Safety has long been recognised as fundamental to the work of rehabilitation and recovery from torture and trauma. Over the past 30 years, therapeutic counselling provided by Australian torture and trauma centres has primarily been carried out with survivors who have been granted permanent residency in Australia. When working with permanently settled refugees, Australian torture and trauma centres use a trauma recovery framework predicated on the assumptions that a) the traumatic event/s are in the past and b) that the survivor is now living in a relatively safe and secure environment.
With the reintroduction of progressively harsher measures aimed at the deterrence of asylum seekers arriving by boat, (including detaining asylum seekers in offshore processing facilities on Nauru and Manus Island), Australian torture and trauma centres are again providing services in immigration detention facilities where asylum seekers, including those with histories of torture and trauma, can be detained indefinitely.
Protracted, arbitrary and indefinite detention is profoundly destructive of mental health. For survivors of torture and trauma in particular, detention frequently replicates past experiences of imprisonment, torture and other forms of violence. Detention re-traumatises through perpetuating injustice and reinforcing powerlessness and lack of choice. Further, it isolates, depersonalises and dehumanises survivors, trapping them in a limbo of uncertainty and fear.
Counsellors observe and report an exacerbation of post-trauma symptoms with high levels of PTSD, depression, anxiety and significantly impaired functioning all prevalent.
Providing torture and trauma services in immigration detention settings is ethically challenging, forcing us to confront difficult questions of whether effective mental health care can be provided in such settings and whether services provided by torture and trauma centres will be used by governments to legitimise the detention of asylum seekers.
This paper will identify and discuss the ethical issues of counselling torture survivors in detention and will offer observations made by counsellors of their approach to working with torture survivors in detention settings and the interventions they have been found to be helpful.
Funding & No Conflicts Declaration
The Australian Government funds torture and trauma services in all Australian and Australian-run offshore detention centres. These services are provided by non-government, not-for-profit specialist agencies.