10 | Recommendations Recommendation 7: The Department, Serco and IHMS should increase the provision of counselling, rehabilitation services and education to minimise harm and reduce demand for alcohol and other drugs within the detained population at the centre. Recommendation 8: The Department should, in consultation with facility staff and people in detention, review its policy on access to recognised programs of study and vocational training in immigration detention; with a view to enhancing opportunities for rehabilitation and reintegration. Health Services Recommendation 9: The Department and IHMS should make further efforts to attract and retain locally engaged health staff at the centre. Where this is not possible, IHMS should review their contracting arrangements to ensure there is a greater level of consistency in the staffing personnel at the centre. Recommendation 10: The Department and IHMS should ensure that every initial assessment includes a robust assessment of mental health and cognitive disability, as well as screening for neurodevelopmental disability to identify support needs. Recommendation 11: Where a screening assessment identifies a significant mental impairment, cognitive disability or neurodevelopmental disability, this should prompt an assessment by the Department and IHMS of the decision-making supports that may be required by that person. Recommendation 12: The Government should support and provide resourcing to the Department to liaise with state and territory corrective services, youth justice departments and justice health agencies in the development of national 66 practice guidelines for screening in custody, as recommended by the Disability Royal Commission. Recommendation 13: The Department and IHMS should review the efficiency of the current health services referral and triage procedures within immigration detention. This review should include examining the accessibility of the procedures and whether the mental health and torture and trauma referral system aligns with community mental health service standards and best practice. Recommendation 14: The Government and the Department must urgently address the lack of on-site healthcare out-of-hours in immigration detention and return to a 24/7 staffing model. Recommendation 15: The Department and IHMS must ensure that there is consistent, timely access to pain relief and other urgent/ unplanned medication needs at the centre across the whole out of hours and weekend period. Recommendation 16: The Department and IHMS should ensure that people detained at the centre have consistent access to clinical staff, including both nursing and medical staff with Emergency Department level competencies and experience. At the very least, if there are periods when this is not possible on site, it should be accessible through telehealth. Recommendation 17: The Department and IHMS should develop retrieval options for emergencies (e.g. trauma) at the centre, in addition to the local St Johns Ambulance service. This should include when rapid access directly to a tertiary Emergency Department in Perth is required. Recommendation 18: There should be high level (executive level) liaison on a regular basis between IHMS central office and the WA Country Health Service (Northam Hospital), St John of God (Midland Hospital), and St Johns Ambulance to ensure