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Workshop on Immigration Detention (ID): addressing health challenges and exploring Alternatives to Detention (ATD) Co-organized in collaboration between WHO Regional Office for Europe, the International Detention Coalition (IDC), UNHCR, and Uppsala University, hosted by the Secretary of State for Equality and Migration and the Secretary of State of Health Promotion on behalf of the Portuguese Government Proposed dates and venue: 22-23 November 2023, Lisbon, Portugal Workshop format This is a 2-day event with interactive sessions in a workshop style with in-person participation. Based on WHO Europe country implementation guide ‘Addressing the health challenges in immigration detention, and alternatives to detention’ (1), the workshop will delve into the health challenges of refugees and migrants in immigration detention (ID), and interventions to address it. The workshop will also explore viable ways to promote and implement Alternatives to Detention (ATD), and how these can be used to mitigate and address health outcomes. The workshop will ensure a whole-of-government approach by inviting diverse governmental authorities involved in ID and ATD, and it will explore the implications of a whole-of-society approach. The workshop will present, discuss and deliberate on lessons learned, good practices and effective approaches that participants will bring to the workshop with their presentations on their contexts, practices and challenges. The event will serve as a blueprint to create a community of practice in Europe where participants interested in working together will find a common space to continue to share good practices, learn from each other’s experiences, and collaborate. The working language will be English. Workshop purpose • Present evidence on the health challenges of refugees and migrants in ID within the WHO European Region; how the detention environment contributes to poor health, and the importance of exploring relevant interventions • Illustrate and discuss successful approaches in mitigating poor health in ID, with a focus on how ATD can contribute to reducing the negative health outcomes of ID and improve well-being • Reflect on the promotion of ATD and the possibility for its implementation as a good practice, including exploring ways of introducing small-scale projects to pilot ATD • Recognize that health in ID and ATD require a whole-of-government and whole-of-society approaches at the national and regional levels, and engage government authorities other than Ministries of Health, including other Ministries and Departments, European Commission agencies, UN agencies, civil society, academia, and other stakeholders • Establish a blueprint for a community of practice where participants can collaborate on interventions tackling health in ID and promoting ATD Background and current context Global compacts, international guidelines and law (2-8) state that immigration detention should only be used as a last resort, and never for children, though it has become an increasingly used tool to manage migration flows over the years (1), including in Europe. As a fundamental human right, health is crucial 1 to migrants and refugees and to ensure overall public health (5). Research on individuals subject to ID, however, has shown the negative impact of detention on both physical and mental health, hence highlighting the importance of investing in the response to health needs in ID (9-12). ID is shown to either create new health issues or exacerbate existing health issues, especially related to mental health, of migrants (1). Health of migrants tends to worsen with the increasing duration of detention. The negative impacts can be long lasting, even after release, especially in children (13). Though the mental health needs of migrants in ID are well documented, psychological care is often missing in ID. The detention conditions also place migrants at risk of the spread of communicable diseases, violence, and traumatic events. A multitude of stressors exist within ID including the uncertainty of migration proceedings, feelings of isolation, uncertainty over their legal status, criminalization of migration, lack of support from staff, and communication barriers (1). Studies have also shown the challenges faced by detention staff and healthcare providers in ID to provide care for refugees and migrants in ID. There exist also evidence showing the negative impact of detention on detention staff as well and the need for support (1). Alternatives to detention (ATD) should be considered and prioritized over ID. Several countries within the WHO European Region have legal provisions to implement ATD. Adequate ATD options may include case management-based and community approaches, which are well documented and have been proven to be effective in terms of achieving case resolution and more cost efficient than ID, while protecting and improving the well-being of migrants (1). However, there remains a lack of systematic implementation of ATD in these countries. Since September 2020, the European Commission is developing the New Pact on Migration and Asylum, which includes a series of legislative proposals, roadmaps and recommendations. Trilogue negotiations are currently