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Measuring the Quality of Life in Immigration Detention

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Post by Mary Bosworth, Centre for Criminology, University of Oxford

For some years now, I have been conducting research in British immigration removal centres (IRCs) using a range of methods. IRCs are particularly challenging research environments, both because of the extreme anxiety suffered by many detainees and because research access is closely guarded by the state and the private companies who run them. Under these circumstances it has been important to develop a range of methods to understand these sites better and to ensure we can communicate the research findings with a wide range of audiences. Whereas in the creation of the Immigration Detention Archive I am using visual methods, alongside observation and unstructured interviews, such qualitative methods are of limited use to policy makers who require larger, more representative, statistical data. It is here, that the Measure of the Quality of Life in Detention (MQLD) has been most effective and has the greatest potential for effecting change. Not only does it enable researchers to gather the viewpoints of a large group of immigration detainees, but its quantitative nature mean that its results can be shared with and used by policy makers.

Like the Measure of the Quality of Prison Life (MQPL), developed by Professor Alison Liebling at the University of Cambridge and administered by HM Prison Service, on which it is modeled, the MQLD has been developed specifically for understanding the characteristics, needs and experiences of immigration detainees with a view to improving detention conditions and policy. It is made up of three parts. The first gathers self-report demographic data including: citizenship, immigration status, information about former periods in custody, marital and family status. The second section concentrates on their health needs, with particular attention to suicide and self-harm. It includes an abbreviated form of the Hopkins Trauma Scale (HSCL-D) measuring depression. The third and final section addresses quality of life.

The exercise yard of Colnbrook IRC's short-stay unit. (Photo: Immigration Detention Archive, Border Criminologies)
‘Quality of life’ is a broad ranging concept that connects health, relationships, autonomy, personal beliefs and legitimacy, to salient features of the environment in which people live. It includes people’s general physical, mental and social wellbeing, and their sense of satisfaction or dissatisfaction with the conditions in which they are living relative to their goals, expectations, standards and concerns. People’s assessment of their current quality of life will be shaped by their previous experiences and their sense of self. Using a likert-type scale the MQLD asks respondents to agree or disagree with 53 statements, measuring their perceptions of the justice, fairness, safety and legitimacy of their treatment. This final section includes some space for them to offer additional free text comments about their experience of detention.
 
The survey was applied in a range of IRCs since September 2013, by postdoctoral research fellow Dr Sarah Turnbull and by psychology Lecturer Dr Blerina Kellezi from the University of Staffordshire. The results were then written up into a report which is now available to download. Below, I summarise the report’s main findings. Based on these findings, we are continuing to adjust the survey, in preparation for another round of systematic application, across six additional sites.
 
Part One of the Survey: Demographics and Depression
 
The report is based on 213 surveys. The men and women in detention who completed the questionnaire came from a variety of countries and presented with a range of family, legal and medical histories. Some of them reported that they participated in activities in the centre, but quite a few others found being in detention very difficult and could not take part in any of the activities on offer.

The level of depression among the surveyed population was very high with four-fifths of the respondents, 80.4% (n=176), meeting the criteria for depression using the abbreviated form of the HSCL-D. This result reflects similar findings in other jurisdictions, e.g. with detainees in Norway and with former detainees in Australia as well as with our previous research in 2012 (Bosworth and Kellezi, 2012).

The chapel at Colnbrook IRC. (Photo: Immigration Detention Archive, Border Criminologies)
Those who were more depressed were: women, had health problems and were taking medication, had not lived long in the UK, had not been in prison prior to detention, had applied for asylum (up to 2 times), and/or had applied for judicial review. Those who were depressed had also specific experiences in that particular IRC: they were more likely to have participated in a fluid or food refusal, to have been placed on an ACDT (Assessment Care in Detention and Teamwork) plan, to have used interpreters, and to have been longer in detention. They did not use activities like the gym, or religious services, did not report staff or the IT room or library as positive aspects of detention, and spent less time reading. They were also more likely to report that immigration detention was unjust.
 
There were no significant differences between the overall scores (means) of depression among the four removal centres. Although women were more depressed, the surveys in Yarl’s Wood included a number of men and the comparison includes the overall scores for each centre. Overall, there were no significant differences between Yarl’s Wood depression mean scores and those from the other centres.
 
Notwithstanding such high rates of depression on the HSCL-D scale, the current ACDT plan did not extend to all participants who reported that they were thinking about suicide ‘quite a bit’ or ‘extremely.’ This gap could reflect communication barriers between staff and detainees or it could signal a lack of trust and willingness on the side of detainees in reporting this information to centre staff. The men and women who took part in the survey reported a number of physical and additional psychological problems in addition to depression.
 
When participants were asked to report negative aspects of detention, their responses focused on the restrictions inherent in detention, the food and other conditions in the centres, separation from their families, centre staff, and their deportation or immigration case. Many, quite simply, believed detention to be unjust. When participants were asked to report positive aspects about the particular IRC they identified socialising with other detainees, positive personal growth, religion, staff members and a number of centre activities. All the positive and negative aspects of detention that the participants identified without prompting are also currently measured in the MQLD questionnaire.
 
Part Two of the Survey: Quality of Life in Detention (MQLD)
 
‪The second part of the questionnaire measures detainees’ views of the ‘quality of life’ in their current detention centre. In line with other measures such as the MQPL and the The World Health Organization Quality of Life Survey (WHOQOL) the ‘quality of life’ refers to people’s general physical, mental and social wellbeing, and their sense of satisfaction or dissatisfaction with the conditions in which they are living relative to their goals, expectations, standards and concerns. It is a broad ranging concept that connects health, relationships, autonomy, personal beliefs and legitimacy, to salient features of the environment in which people live.
 
