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who should have some knowledge of psychiatry. The medical servicesshould be organized in close relationship to the general health administrationof the community or nation. They shall include a psychiatric servicefor the diagnosis and, in proper cases, the treatment of states of mentalabnormality.” 305 The Rules also provide that “[s]ick prisoners who requirespecialist treatment shall be transferred to specialized institutions or tocivil hospitals. Where hospital facilities are provided in an institution,their equipment, furnishings and pharmaceutical supplies shall be properfor the medical care and treatment of sick prisoners [or detainees], andthere shall be a staff of suitable trained officers.” 306International law also recognizes that health professionals who providecare for detainees are bound by significant ethical obligations. These professionals“have a duty” to protect detainees’ “physical and mentalhealth” and to provide “treatment of disease of the same quality and standardas is afforded to those who are not imprisoned or detained.” 307PunishmentThe applicable international standards also establish two fundamentalprocedural safeguards regarding the punishment of detainees. First,according to the Body of Principles, the types of conduct that constitutedisciplinary offenses must be specified by law or lawful regulation andmust be duly published or communicated to detainees. 308 Second,detainees are entitled to both notice of the disciplinary offenses with305Standard Minimum Rules, Rule 22. (1).306Standard Minimum Rules, Rule 22(2).307Principles of Medical Ethics relevant to the Role of Health Personnel particularly Physicians,in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (Adopted as UN General Assembly Resolution37/194, 18 December 1982), Principle 1.308Body of Principles, Principle 30(1), provides, “The types of conduct of the detained orimprisoned person that constitute disciplinary offences during detention or imprisonment,the description and duration of disciplinary punishment that may be inflicted and the authoritiescompetent to impose such punishment shall be specified by law or lawful regulationsand duly published.” The Standard Minimum Rules, Rule 30(1) “No prisoner shall be punishedexcept in accordance with the terms of such law or regulation, and never twice for thesame offence.”309Body of Principles, Principle 30(2) provides, “A detained or imprisoned person shall havethe right to be heard before disciplinary action is taken. He shall have the right to bring suchaction to higher authorities for review.” The Standard Minimum Rules, Rule 30(2) provide,“No prisoner shall be punished unless he has been informed of the offence alleged againsthim and given a proper opportunity of presenting his defence. The competent authority shallconduct a thorough examination of the case.” See Body of Principles, Principle 4 (“Any formof detention or imprisonment and all measures affecting the human rights of a person underany form of detention or imprisonment shall be ordered by, or be subject to the effective controlof, a judicial or other authority”) (emphasis added). See also the Civil Rights Covenantand UDHR proscriptions against “arbitrary” detention.LEGAL STANDARDS 171
which they are charged and a fair hearing on those charges, including anopportunity to present a defense, before disciplinary action is taken. 309The UNHCR Guidelines call for “access to a complaints mechanism(grievance procedure) where complaints may be submitted either directlyor confidentially to the detaining authority.” 310Segregation (Solitary Confinement)In addition to the substantive and procedural safeguards regarding punishmentgenerally, as described above, international law also sets forthguidelines governing the specific punishment known as “segregation,” orsolitary confinement. The UN Human Rights Committee has stated that“prolonged solitary confinement of the detained or imprisoned personmay amount to acts prohibited by Article 7” (of the Civil RightsCovenant, prohibiting torture, cruel, inhuman or degrading treatment). 311The Basic Principles for the Treatment of Prisoners, for example, encouragethe abolition or, at least, restriction of the use of solitary confinementas a punishment. 312 The Standard Minimum Rules impose procedural protection,prohibiting the use of “close confinement” (or any other punishmentthat may be harmful to a detainees’ physical or mental health)“unless the medical officer has examined the prisoner [or detainee] andcertified in writing that he is fit to sustain it.” 313ShacklingThe Standard Minimum Rules provide in pertinent part, that, “Instrumentsof restraint, such as handcuffs, chains, irons and strait-jacket, shallnever be applied as a punishment. Furthermore, chains or irons shall notbe used as restraints. Other instruments of restraint shall not be usedexcept in the following circumstances: (a) As a precaution against escapeduring a transfer, provided that they shall be removed when the prisoner[or detainee] appears before a judicial or administrative authority; (b) Onmedical grounds by direction of the medical officer; (c) By order of thedirector, if other methods of control fail, in order to prevent a prisoner [ordetainee] from injuring himself or others or from damaging property; insuch instances the director shall at once consult the medical officer andreport to the higher administrative authority.” 314 Moreover, “[s]uch310UNHCR Guidelines, Guideline 10.311UN Human Rights Committee, General Comment No. 20, Replaces general comment 7concerning prohibition of torture and cruel treatment or punishment (Article 7), 44 th Session,3 Oct. 1992, para. 6.312Basic Principles for the Treatment of Prisoners (Adopted and proclaimed by GeneralAssembly resolution 45/111 of 14 December 1990), art. 7 [Basic Principles].313Standard Minimum Rules, Rules 32(1) and (2).314Standard Minimum Rules, Rule 33.172 FROM PERSECUTION TO PRISON
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From Persecution to Prison:The Heal
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CONTENTSAcknowledgements . . . . .