underway on the proposal contained within the Pact, which are likely to expand the use of border procedures, meaning that EU Member States will be required to deal with a higher number of asylum claims at the border. In turn, there is an increased likelihood that more people might be placed in ID at the border. In this context, it is important to facilitate a workshop to improve awareness on the health consequences of ID and how to address them, and explore effective ways to implement rights-based ATD that allow refugees and migrants to live in the community while a decision is being made on their migration case. In May 2022, WHO Europe organized a training workshop which convened Minister representatives and other governmental authorities, advisors, CSOs and UN agencies. The workshop in November 2023 aims to establish a community of practice for future cooperation among key stakeholders who wish to collaborate on health in ID and the promotion of ATD. Participants Approximately 20 representatives from Member States in the WHO European Region, including ministries of health and interior, and other relevant stakeholders. Expected learning outcomes • Increased understanding of the health and well-being of refugees and migrants in ID 2 • Understanding of health challenges, including disease prevalence, in ID • Identify strategies to mitigate poor health of migrants in ID • Identify strategies to support staff, including healthcare providers, working in ID • Identify strategies to use and promote ATD • Identify steps to increase the routine use of rights-based ATDs Proposed workshop structure Prior to the workshop, participants are required to read the WHO Europe country implementation guide Addressing the health challenges in immigration detention, and alternatives to detention (1). Plus, using a template provided by the course organizers, participants will be asked to identify main challenges and potential solutions in relation to health in ID and use of ATD to bring to the workshop. On day 1, participants will explore theoretical fundamentals and engage in discussions. It is expected that participants will present the challenges and potential solutions in their contexts, and will identify new challenges and/or revise previously identified solutions based on the discussions during the workshop. The participants will receive and feedback on their solutions from expert advisors and other participants. These strategies/interventions are to be considered as initial ideas that could be developed further adapted to their respective country context. On day 2, there will be a deeper exploration of the Portuguese context, participants will discuss learnings from the workshop and engage in group work. Throughout the workshop, discussions will be held to identify synergies, common challenges and potential partnerships with a view to establishing future collaboration among Member States, CSO, European Commission partners, UN agencies, and other relevant stakeholders in a community of practice focused on health in ID and ATD. References 1. Addressing the health challenges in immigration detention, and alternatives to detention: a country implementation guide. Copenhagen: WHO Regional Office for Europe; 2022. Licence: CC BY-NC-SA 3.0 IGO 1, 4, 12, 15, 35/38 2. Detention guidelines: guidelines on the applicable criteria and standards relating to the detention of asylum-seekers and alternatives to detention. Geneva: United Nations High Commissioner for Refugees; 2012 3. UN Committee on Migrant Workers, Global Detention Project, Muhamat AAA, Flynn M. Committee on migrant workers: general comment No. 5 (2021) on migrants’ rights to liberty, freedom from arbitrary detention and their connection with other human rights. New York: United Nations; 2021 (Report No. CMW/C/GC/5 4. United Nations High Commissioner for Refugees, Association for the Prevention of Torture, International Detention Coalition. Monitoring immigration detention: practical manual. Geneva: Association for the Prevention of Torture; 2014 5. Universal declaration of human rights. Paris: United Nations; 1948 6. Global compact for safe, orderly and regular migration. New York: United Nations; 2019 (A/RES/73/195) 3 7. European Parliament and Council. Directive 2008/115/EC of the European Parliament and of the Council of 16 December 2008 on common standards and procedures in Member States for returning illegally staying third-country nationals. OJ. 2008;L. 348/98 8. Directive 2013/33/EU of the European Parliament and of the Council of 26 June 2013 laying down standards for the reception of applicants for international protection (recast). OJ. 2013; L. 180/96 9. Report to the Danish Government on the visit to Denmark carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). Strasbourg: Council of Europe; 2019 10. Report to the Bulgarian Government on the visit to Bulgaria carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). Strasbourg: Council of Europe; 2018 11. Report to the Greek Government on the visit to Greece carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). Strasbourg: Council of Europe; 2020 12. Report to the Italian Government on the visit to Italy carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). Strasbourg: Council of Europe; 2017 13. Burnett