Updated | Asylum seekers face adverse conditions in Mount Carmel, Jesuits warn

Adds comments by parliamentary secretary Chris Fearne in parliament

Asylum seekers who are treated for mental health problems in the Asylum Seekers Unit (ASU) within Mount Carmel Hospital face harsh and potentially adverse conditions, the Jesuit Refugee Centre warned.

“They are placed in Spartan conditions, in single rooms with only a bed and a toilet bowl,” JRS psychologist Julian Caruana said. “Since the toilet flushing is outside their cells, they have to call a guard when they want their waste flushed. They have no recreational facilities or therapy rooms and they are not allowed to leave their wards at any time. Their only free time is when they get an hour off to walk down the corridors. Their conditions are so bad that some patients have actually asked to be transferred back to detention centres.”

Moreover, Caruana warned that the ASU only caters for ten people at any given moment and faces problems of over-crowding. To make matters worse, the unit also accommodates female prisoners with drug abuse issues.

He was speaking at the launch of a report into the provision of mental health care for detained asylum seekers that he co-authored with psychologist Alexia Rossi.

The report, based off a study amongst 74 patients between December 2013 and June 2014, indicates that auditory hallucinations are the most commonly reported mental health syndrome, followed by mood disturbances, suicide ideations and insomnia.

31 (41.9%) of the patients sent to Mount Carmel had attempted suicide while in the detention centre. Of these, three people also attempted suicide repeatedly while in the asylum unit.

Caruana also pointed out that the vast majority (70%) of patients couldn’t speak English or Maltese and required interpretation. However, 33% of them either had no access to interpreters or only had access to untrained interpreters such as fellow detainees.

“Sometimes, it is even more dangerous for a detainee to have an untrained interpreter than to have no interpreter at all,” Caruana said. “Apart from the issues of translation, mental health problems are very heavily stigmatised in detention centres and detainees might not be comfortable speaking about such problems to a fellow detainee.”

As solutions, he recommended that health centres set up outreach clinics within detention centres that would provide the services of a doctor, nurse and social worker on a regular basis, and of more specialised mental health professionals on a less frequent basis. He also suggested that inpatient mental health services become more targeted to the specific problems faced by detainees, such as issues of past trauma, multiple losses, anxiety and insecurity.

With regards the situation at Mount Carmel, he said that the Asylum Services Unit should be transformed from a “secure space” to a more “therapeutic space”.

“Their rooms could become more hygienic, with toilets outside their rooms,” the report said. “Common areas can be furnished with comfortable seating and equipped with recreational options for reading, listening to music, drawing, socialising and watching TV. Patients should also be allowed to spend most of their free time outside their wards.”

He also repeated UN human rights expert Francois Crepeau’s call for Malta to step up its preparations for a considerable increase in the number of refugee arrivals next year.

“Not many refugees arrived this year, but Italy’s Mare Nostrum operation has now been cancelled,” Caruana said. “We should start thinking about creating an asylum seekers’ unit that caters for more than 10 people.”  

In parliament, parliamentary secretary for health Chris Fearne said he had yet to read the report but said he would discuss it with both the health department and Mount Carmel Hospital’s management.

Pressed by shadow health minister Claudio Grech, Fearne said the parliamentary secretariat for health would react to the report once “we analyse it and decide what action to take based on its recommendations.”