Jon Jureidini

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Jon Jureidini is a child psychiatrist at the Women’s and Children’s Hospital in Adelaide, where he works with ill and disabled children and their families. He has also trained in philosophy (PhD, Flinders University), critical appraisal (University of British Columbia) and psychotherapy (Tavistock Clinic). He has been publicly critical of detention centres and their tendency to foster poor mental health standards. He was involved in highlighting the inadequacies and dangers relating to immigration detention, particularly in light of the case of Cornelia Rau in Baxter Detention Centre, which brought this issue to the fore in the media. He is currently a professor in the Disciplines of Psychiatry and Pediatrics at the University of Adelaide.

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Transcript of Interview

14 September 2006

Interview conducted by Liz Dean

MS DEAN Liz Dean, L-i-z, D-e-a-n interviewing Jon Jureidini at Adelphi in Melbourne 14/09/06.

MR JUREIDINI I’m Jon Jureidini, J-o-n, J-u-r-e-i-d-i-n-i.

MS DEAN Thanks. Jon, I’ll just ask you again your name?

MR JUREIDINI Jon Jureidini.

MS DEAN And your date of birth?

MR JUREIDINI 02/07/56.

MS DEAN And when were you born, sorry where were you born?

MR JUREIDINI I was born in Kingston in South East of South Australia.

MS DEAN And can you describe say your family up bringing?

MR JUREIDINI Well, I grew up in a hotel which probably taught me more psychiatry than being at psychiatry school.

MS DEAN Fantastic.

MR JUREIDINI I’m the youngest of three boys by some considerable number of years. One of my brothers was born in Jerusalem and the other in Beirut but I was born after my parents came or my mother came back to Australia and my father came to Australia.

MS DEAN And can you describe what your earlier aspirations were or inspirations if you like?

MR JUREIDINI I don’t know that had any full formed view about what I wanted to do. I kind of drifted into medicine. It wasn’t a passion and it wasn’t really until I started to do psychiatry that I felt like I was doing something that I enjoyed.

MS DEAN So, how did arrive at or decide upon child psychiatry do you think?

MR JUREIDINI Well, I started out doing something else. I started out doing physician’s training and was disenchanted with that and then thought it would’ve been one of the reasons was that I was dealing with old people who seemed to be dying all the time and I didn’t think I was doing much for them. I suppose my disenchantment with that might have been related to the fact that both my parents had died a couple of years before I graduated and so, I thought, adolescents, that’s a good safe way away from geriatrics and so I decided do adolescent medicine. There wasn’t a specialist qualification in that and so I went for psychiatry and then stuck with that.

MS DEAN Would you describe your family as having sort of, an ethical or humanitarian, human rights kind of, background or was that more something you moved towards through ?

MR JUREIDINI No, but there was a kind of an appreciation of the underdog, I think, more than a human rights. I mean, in some ways I guess my parents were quite racist having come to Australia because of what happened in 1948 in the Middle East but – I was quite right-wing as a teenager as well. I mean, I went to a private boarding school and was bullied and became a bit of a bully in my turn as a result of that or maybe not as a result of that.

MS DEAN And your social network, would you describe them as being involved in kind of more human rights, refugee activists work?

MR JUREIDINI Yes. I think I’ve got a very good group of friends and family who were pretty like-minded and – in fact I can’t tolerate spending time with anybody who’s, you know, are kind of – without deliberately really doing it. A guy I was quite close to was sort of, you know, saying supportive things about Howard and I haven’t seen him since.

MS DEAN So how did you come to work with detained asylum seekers and refugees?

MR JUREIDINI Actually, in a way I kind of avoided it for a while, not deliberately but looking back on it I reckon, we had – our country CAMHS, Child and Adolescent Mental Health Service, provided some – I can’t quite remember how they were contacted but they were contacted about a couple of kids who were in Woomera. And one of our trainee psychiatrists was involved in doing some telemedicine work in doing an assessment and he came to me as his supervisor to talk about it.

