Why Immigration Detention Hurts Minds and Bodies

On paper, immigration detention is about border control. In practice, it’s a public health emergency.
A new systematic review in PLOS Global Public Health brings human voices to a global problem: how detention erodes the physical and mental health of asylum seekers and refugees long after they’re released. Drawing on 20 qualitative studies across seven countries, the review captures stories of trauma, deprivation, and moral injury that statistics alone can’t convey.

A System Built on Uncertainty and Control

The review reveals detention as an environment of chronic uncertainty—a place where days blur into months with no clear end in sight. Participants described feeling powerless, criminalized, and dehumanized by systems that treated them not as people seeking refuge but as risks to be contained. The phrase “a prison with extra flavours” from one study in Sweden captures the sentiment vividly.

Subthemes that emerged include:

• Constriction of agency: Detainees couldn’t make even basic decisions about food, privacy, or communication.
• Endemic uncertainty: With no timeline for release, stress and insomnia became routine.
• Systemic deprivation: Poor nutrition, overcrowding, and limited medical care compounded trauma.
• Loss of safety: Reports of violence—including sexual assault—were common.
• Perceived injustice: Many felt they were being punished for seeking help.

Health Systems That Failed the Vulnerable

Researchers found that systemic failures in healthcare provision were widespread. In U.S. facilities, suicide was often linked to organizational negligence, like untrained staff or ignored mental health warnings. In the U.K., pregnant women were denied timely maternity care. In Australia, detainees described deteriorating health as “a slow death of the mind.”

Even basic medical protocols, such as translation services, pain management, or follow-up care, were frequently missing. This failure wasn’t isolated; it was structural.

The Cost: Mind, Body, and Childhood

Across the 513 participants in the reviewed studies, detention consistently produced or worsened mental illness. Adults reported severe anxiety, depression, PTSD, and demoralization, while children showed aggression, nightmares, regression, and self-harm.

Children detained for just two months exhibited developmental delays and psychiatric symptoms that persisted long after release.
In one study, all 10 children met diagnostic criteria for both PTSD and depression.

Physical health also declined—malnutrition, untreated infections, and chronic pain were common. Some detainees developed new conditions, like obesity or skin diseases, tied to stress, inactivity, and poor care.

Life After Release: The Trauma Doesn’t End

Even years later, former detainees spoke of fragmented identities and eroded trust. They struggled to reconnect with family and society, haunted by feelings of guilt and futility. Some described themselves as “permanently damaged.” Depression, sleeplessness, and somatic pain persisted long after freedom was regained.

This enduring harm underscores a core message of the review: Detention doesn’t end at release—it reshapes lives.

What This Means in Practice

For public health professionals and policymakers, the implications are clear:

• Reframe detention as a public health issue, not a migration tactic. Mental health deterioration, suicide risk, and trauma transmission to children are measurable outcomes.
• Integrate trauma-informed care into immigration systems. Screening, early intervention, and staff training are essential.
• End child detention. The UN Convention on the Rights of the Child calls it a “measure of last resort”—yet it remains widespread.
• Build community-based alternatives. Community placement, case management, and humane monitoring reduce both harm and cost.

What’s Next?

The authors urge new research into post-detention interventions, especially for families. They also call for policy reform grounded in health and human rights, not deterrence.

In the words of lead author Bafreen Sherif (Monash University), the evidence is overwhelming:

“Immigration detention uniformly undermines health and well-being. Its effects persist long after release. We must center health and human rights in migration policy.”

Open Questions for Readers

• How can local health systems support former detainees’ recovery?
• What role should public health agencies play in advocating for alternatives to detention?
• How can trauma-informed care be implemented across immigration systems?