amongst the commonly diverted drugs. This has contributed to the issue of drug and substance abuse (see drug infiltration section). RECOMMENDATION 20: The Procedural Instruction relating to the use of force should be amended to require that the impact that not being escorted outside of a detention centre may have on the health or wellbeing of the individual be considered as a mandatory factor in the risk analysis prepared when seeking approval for a planned use of force. 7.7 Medication management Medication is dispensed twice a day, with separate pharmacies for the general population and highrisk areas. Some people detained are given blister packs of their medications for a longer period to self‑administer. Two IHMS staff are present for each medication dispensing time and a record is kept of any person who fails to collect their medication. This practice was implemented after a coronial inquiry found that a detained person had suffered a fatal seizure due to not taking his epilepsy medication in 2015.83 The Commission observed a medication round and found a group waiting outside to come into the dispensing area, usually proceeding into the area in twos. The Commission observed privacy in the dispensing area to be minimal. People who are detained must be observed taking the medication while in the dispensary, however there are no powers to check if the medication has been swallowed. As a result, the Commission was told that there is a high level of drug diversion occurring at YHIDC. Quetiapine and Pregabalin are Figure 8: IHMS medical dispensary RECOMMENDATION 21: IHMS should review its practices at the centre, with a view of improving privacy within the dispensing area. 7.8 Physical health As noted in the Commission’s 2017 inspection, the change in cohort has led to ‘a change in medical presentations’,84 including substance abuse issues and higher rates of metabolic disorders such as diabetes within the detained population. While the Commission did not have access to any data or information about common presentations, interviews with staff and people in detention provided anecdotal evidence to support this continued observation. In addition to medical conditions, the Commission was told that there Yongah Hill Immigration Detention Centre Inspection Report • 2024 • 43