Based on the Commission’s interviews with people detained and staff, as well as written submissions, it appears that some degree of mental health concern is almost universal among the detained population. Many people also expressed concerns around delays in accessing mental health appointments, sometimes they would submit their request forms and allege that IHMS would insist they never received them. Many of the people who spoke to the Commission from the s 501 cohort related their history of mental illness and/or substance use. These mental health issues or substance use issues then continued through their time in prison and immigration detention. One person disclosed that his offence had occurred because he developed an alcohol issue after a family break up, and ‘got into a fight’ while intoxicated. Another had offended due to his alcohol use at the time; and yet another said that his offence occurred in the context of a suicide attempt. Notwithstanding the change in population profile, many of the people spoken to had originally come to Australia seeking asylum and had very significant trauma histories, so any assumption that the mental health profile of the population has significantly changed with the increased s 501 cohort may not be correct. Most of the people spoken to relayed details of their mental health diagnosis, past and current treatments, and histories of trauma. Some of the detained men also appeared likely to have cognitive disabilities, including intellectual disability and acquired brain injury, and they may require supports to engage in the legal process. It appears common for people detained at YHIDC to concurrently have a history of trauma, mental health concerns, and substance use, as well as possibly cognitive impairment and neurodevelopmental disability. This is then exacerbated by the extreme distress and uncertainty of the experience of immigration detention, particularly where the period of detention is also indefinite and with an uncertain outcome. This is therefore a population with a rate of severe, complex, comorbid mental health and substance use issues that is very high, and significantly higher than the general population. This is also a population that lacks access to the usual family, social, community and other informal supports that people rely on to alleviate mental distress. Many of the people spoken to told the Commission about their separation from families who were unable to visit. Some told of family break downs, separation, and loss of contact with their children, some of whom were now in state or extended family care far away from their fathers. The structural and operational processes of the centre also do not necessarily support mental wellbeing. For example, people interviewed reported the following as affecting their day-to-day level of distress: • • • • • • • • lack of meaningful day to day activity, feeling purposeless difficulties accessing resources to manage their legal processes, increasing their fear and anxiety about its resolution problems sleeping due to lack of sufficient daytime activity, room sharing, unstable bunk beds, mouldy or too short mattresses, and 4am headcount checks lack of privacy in rooms lacking agency and having to rely on decisions from Serco staff, which may be experienced as arbitrary and inconsistent threat of sudden movement to another centre use of handcuffs for transport to appointments some reports claiming bullying, provocation, or aggressive behaviour from staff Yongah Hill Immigration Detention Centre Inspection Report • 2024 • 45