National Inquiry into Children in Immigration Detention

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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

Introduction
Role and Responsibilities of the Department of Human Services
The DHS policy context for the care and protection of children in immigration detention and upon their release into the South Australian community
Child development and support for children in immigration detention
Health aspects of care of children in immigration detention
Children with disabilities in immigration detention
Child protection arrangements between State child welfare agencies and the Department of Immigration and Multicultural and Indigenous Affairs
Issues regarding standards of care for children in immigration detention
Conclusion

Appendices

Summary of DHS services to new arrivals and refugees
Collaboration and liaison across government and non-government sector in supporting TPV and PPV holders
Submissions by the Child and Youth Service and the Australian Association for Infant Mental Health (AAIMH)
Child protection notifications - Woomera
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.

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.

Families must be kept together at all times, which includes their stay in detention as well as being released together.

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.

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.

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.

depression;
stress;
loss and grief; and
anger, etc.

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.

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

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

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.

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.
- Liaising 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 Australian 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.

Age	Number
00-01	11
02-04	33
05-09	38
10-14	52
15-17	28
Other	1
TOTAL	163

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

Number of notifications	Number of children
1	70
2	26
3	4
5	1
7	1
Total notifications - 146	Total number of children - 102

Search

National Inquiry into Children in Immigration Detention

Submission to the National Inquiry into Children in Immigration Detention from

the South Australian Department of Human Services

May 2002

Appendices

Executive Summary

Section 4. Child development and support for children in immigration detention

Section 5. Health of children in immigration detention

Section 6. Children with disabilities in immigration detention

Section 7. Child protection arrangements between State child welfare agencies and the Department of Immigration and Multicultural and Indigenous Affairs

Section 8. Issues regarding standards of care for children in immigration detention

1. Introduction

2. Role and Responsibilities of the South Australian 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

Delegated authority

DHS service provision

1. Rights of the child - Best interests

2. Psychological and social wellbeing

3. Education

4. Legal and administrative framework for children

Recommendations

5. Health of children in immigration detention

The case of immunisation

Dental care

Mental health

Recommendations

6. Children with disabilities in detention

Legislative Framework

Recommendation

7. Child Protection arrangements between State child welfare agencies and the Department of Immigration and Multicultural and Indigenous Affairs (DIMIA)

Recommendations

8. Issues regarding standards of care for children in immigration detention

Recommendations

9. Conclusion

Appendix 1

Summary of DHS services to new arrivals and refugees

Housing - Permanent Residents

Temporary Residents (holders of Temporary Protection Visas, subclass 785)

Health (the South Australian public health system provides services to temporary and permanent residents who are all eligible for Medicare coverage)

Community services - Permanent Residents

Temporary Residents (holders of Temporary Protection Visas, subclass 785)

DHS/FAYS unaccompanied humanitarian minors and community detention program

Services and functions profile

Appendix 2

Collaboration and liaison across government and non-government sector in supporting TPV and PPV holders

Appendix 4

Child Protection Notifications - Woomera

Appendix 5

Guidelines for the public health management of communicable diseases in Australian detention environments

Guidelines for the public health management of communicable diseases

in Australian detention environments