I kind of had the capacity to know what was going quite a bit before it entered my consciousness really and I just kind of supervised that case at a difference without really, I think, ever really understanding quite how terrible it was. So that was several months before I got actively involved and then another referral came through and I was asked to become involved and I rang an adult psychiatric colleague, Fiona Hawker, to see her, to get her advice about, you know, setting up the telelink and stuff and she no, go there and see what it’s like, and so I went to Woomera to see this young man and it was kind of a life-changing experience really.

MS DEAN Can you describe Woomera, how did you get to Woomera?

MR JUREIDINI I’m pretty sure I flew up that time to Roxby and then drove up. I’m not sure whether somebody picked me up or – in fact, that time I think people from ACM, the health people from ACM picked me up from the airport. I think I went up with somebody else.

I think it was a day or two after the UN had been to visit. So the place was at it’s absolute best, you know, they cut down some of the razor wire and planted a few trees and it was a beautiful winter’s day and I love the desert. So it was all set up for me to have a lovely time and I just walked in to this place and I just couldn’t believe how bad it was. Like I’d been to gaols and horrible places and but it still just an absolute shock to go in there.

Part of what was shocking about it, you walk into a gaol and you see the people in gaol who, you know, kind of look like they belong in gaol. Whether they do or not, they’ve got the persona, they’ve got the tatts and the broken teeth and all the kind of stuff. That leads you to believe that they’re the right people in the right place even if you don’t think gaol’s are good things.

To walk in to Baxter and see all these kind of, you know, children who could’ve been my children in appearance and ordinary-looking people but in this horrible environment and to hear children called by numbers and it was – by the time I got there supposedly the identifying people by numbers had finished but it was still happening, and what was one of the first things that really upset me was to hear kids calling themselves by numbers, identifying themselves by their number.

Just the kind of – the fact that you couldn’t look in any direction without seeing razor wire fences and the institutionalisation of it. You know, the mess halls and the horrible and the obsequious relationships that the detainees had with the staff, and the complete destruction of family life and the dongers, the – I don’t know whether people have described them for you already but

MS DEAN No, could you describe it, Jon?

MR JUREIDINI You walk into a little kind of transportable hut, really. I suppose they were set up for – designed for maybe mining sites or something like that. It’s like a dormitory arrangement. There were little cells maybe two-metre cubes with, I think from memory, two double bunks in each one or maybe it was – they were so small there was only one double bunk. But you’d have a whole family in each little room and at the end of the donger would be a little common room smaller than maybe half the size of this room, with a television up on the wall blaring away in English and there’d be nothing else.

No capacity to prepare food. Dinner was served in the mess at five o’clock in the afternoon or something and that was it for the day. So all the family rituals that might preserve some kind of mental health in that kind of setting were completely taken away from people. No privacy. I think from memory the doors of the – you know, the little doors of the little cells just had a blanket tacked up across them, there were no doors.

You know, lots of things had been destroyed in riots and nothing had been replaced. The story was, well, they had it but they burnt it down so, they don’t deserve to have it replaced, kind of thing. There was no schooling or anything for the children at that stage and so. And then to just see these incredibly dispirited people.

MS DEAN (Indistinct) your first impression of Woomera. I mean, you’ve gone into describing but what did you first sort of sense of the (indistinct) there?

MR JUREIDINI It’s hard to know what was immediate and what, when you think back on it several years ago but you know, I remember concluding that you couldn’t really design and environment more destructive to child development. What is essential for children to survive adversity is that they have a kind of safe place, comfort available from their parents or others and that was completely lacking by the time we became involved. Most of the parents had been destroyed in terms of their capacity to provide adequate parenting. So that’s one thing that children need, the comfort.

The other thing they need is the capacity to play and explore and develop and you know, kids can play with stones on a dirty bit of ground but you’ve got to have an environment that’s kind of contained and conducive to play on. It felt like children couldn’t play in this environment.

