'Protection or punishment?' The implications of detention on the mental health and well-being of migrants, a review of the literature.
Authors: Stagg Edward 
Published: December 2020

Background: The number of individuals forced to leave their home and seek asylum in other countries has risen alongside political instability, conflict and persecution in many parts of the world. These individuals are therefore extremely vulnerable. Many asylum-seekers have witnessed and experienced traumatic events that have contributed to mental illness. Detention is often used to incarcerate asylum-seekers who are waiting for asylum decisions to be made, however many are held in inadequate conditions for long periods of time. With governments using immigration detention increasingly more often, there are serious questions surrounding the impact this has on the mental health of detainees.Methods: A systematic review was undertaken using a comprehensive search strategy across six databases. Both qualitative and quantitative studies were included in the review providing that the mental health implications of immigration detention were explored or measured. Grey literature was also searched. The quality of the included studies were appraised and a narrative synthesis conducted in order to establish the main findings of the review. The results of the narrative synthesis were included in a conceptual model that explains how detention works to influence mental health. Results: 22 studies were included in the review. Six themes were identified from analysis of study findings from around the world. Five of those themes also occurred within studies conducted within the UK. In both the UK and globally: detention was associated with poor and deteriorating mental health outcomes; specific conditions inside detention centres were found to contribute to poor mental health; longer durations spent in detention were associated with poorer mental health outcomes; several negative behavioural and emotional responses to the detention experience were observed – particularly in children; the trauma of detention and mental health difficulties developed while in detention remained with individuals after release. In addition to these five themes, a higher number of relocations between detention centres contributed to greater mental distress among detainees outside the UK.Conclusions: This review provides evidence to suggest that an association exists between immigration detention and poor mental health outcomes and that many of the mediators of this relationship are universal. The findings of this paper have several implications for further research and policy. The UK must end indefinite detention and move towards alternative solutions for dealing with asylum-seekers. Detention should only be used as a last resort. Vulnerable individuals, such as children and individuals with existing mental health issues should never be detained. Finally, greater care should be taken to ensure that families with young children are not separated from one-another. Due to the implications of the findings included in this review, it is vital that scientific research of this type is allowed to continue. Future research must evaluate the feasibility and suitability of alternative policies to detention.