific occupational groups may require additional vaccinations as recommended

in the current edition of the Australian Immunisation Handbook.

Australian Standard

Vaccination Schedule available from http://immunise.health.gov.au/schedule.htm

Contact details

Communicable Diseases Network Australia

Secretariat: MDP 6, PO Box 9878 CANBERRA, ACT 2601

Email: CDNA@health.gov.au

Ph: (02) 6289 1555, fax. (02) 6289 7719

Acknowledgement:

These Guidelines are based on an initial protocol developed by the Department

of Health and Aged Care's Surveillance and Management Section and the

Department of Immigration and Multicultural Affairs.


1.

Citizens as sited in this document includes residents and non-residents.

Last

Updated 3 January 2003.