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The Bellevue/NYU Program for Surviv
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don, Miranda Ip, and Meriam Alrashi
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Significant symptoms of depression
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Detained asylum seekers participati
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persecution, yet most emphasized ho
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In many facilities, the response to
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years in detention, she finally got
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abuse For example, while being take
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They didn’t let me use the phone
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intensely personal events they had
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Limitations of this study include t
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Non-governmental organizations serv
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22 FROM PERSECUTION TO PRISON
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the late 1990s ranging from 10 to 7
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Historical BackgroundFor most of th
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international standards with the 19
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apply for asylum make up the majori
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tion judge. 57 Yet in many parts of
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York and Newark, New Jersey has had
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trict began denying parole to them
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Correctional Facility in 2000. “[
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men of which 750 were detained on i
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from that same country from seeking
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Detention Facilities in this StudyF
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high reliability in numerous langua
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York County Prison in York Pennsylv
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TABLE 2:Demographic Characteristics
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TABLE 4:Prevalence of Pre-Migration
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on a part time basis, researchers w
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Case #1(DK): “Loneliness and Fear
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TABLE 6:Hopkins Symptom Checklist-2
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TABLE 8:Harvard Trauma Questionnair
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think such services were available.
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When I am talking to you now it is
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After being granted asylum and rele
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“Being here is like going through
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In my country even though I became
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how long they were there - six mont
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Thoughts of SuicideSeveral asylum s
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here?’ I told the doctor, they br
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Another subject reported a positive
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substantial distance from their att
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eported that her experience in dete
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e somatic manifestations of the psy
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Case #2 (JG): “Health Care in Cha
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TABLE 11:Detainee Perceptions of He
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TABLE 13:Availability and Quality o
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detainees, or because they did not
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Difficulty Obtaining Specialized Ca
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Another detained asylum seeker repo
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One detainee who speaks French and
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Detention Facilities in this StudyS
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even though many reported having ex
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CASE #3 (HN): “SOLITARY CONFINEME
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Here, I’m scared. In [the detenti
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emote control and watch what he wan
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Whenever someone misbehaves, they t
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This subject was himself threatened
Page 129 and 130: One detainee reported several incid
Page 131 and 132: Some Process Exists to Respond to R
Page 133 and 134: There were no witnesses other than
Page 135 and 136: tion. An INS officer said they put
Page 137 and 138: There is an Anglican minister who c
Page 139 and 140: The dentists didn’t explain anyth
Page 141 and 142: tion between dental age and chronol
Page 143 and 144: Case #4 (LK): “Fifteen-Year-Old G
Page 145 and 146: 136 FROM PERSECUTION TO PRISON
Page 147 and 148: TABLE 16:Treatment/Abuses Reported
Page 149 and 150: “There is no political asylum her
Page 151 and 152: I was crying. I was so afraid with
Page 153 and 154: save her life, but was not able to
Page 155 and 156: Case #5 (CR): “Begging for Mercy
Page 157 and 158: ehind and told me to sign. He physi
Page 159 and 160: days and it is now 2 years and four
Page 161 and 162: viewers asked for additional inform
Page 163 and 164: y study participants. In evaluating
Page 165 and 166: trast, under US law, detention of s
Page 167 and 168: nation for an asylum determination
Page 169 and 170: very negative effects of detention
Page 171 and 172: authority to grant asylum and with
Page 173 and 174: absconding.” 250 Since the passag
Page 175 and 176: said “[F]reedom from imprisonment
Page 177 and 178: Standards relevant to this study ar
Page 179: “detained person” generally as
Page 183 and 184: esponse to substantial public press
Page 185 and 186: specified procedures, provided they
Page 187 and 188: PunishmentThe Detention Standard on
Page 189 and 190: any time the detainee complains.”
Page 193 and 194: while in detention, thus adding to
Page 195 and 196: Establish a Uniform National Parole
Page 197 and 198: that effect. These officers should
Page 199 and 200: Besides their inaccuracy, these exa
Page 201 and 202: friends so asylum seekers can maint
Page 203 and 204: appropriate staffing of such groups
Page 205 and 206: efugees and asylum seekers who win
Page 209 and 210: of thorough documentation. However,
Page 211 and 212: Human development is complex and di
Page 213 and 214: 18. Country from which fleeing pers
Page 215 and 216: 9. Being close to death.10. Forced
Page 217 and 218: Complete for each health problem:5.
Page 219 and 220: Explain:(Interviewer: Write brief n
Page 221 and 222: 2. Depression SymptomsA How much we
Page 223 and 224: B. You said that you have experienc
Page 225 and 226: Explain:13. How was your physical h
Page 227 and 228: Yes ...........1No............22. W
Page 229 and 230: Explain:20. At the time of your arr
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