Review of Mental Health Issues in Immigration Return Centres

Review of Mental Health Issues in Immigration Return Centres

A report prepared for Home Office by Dr David Lawlor, Dr Mannie Sher and Dr Milena Stateva.


16 February 2015

A report prepared for Home Office by Dr David Lawlor, Dr Mannie Sher and Dr Milena Stateva. The purpose of the Review was to help the Home Office Immigration Return Centres improve conditions for detainees with mental health issues.

The Tavistock Institute of Human Relations (TIHR) was invited by the Immigration Directorate of the Home Office to conduct a review of Immigration Return Centres capacity to help detainees who were suffering or likely to suffer mental health problems. The TIHR worked with three Immigration Return Centres.

These three centres were seen to be typical of the Home Office Immigration Directorate Estate. TIHR conducted an action research project with the three centres and the casework system that manages the detainees whilst they are detained. We discovered a system that was complex and at first difficult to understand. Our approach was to use a mix of observation and interviews with the differing layers of staff in the system and detainees. We found staff that were struggling to meet the emotional and health needs of detainees. We discovered a system that had a marked split between the control task and the welfare and caring task. From a deeper examination of the particular experiences of staff groups and individuals we discovered a system that had a confused and highly contested task. It has to be borne in mind that these confusions were below the surface and largely unarticulated. Here our systems psychodynamic theory helped us in our thinking. We used socio-technical theory, defences against anxiety and open systems theory to make sense of the dynamic processes in the Immigration Return Centres and their relationship with the external environment. At the same time we engaged with external stakeholders who advocate for the legal and human rights of detainees. Here again we found splits. Whilst on the ground in the detention centres some poorly trained detention staff did the best they could in very difficult circumstances. At the same time the casework system located outside the return centres manages and are the decision makers for detainees right to remain but again are experienced as split off and distant and subject to complex policies and procedures.

From these findings, which were fed back to our clients the senior staff of the Immigration Directorate, we formed a working hypothesis that we had system with serious task confusion. Within all of these complex organisational processes and dynamics we also had many unhappy people whose lives were on hold. We concluded that the split between care and control had led to institutions that were ‘off task’ and unable to help detainees feel purposeful or staff who felt on task and focused. The end result was that Immigration Return Centres were experienced as ‘waiting lounges’ for detainees rather than institutions that were set up with the task of helping people come to terms with their immediate present and make meaningful plans for the future. One of our recommendations, which have been accepted, is to set up a pilot project in a Return Centre to engage in culture change and a redefinition of the institutional task that works at reducing the psychological needs for splitting and thereby change the structural properties of the system.

Our thinking for the pilot is influenced by theories of transitional change. Transitions, particularly those occurring in organisations are difficult to manage. Transition is a process in which a previously established structure or set of structures that composed the system is modified or even relinquished, new forms of structure may emerge, and the mutual alignment of structures within the whole is altered. Organisation transition can be conceptualised as operating in two interlinked domains the social and the psychological. The social system includes status, roles, relationships, authority, collaboration and competition, group norms, conformity, social conflict, and culture. In the psychological domain we are examining motivation, learning, perception, behaviour, thoughts, feelings, needs, anxiety. Working at change requires effort in both of these domains. Social and organisational change can be seen as a psychosocial process. We suggested to the Immigration Directorate that for the pilot project the key features of the transitional approach to change management should be a working concept.

Whole systems development operates within a context of change defined by the underlying policy dilemmas and values that guide the work. Implementation, and not vision or strategy, is the biggest challenge in any development and change process. Change architecture articulates a plan, even if the details are unclear. It is a road map that shows what will happen when and who will be involved. The aim of the change plan is to create spaces for action and learning at local levels, and then for the sharing of this learning in a system-wide process of creating meaning and direction.

The TIHR Review can be accessed at www.gov.uk.
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