The arts and crafts room in Campsfield House IRC. (Photo: S. Turnbull)
Overall, the survey suggested that detainees were broadly dissatisfied with their quality of life in the four IRCs, although on each dimension a sizeable proportion neither agreed nor disagreed, suggesting some level of ambivalence. There was some variation in results among the centres and between the dimensions. Within the dimensions as well, certain issues tended to attract more negative or positive viewpoints than others. These variations point to the utility of the survey and also identify areas for future research and policy action.
 
The dimension on which the most sizeable minority of detainees recorded levels of satisfaction related to staff decency, with 40% of respondents across the board agreeing that officers were reasonable and appropriate. Close behind, 37% of detainees agreed that the centres were safe. The same proportion (i.e., 37%) also agreed that detainees had agency and self-determination, suggesting that respondents felt able to communicate and make decisions for themselves (communication and autonomy dimension).
 
Overall, 41% of detainees in this sample reported that they did not feel that the IRC in which they were held was characterised by kind regard and concern for the person that recognised their value and humanity as an individual. This dimension on ‘dignity,’ points to a sizeable legitimacy deficit among the confined. As we found in the previous application of the survey, immigration staff tended to be viewed more negatively than custodial staff. Thus, 40% of detainees did not feel that immigration officers were impartial or legitimate (immigration procedural fairness dimension). The same proportion (i.e., 40%) also did not believe the immigration system was clear, predictable or reliable (immigration organisation and consistency dimension).
 
Higher depression scores on the HSCL-D were related to more negative evaluations of a number of dimensions on the MQLD. Essentially those who were more depressed tended to rate lower (i.e., to dispute the presence of) dignity, safety, staff decency, immigration organisation and consistency, immigration procedural fairness, communication and autonomy, healthcare, care for vulnerable, and staff help and assistance.
 
There were some differences among the centres on certain dimensions. Overall, residents in Campsfield House were more positive about all aspects of their quality of life in detention measured by MQLD. The differences were statistically significant.
 
In all centres, detainees who had applied for asylum had lower mean scores for (i.e., were more negative about) the dimensions measuring immigration procedural fairness and communication and autonomy. Those who had used interpreters or translation services in the centre and thus were likely to speak less English, had lower mean scores for (i.e., were more negative about) dimensions measuring healthcare, dignity, immigration organisational consistency, communication and autonomy. They were also more distressed. Those who reported having health problems had lower mean scores for (i.e., were more negative about) healthcare, dignity, immigration procedural fairness. They were also more distressed. And finally, those who had stayed longer in detention had lower mean scores for (i.e., were more negative about) healthcare, dignity, safety, staff decency, immigration procedural fairness, communication and autonomy, care for the vulnerable and staff help. They were also more distressed.
 
Since one centre is primarily for women and three for men, when comparing Yarl’s Wood to Campsfield House, Colnbrook and Dover it is not possible to conclude which of the differences in perception is due to gender or which is a result of different regimes/practices in the IRCs. Although the Yarl’s Wood sample included a number of men, it is again not possible to conclude which of the differences are due to being in a mixed environment or which result from the different regimes/practices in the IRCS.
 
Conclusion
 
The survey uncovered some differences in detainee perceptions of the centres on specific parameters as well as some absolute differences between the centres. Those in Campsfield House were more positive about their quality of life in detention than detainees were about the other three centres. In all centres, asylum seekers (who had applied for asylum up to two times) had higher levels of depression. Those who did not leave their rooms were also more likely to be distressed, and women overall had higher levels of depression. Those who had been detained for longer were also more likely to be depressed.
 
The survey found that detainees differentiated between custodial staff and immigration staff, trusting the former more than the latter, while uncovering a worrying gap between those detainees who had been placed on an ACDT relative to the numbers who reported suicidal thoughts on the HSCL-D. All of these issues were also identified when an earlier version of the survey was previously administered in 2012 (Bosworth and Kellezi, 2012).
 
The sports hall, Colnbrook IRC. (Photo: Immigration Detention Archive, Border Criminologies)
A number of attempts were made to develop dimensions on regime, preparation for release and uncertainty. Regime is an essential dimension in the MQPL prison survey but it has not been possible, thus far, to replicate a similar measure in detention. This is partly due to the different nature and purpose of the regime in IRCs but also may be a result of the high turnover and unpredictable nature of detention. During the qualitative work we found that detainees were preoccupied with their return to their country of origin. Previous versions of the survey tried to measure attempts to prepare detainees for their return to country of origin. However, we found that the vast majority of detainees could not identify any attempts to prepare them for life after release or could not understand the questions. Finally, another important issue identified during the qualitative work that we have not yet been able to develop an adequate measure of is uncertainty. Because it is so prevalent, it is difficult to develop a dimension that measures it meaningfully.
 
The issues faced by the men and women in detention are complex and need to be understood in more depth. This survey attempts to gather information on their needs and experiences in a systematic fashion. Low levels of trust and high levels of depression, alongside language barriers and varying times in detention present significant challenges to administering a survey of this nature. The largest sample gathered over the shortest period of time occurred at Dover, where men were offered £5 telephone top ups to participate.
 
More work needs to be done on obtaining a random sample and on including non-English speakers. Dimensions on regime, preparation for release and uncertainty also need to be expanded. Based on these findings we have adjusted the MQLD, and hope to start administering it for a third time later this year. You can read the report here.

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How to cite this blog post (Harvard style):

Bosworth, M. (2015) Measuring the Quality of Life in Immigration Detention. Available at: http://bordercriminologies.law.ox.ac.uk/measuring-quality-of-life-immigration-detention/ (Accessed [date]).

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