Policy and practice
An Overview
Either the person is already identified as an adult at risk and information about their level of risk is provided to the gatekeeper
Or the gatekeeper makes a decision about the whether the person falls within the adults at risk policy based on the information held on the Home Office file.
The gatekeeper then decides whether the person should be detained applying the Adults at Risk Policy (AAR)
At this appointment the detained person held in a STHF is offered a screening by a nurse or a doctor under Rule 30 STHF Rules 2018. For people held in an IRC a screening appointment by a doctor under Rule 34 DCR 2001 is offered to allow for a mental and physical health assessment.
At the Rule 30/ Rule 34 assessment a decision is made by the clinician as to whether the person falls within the Rule 32 STHF Rules 2018 or Rule 35 Detention Centre Rules 2001 categories:
Is the person’s health likely to be “injuriously affected” by their detention or conditions of detention?
Does the clinician suspect that the person has “suicidal intentions”?
Is the person a “victim of torture”?
If the person does not fall within these categories then no further action is taken. If they do, then the clinician must complete a template report for each category and provide a copy of the report(s) to the person and their legal representative, if they have one.
If the person agrees, the report is sent to the Home Office. If they do not agree, then no more information is shared with the Home Office about their risk in detention.
If the person remains in detention, then there is no further obligation on the Home Office to proactively gather evidence about their risk after these initial screening and reporting processes.
However a Rule 35 (IRC) or Rule 32 (STHF) report can be requested by the person in detention or completed by a clinician of their own volition. These safeguards do not apply to people held in prison.
Summary of the Home Office’s approach to people’s vulnerability in detention
The Home Office’s general policy on identifying vulnerability is to move away from a category-based approach. So technically any information that could be an issue of vulnerability will be considered. But the categories below are particularly relevant to visiting people in detention as they have particular policies that apply to them.
People with mental illness either on arrival or who develop one whilst in detention. People whose mental health deteriorates in detention.
R35/32(1) report is required where a person’s health is likely to be injuriously affected by continued detention or the conditions of detention.
This triggers a review of detention by applying the Adults at Risk policy.
People with a history of trauma that means they are recognised as victims of torture or trafficking/ modern slavery.
R35/32(3) report is required where there is concern the detained person may have been the victim of torture.
This triggers a review of detention by applying the Adults at Risk policy.
First responder organisations have a duty to refer to the National Referral Mechanism. If a person receives a reasonable grounds decision from the Immigration Enforcement Competent Authority this triggers a review of their detention on the basis that they will be considered at least at level 2 under AAR.
People with suicidal or self-harming thoughts or behaviour.
R35/32(2) report is required where there is concern the detained person has suicidal intentions.
This triggers a review of detention by applying the Adults at Risk policy.
People who lack decision-making capacity. This can be for a variety of reasons including mental illness or disabilities.
The Detention Service Order for mental vulnerability and immigration detention relies on detention staff to identify people who may lack capacity, draw this to the attention of the IRC duty manager and the vulnerability lead (onsite supplier manager in STHFs) and request an assessment by the healthcare department. There is also an obligation to share the initial information that capacity may be a concern internally within the Home Office using a form called IS91RA. This then triggers a review of the person’s detention and recognition that the person falls within the Adults at Risk policy.
In addition to the aforementioned groups, the Adults at Risk policy, highlights the following as possible indicators that some one is at risk of harm in detention:
The person has “been a victim of sexual or gender-based violence, including female genital mutilation”.
The person is “suffering from post-traumatic stress disorder (which may or may not be related to one of the above experiences)”.
The person is pregnant.*
The person is “suffering from a serious physical disability, suffering from other serious physical health conditions or illnesses.”
The person is aged 70 or over.
The person is transgender or intersex.
*For women who are pregnant there is a seventy-two hour time limit for their detention.
It is worth remembering that people can also be in a situation where more than one category that applies to them.
Ad hoc safeguarding policies that monitor vulnerable people in detention and so identify their vulnerabilities but do not specifically trigger a review of whether the person should be held in detention
Vulnerable adult care planning
This is a process for assembling a care plan for a person who is identified as vulnerable whilst they are detained. This process requires reviewing of the decision-making, with input from the healthcare department. This allows for information sharing if a person is transferred within the detention estate.
People held in segregation conditions
This sets out safeguards for people who are separated from others in the detention site. This includes documenting the basis for the decision to segregate the person, the conditions they are placed in, the involvement of the healthcare department , time limits and requirements for approval by Home Office personnel.
People at risk of suicide and self-harm
This is managed by a process (the ACDT system) of documenting decisions about how to manage the risk of suicide and self-harm, with input from the healthcare department. This allows for information sharing if a person is transferred within the detention estate,
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