The recent overhaul of Canada’s refugee system, specifically the revamped detention policies, may have “a serious negative impact on the mental health of refugees,” warns a commentary published in the Canadian Medical Association Journal.

Bill C-31, which overhauls Canada’s immigration and refugee system and became law late last month, immediately drew the ire of legal experts and the opposition. The criticism led Immigration Minister Jason Kenney to introduce some amendments, including shorter detention periods for large groups of asylum seekers.

In their commentary, released Monday, Drs. Janet Cleveland and Cecile Rousseau decry the detention of designated refugee claimants in high-security facilities until their claim is resolved. They also criticize the five-year waiting period before these refugees can be reunited with their families once they are deemed a bona fide refugee.

They also object to measures that call for teens aged 16 to 18 to be detained, and children under 16 to either be placed in foster care or be detained only with their mothers, citing “consistent evidence that both detention and separation are harmful to children.”

The authors point to research that demonstrates “high levels of psychiatric symptoms” among refugee claimants who have been detained, if even for only short periods.

The studies also show that in general, symptoms worsen over time.

According to the commentary:

  • Research from the U.K. found that, after a median 30-day detention, 76 per cent of detained refugee claimants were clinically depressed, in contrast to 26 per cent of a non-detained comparison sample.
  • U.S.research found that after a median detention of five months, 86 per cent of refugee claimants exhibited clinical levels of depression, 77 per cent had clinical anxiety and 50 per cent had clinical post-traumatic stress disorder. After a few months, the mental health of those who remained in detention continued to deteriorate, while those who had been released improved.
  • The most alarming research comes from Australia, where, since 1992, all refugee claimants entering the country without a visa are detained until their claim is resolved. Over a period of 10 months in 2010-2011, there were more than 1,100 incidents of self-harm inside immigration detention centres, including six suicides, among a population of about 6,000 people. That suicide rate is about 10 times the suicide rate among the general population in Australia and Canada. The research showed that in Australia, nearly 90 per cent of “irregular” claimants are later accepted and go on to settle in the country permanently.

“As health professionals, it is our responsibility to urge the government to minimize harm to children, pregnant women, trauma survivors and other vulnerable people,” the doctors write.

“Children should not be incarcerated or separated from their parents. Detention of all refugee claimants should be limited to the shortest possible time required for identity and security checks and should generally be in noncarceral accommodation, especially for vulnerable individuals.”

The authors say ongoing oversight by an independent tribunal “is an essential safeguard.”

Moves to overhaul Canada’s refugee system followed the arrival in British Columbia of two boats, one in 2010 and another in 2011, which contained hundreds of Tamil refugees.

Kenney has said the measures are needed to streamline a system that’s been under strain from an ever-increasing number of refugee claims. He also touted the need to crack down on human smugglers.

Cleveland and Rousseau praised Kenney’s decision to bow to opposition pressure and propose amendments, which included detention reviews within the first 14 days and then again six months after arrival for detainees who arrived in a large group of asylum seekers. The bill originally allowed for these detainees to be held for up to one year without a review by the Immigration and Refugee Board.

But the issue of health care for refugee claimants has remained a hot topic.

Health-care workers have decried a new policy that cut extended health-care coverage, including drug, dental and vision coverage, to refugee claimants. The government says the change will save $20 million per year over the next five years.

However, advocacy groups pointed out that the new rules would also have applied to government-assisted refugees, which number about 7,500 per year. An order-in-council quickly amended the rule to exclude refugees settled by the federal government. For other claimants, such coverage will only be offered to those deemed to pose a risk to public health or safety.