The “Illegal Migration Bill” is a new piece of legislation being proposed by the UK government. It has already been passed by the House of Commons, and is now with the House of Lords for amendments. It has been sped through these stages at an alarming speed, which indicates the lack of thoughtful consideration that has gone into it.
As I have followed this Bill, and written about it, I have wondered whether I have anything to contribute from an expert perspective as a psychiatrist. I am in two minds about this.
On the one hand, my primary concern (shared by many organisations and individuals) is that the Bill is morally unjustifiable. It is an effective ban on the right to seek asylum for the vast majority of those who are seeking protection. It strips them of legal protection and the right to appeal, and places a duty on the Secretary of State to remove them from the UK. My position is that the Bill is cruel, and seemingly by deliberate design.
As a psychiatrist, I do not have a more attuned moral compass, nor am I a legal or policy expert (although see here for some commentary on the Bill’s compatibility with the 1951 Refugee Convention and here for the Refugee Council’s impact assessment of the Bill). It does not, however, in my perspective, require any special expertise in these areas to look at the changes that the Bill proposes and find, at a very minimum, a lack of basic compassion. I certainly have not found it when listening to the proponents of the Bill.
I can, however, consider the medical evidence that is available on this subject, and while it is impossible to cover all of the worrying aspects of this Bill, I will offer a few thoughts about some of the mental health implications of this Bill, were it to become law.
Firstly, passing the Bill will lead to many more people being held in immigration detention centres. Unlike all other European countries, if you are detained in the UK, there is no time limit, and you can be held indefinitely. This Bill significantly increases the powers of detention, meaning that children, pregnant women, and survivors of torture could be detained. There is much that can be said about the harms of detention, and Medical Justice have more research on this. Evidence about mental health in immigration detention is clear that the environment of detention contributes towards and exacerbates pre-existing mental health problems, and prevents recovery through social isolation, lack of access to treatment and support, and long periods of uncertainty. The harm increases the longer detention continues.
The Bill includes no provisions for screening for vulnerabilities or mental health difficulties, and reduces the amount of time within which an appeal is possible. The grounds for appeal, furthermore, have been severely limited to whether someone would face a “real risk of serious and irreversible harm” were they to be removed to a specific country. The complex nature of mental health means that this presents assessing psychiatrists with a serious problem. Surely, someone being told that they will not be cared for, regardless of past trauma, and that they will be detained, freedoms curtailed, before being removed from the country, has the potential to lead to serious or irreversible harm to their mental health. Clinical experience tells us that the very act of being served a removal notice can significantly increase the risk of suicide and self-harm. There are no clear guidelines suggested as to how mental health might be legally considered as grounds for appeal, however.
So, as both a psychiatrist and as a citizen, I am offended and greatly disheartened when I read this Bill. I feel overwhelmed by the futility of my work as a psychiatrist when I consider the scale of the trauma this Bill would inflict on others, and when I see the ways in which callous language have created more fear in this country. I am not alone in watching the progress of this Bill with alarm, and gearing myself up for the consequences of it passing into law.
The Bill hasn’t yet been passed, however, so do write to your MP to communicate your strength of feeling, and highlight the negative mental health impacts of the Bill. Even if the Bill is passed, join or support the many organisations such as Centre for Mental Health, Medical Justice, Refugee Action and many others, who will continue to campaign for the rights of people seeking sanctuary, and share the word that refugees are welcome here!
Find out who your local MP is and how to contact them.