J, Carter J, Evershed J, Kohli M, Powell C, Wilde G. “State sponsored cruelty”: children in immigration detention. London: Medical Justice; 2010 4 Date: 13 September 2023 WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ WELTGESUNDHEITSORGANISATION Ms Elen Ohov ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ Adviser REGIONAL OFFICE FOR EUROPE European Union Affairs and International Co- BUREAU RÉGIONAL DE L’EUROPE REGIONALBÜRO FÜR EUROPA operation Department ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО Ministry of Social Affairs Head office: Suur-Ameerika 1 UN City, Marmorvej 51, Tallinn 10122 DK-2100 Copenhagen Ø, Denmark Estonia Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected] Website: https://www.who.int/europe Dear Ms Ohov , Invitation to the workshop on Immigration Detention (ID): addressing health challenges and exploring Alternatives to Detention (ATD), 22 – 23 November 2023, Lisbon, Portugal. I am writing to invite you to the WHO Regional Office for Europe workshop on addressing health challenges in immigration detention (ID) and exploring Alternatives to Detention (ATD), in collaboration with the International Detention Coalition (IDC) and the WHO Collaborating Center Uppsala University. The event is hosted by the Secretary of State for Equality and Migration and the Secretary of State of Health Promotion on behalf of the Portuguese Government and will take place at the High Commission for Migration. The workshop will discuss successful approaches in mitigating poor health in immigration detention, with a focus on how Alternatives to Detention can contribute to reducing these negative health outcomes and improve well-being. It will build on the recognition that health in immigration detention and Alternatives to Detention require whole-of-government and whole-of-society approach at the national and regional levels and will engage government authorities responsible for migration, as well as Ministries of Health. Participants will be asked to present their contexts, practices, and challenges. The workshop will aim to establish a community of practice in Europe where participants will find a common space to continue to share good practices, learn from each other’s experiences, and collaborate. To promote a whole-of-government approach, I kindly request you to nominate two participants representing the Ministry of Health or a public health authority, and the responsible authority for migration affairs and/or immigration detention. I am pleased to inform you that WHO will cover the travel and accommodation. Please liaise directly with Ms Simona Melki ([email protected]) for any questions you might have. I look forward to receiving both nominations by 16 October 2023. Sincerely, Gundo Weiler Director Country Support, Emergency Preparedness and Response UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Fax: +45 45 33 70 01 Website: https://www.who.int/europe Denmark Encls: Draft concept note Copy for information to: Ms Triin Uusberg, Head, European Union Affairs and International Co-operation Department, Ministry of Social Affairs, Suur-Ameerika 1, Tallinn 10129, Estonia H.E. Ms Riia Salsa-Audiffren, Ambassador Representative of the Republic of Estonia, Permanent Mission of the Republic of Estonia to the United Nations Office and other international organizations in Geneva, Chemin du Petit-Saconnex 28A, Genève CH-1209, Switzerland H.E. Mr William Mart Laanemäe, Ambassador Extraordinary and Plenipotentiary, Embassy of the Republic of Estonia, Frederiksgade 19, 4th floor, Copenhagen K 1265, Denmark Ms Kristina Köhler, Liaison Officer, WHO Country Office, Estonia, Paldiski Road 81, Tallinn 10617, Estonia –2– Saatja: WHO EURO Migration Health Programme <[email protected]> Saadetud: 15.09.2023 11:01 Adressaat: <"Elen Ohov"> Koopia: <"Triin Uusberg">; <"SM Info">; <[email protected]>; Kaisa.Mitt- Alvarez <[email protected]>; <[email protected]>; <[email protected]>; KÖHLER, Kristina <[email protected]>; MAUER- STENDER, Kristina <[email protected]>; BARTOVIC, Jozef <[email protected]>; MELKI, Simona <[email protected]>; WHO EURO Migration Health Programme <[email protected]> Teema: Invitation to the workshop on Immigration Detention (ID): addressing health challenges and exploring Alternatives to Detention (ATD), 22 – 23 November 2023, Lisbon, Portugal. Please see the attached correspondence sent from the World Health Organization, Regional Office for Europe. One or more attachments may be included.Veuillez vous r¨¦f¨¦rer ¨¤ la correspondance ci-jointe du Bureau r¨¦gional de l'Europe de l'Organisation mondiale de la sant¨¦. Une ou plusieurs annexes peuvent ¨ºtre jointes.Mit der Bitte um Kenntnisnahme der beiliegenden Korrespondenz (eine oder mehrere Anlagen), Weltgesundheitsorganisation, Regionalb¨¹ro f¨¹r Europa§³§Þ. §á§â§Ú§Ü§â§Ö§á§Ý§Ö§ß§ß§í§Ö §á§Ú§ã§î§Þ§Ñ §à§ä §¦§Ó§â§à§á§Ö§Û§ã§Ü§à§Ô§à §â§Ö§Ô§Ú§à§ß§Ñ§Ý§î§ß§à§Ô§à §Ò§ð§â§à §£§ã§Ö§Þ§Ú§â§ß§à§Û §à§â§Ô§Ñ§ß§Ú§Ù§Ñ§è§Ú§Ú §Ù§Õ§â§Ñ§Ó§à§à§ç§â§Ñ§ß§Ö§ß§Ú§ñ (§à§Õ§Ú§ß §Ú§Ý§Ú §ß§Ö§ã§Ü§à§Ý§î§Ü§à §á§â§Ú§Ü§â§Ö§á§Ý§Ö§ß§ß§í§ç §æ§Ñ§Û§Ý§à§Ó). Country Implementation Support for Impact Unit Division of Country Support and Health Emergencies World Health Organization ©¦Regional Office for Europe UN City - Marmorvej 51 - 2100 Copenhagen Ø, Denmark Phone: ©¦