Indeed later on, on a subsequent visit when we were assessing some children we had some occupational therapists and speech therapists and so on come up and do some assessments and these kids were completely naive to basic – you know, like jigsaw puzzles, picture books, scissors. Those kinds of things, they’d never seen them before. They didn’t know what to do with them.

MS DEAN With the children that you were seeing in Woomera, was there anything available for them, was there any areas that they could go into?

MR JUREIDINI Yes, I think from memory there was like a bigger room with – I mean, it’s hard to remember back but my memory is that there was a kind of big bare room that kids could go to. I think there was a teacher there then. I think the teachers were struggling to try to find something meaningful to do with kids in that environment.

MS DEAN And when was this, because Woomera of course shut down?

MR JUREIDINI I think it was about May 2002. I think it was 2002 and not 2001. I’d have to check. It might be possible to check from the article.

MS DEAN Yes, exactly and also you went to Baxter. Can you describe what it was like to arrive at Baxter?

MR JUREIDINI Yes, well, Baxter was different. It was more security coming in, like airlocks and you know, on various visits you’d spend – I think we spent half an hour in the airlock one day while they waited to respond to our call. Because it was kind of purpose built or rebuilt, the security systems were in a way less obvious to the outsider coming in but it was a lot of it was based around video and security cameras and stuff.

The compounds were – whereas in Woomera people had relatively free movement through the whole centre, Baxter was designed so that compounds were very isolated and you needed to go through a number of airlocks to get from one compound to another and there was no walking. Everybody had to be transported by – that subsequent changed but everybody had to be transported by buses, so there was no capacity for people to interact except within their compound.

Each compound was organized so that there were little – the cells were a bit bigger. They were two-and-a-half metre cubes rather than two-metre cubes. They had ensuite bathrooms but there were no cooking facilities and there were no windows. They all opened doors that opened into the middle of the compound so if you wanted any ventilation I mean, they were air-conditioned but if you wanted air to come in you had to open your door into a public area and there was grass in the middle, so that was nicer.

I must admit my first impression when I went to Baxter was, well, this I better than Woomera but the, Bobby Sawyer, the social worker from Country CAMHS who came with me that day said, what are you saying, what are you thinking, this place is worse, and she was right. It took me a while to cotton on to it that it was worse, and most of the detainees that I spoke who’d come from Curtin and Woomera said, you know, this is worse.

You could see sky but you couldn’t see out. In some of the compounds, depending on which way they faced, if you went – it was like a closed C – if you went to the little gap in the middle of the closed C, you could look out to the desert and but you were looking through at least five fences to look out. It was hard to look out without looking at all the fences between you and the outside world and I think people found that enormously oppressive.

It was the kind of place that if you went to it as a clearing house, you know, you could cope with it. Families would survive in there knowing that they were going to be there for weeks or maybe a couple of months at the most, not that I would advocate that but it was comfortable enough in terms, of immediate physical comfort, you could get through that but once you were there for any length of time.

Because of the culture that existed in the place, because they kind of imported the culture from Curtin and Woomera, the culture of hopelessness that so many people had been released and these were the kind of people, you know, who identified themselves as the dregs who had not been thought fit to get visas when people who seemed to be in identical circumstances had been given visas. So that sense of hopelessness was pervasive.

I know the government has focused a lot on the fact that what’s been damaging for these people is their uncertainty, not the actually environment in which we’ve placed them and so you can’t blame the environment. I think that’s wrong but the uncertainty and the – well, not so much the uncertainty as the way in which they were dealt with by the system, the slowness of it, the obstructiveness of it, the bureaucratic cruelty was worse than I think the – I don’t know how much violence there was done by guards on detainees. Certainly some, and there was some horrible people in there.

