7 | Health Services is also a high rate of injuries requiring hospital attendance. Significantly, many of the people interviewed reported that their health had deteriorated during their time in detention, which they attributed to both the conditions of detention and inadequate access to health treatment. For example, many people stated they were waiting between two to eighteen months for dental treatment. Another person described attending the emergency department multiple times for high blood sugar yet not being able to access an appropriate diet to manage his condition. Two of the written submissions raised concerns about unexplained delays or denial of access to medical treatment or allied health supports. These submissions indicated that, in the face of significant attempts to advocate for appropriate healthcare, many people in detention feel a loss of hope, experience a sense of withholding or inadequacy of treatment as punitive; and consequently, an exacerbation of and failure to diagnose many serious conditions, including psychosocial disabilities. These observations broadly align with the concerns raised during the Commission’s 2017 inspection: Some felt that their health issues had not been taken seriously by medical staff, their appointments had been rushed or their concerns had not been satisfactorily addressed … Some claimed that they had experienced delays in receiving treatment, including for serious or painful health and dental issues. A small number of people alleged that their health issues had initially been misdiagnosed, and they had consequently endured considerable pain and discomfort before receiving an accurate diagnosis and appropriate treatment.85 44 RECOMMENDATION 22: The Department should establish an independent review of healthcare at the centre, with a view to assessing the standard of care currently provided and proposing measures to address any identified deficiencies. 7.9 Mental health The mental health service consists of mental health nurses, with access to a psychiatrist from an external provider, one day a week by telehealth. Staff reported that services are primarily delivered through telehealth due to the relatively remote location of the centre. A visiting psychologist also attends the centre. The service can manage depot anti-psychotics (medication for psychosis given by intramuscular injection usually on a monthly to 3 monthly basis) but the Commission was told that it was unable to manage Clozapine (a medication for treatment-resistant schizophrenia). The Association for Services to Torture and Trauma Survivors (ASeTTS) has an office in the clinic from which it provides specialist torture and trauma rehabilitation services three times a week. This is facilitated with a high level of consistency by the same counsellor. Several people interviewed said that they trusted and valued the ASeTTS counsellor. However, one person stated they declined counselling because they felt it would not help their ‘visa case’.