There was one guy who was in charge of security one of the last times that I went to Baxter, a guy called Darren Franklin who was you know, a great big – I felt very intimidated by him and I don’t usually get intimidated by people. So there were people like that who you felt might be physically cruel but I think most of the cruelty that happened was much more subtle emotional cruelty that related to just obstructiveness really.

The individual examples of it don’t sound too bad. So when you describe somebody wanting to go to the doctor and being told, you have to put it in writing and you haven’t filled in the right form and so it would drag out over several days before they actually got to see a nurse or something.

MS DEAN The systemic abuse does sound shocking. We’ll talk about that a little bit more in a minute but I wanted to talk to you about whether or not you had to through clearances. You talked about earlier how you would be kept in airlocks for half an hour to wait through. I assume you had made appointments that the (indistinct) knew you were coming. Did you have to come with all the paraphernalia like key cards, passports, drivers license, to get a clearance?

MR JUREIDINI That was incredibly inconsistent. The worst experience we had was – I wasn’t involved in this but two of our staff went to Woomera and somebody hadn’t filled out the right form. So the two staff sat in the Woomera Hospital all day and the four or five families that they had appointments with sat in the detention centre all day and then they flew back at the end of the day and nobody could unstick the situation so that they could see at least some of the people they’d come up to see.

But you know, there was inconsistent – sometimes I was allowed to take a mobile phone in, other times I wasn’t and sometimes there were very high demands of security and other times you could’ve smuggled in a gun I think and nobody would’ve known about it. But there was always a sense that – you know, I mean, it’s hard to judge because it’s kind of an adversarial situation and maybe people’s motivation weren’t nasty but it always felt like if people could exercise some power over you and keep the doctor waiting then that was going to be you know, kind of nice to do that.

MS DEAN What were the procedures involved in gaining access to asylum seekers in detention for you as a professional?

MR JUREIDINI I was personally protected from that because we as a service the Women’s and Children’s Hospital were providing through our Country CAMHS team, services to immigration detention, the manager of Country CAMHS was doing all of the organising. I would just kind of swan in and swan out from that point of view but I know there were enormous demands on her to fill out the forms in time.

It would go to ACM and she’d be told – you know, we had visits cancelled because it had gone to the wrong person and nobody in the service would either tell her that it had gone to the wrong person or forward it on to the right person. So you’d find out on the last day that – I mean, I think it would be really good for you to talk to Monica Mackavoy and or Bobby Sawyer who were the two people who were in that position and they both did a lot of work with detainees as well, if you get an opportunity to do that.

MS DEAN I guess this is a similar question but was the contact with detainees once established easy to maintain or did you have to continuously or your country associates continuously go through the procedure again and again?

MR JUREIDINI Yes, again it might go smoothly. I mean, at one stage we had a level of cooperation where we weren’t actually having to go in to the detention centres at all. The kids were coming – the family were being brought out to see us which was good for them obviously to have some time out but it was also meant that it was completely outside our control, so that they might not turn up and you know – just coming back into mind that you’d be told there was an outing. Somebody thought it was more important for them to go on the outing than to see you and so they didn’t come today.

MS DEAN Did they bother to let you know or was it ?

MR JUREIDINI No, you just, you’d be there. You’d be sitting in Port Augusta hospital and they’d say no, this one’s not coming. It was a combination of seeing them in the detention centres, seeing them at other sites and seeing them over telelinks and sometimes just by telephone calls. It was always a struggle. The easy would have always been to have given up. Several workers burnt out in the process.

Basically the way we organised it was that unless people really didn’t want to do it, everybody in our country team, which I think numbered about eight or 10, took on at least one case so that nobody had to have one or two cases. By the time people had worked with one or two cases they’d had it, they couldn’t do any more.

MS DEAN Was it the bureaucratic difficulties that were undermining the treatment and access plans, that were making it so difficult for clinicians?

MR JUREIDINI That was part of it but the impotence of trying to do anything. I mean, what can you do. The two things that we did that we thought were helpful, one was kind of bearing witness and having somebody sensible, ordinary person tell these detainees that their situation was terrible and that we were really sorry that this was being done to them and there was no possible justification for doing it, and the other was to give them some time out.

There were maybe three or four or five families who had very long relationships with workers from the country where they would be seen sometimes up to once a week, sometimes once a fortnight and they would come to the CAMHS office. And one family used to come and cook, they’d do a cooking thing together. There was nothing mental health about that but it kind of kept a lifeline for them, go and walk in the park or – and one day you’d have a guard come in and say no, you can’t do that.

MS DEAN Were guards always present in the interview?

MR JUREIDINI That varied. They could be incredibly intrusive or they could be really nice about it and just give us some distance. It was just completely unpredictable.

MS DEAN And similarly in a hospital too where it was more private rather than going to detention, was there a guard present or ?

MR JUREIDINI There were always guards present. They weren’t necessary. I never tolerated them being in the room but sometimes you had to be quite assertive to get them out of the room.

MS DEAN Of course this would’ve limited the detainee’s capacity to speak about some of their issues if privacy was an issue?

MR JUREIDINI Yes, and so did having an interpreter as well. I always worked with an interpreter but some of the CAMHS workers worked without interpreters because they figured that just having an intimate time with somebody was better than being able to really understand what each of them were saying.

MS DEAN And what was the nervousness about the translators or interpreters, were they government ?

MR JUREIDINI Yes, they were ACM employees initially when we were working at Woomera and I think probably some of the time at Baxter, yes, some of the time at Baxter as well, and then we started to take our own interpreter and I still don’t know – I don’t think you could get him to talk to you. But the burden – this was one particular Iranian interpreter, the burden he carried was enormous really.

MS DEAN And what sort of room or where did you conduct your assessments or treatments at Baxter?

MR JUREIDINI In the immigration – there was an office that was the immigration territory. There’s kind of a demarcation between immigration territory and ACM or GSL territory. It’s a kind of big – like a central corridor with maybe a dozen rooms off to the side that had very noisy air conditioners in them and very formally set up with a desk, very sparse, so it wasn’t a very conducive environment to interview anybody.

MS DEAN Not very friendly?

MR JUREIDINI No.

MS DEAN So most of your assessments were face to face or (indistinct) capacity?

MR JUREIDINI Most of my family – like my involvement is really in two phases. The first phase was when all the kids and families were in detention and the second phase was after they’d gone and doing mainly stuff that Claire O’Conner and other lawyers asked me to do with single men. So most of the family stuff was face to face. Most of the single men stuff was over tele health links.

MS DEAN Can you generalise about where most of the refugees or asylum seekers detained were from?

MR JUREIDINI Iran probably the most. I couldn’t say with complete certainty but I think I saw more from Iran than anywhere else amongst the families. But Iraqis, Afghanis. I’ve seen a couple of other nationalities, Indian, Pakistani, but most of them were from those three countries.

MS DEAN Okay. You have just mentioned your visiting single men and children. Were there any – again because of confidentiality we can’t mention people by names, but the sort of general presentations that were occurring in the treatments and assessments?

MR JUREIDINI Yes, there were patterns. I mean, I think – do you want me to ?

MS DEAN Yes, please could you describe some?

MR JUREIDINI Let’s talk about the parents first. The parents were – I guess when we first started to go to Woomera, most of the families that we saw had been there for well over a year, maybe the medium would’ve been 18 months or something like that and most of the parents had had it basically. They weren’t able to provide ordinary parenting to their children so there was a lot of guilt about that.

One mother who was hospitalised in the Woomera hospital said, take me back and lock me up for the rest of my life but get my children out of there. One mother said to her daughter, you don’t have a mother anymore, try and be a good girl and live without me, kind of thing.

A father – this is later on the piece – a father said to the welfare service, had three children by that stage, I want you to take these children away from me and place them in a European non-Muslim foster family in the community and I never want to see them again. And our supposition was that his plan was to kill himself and his wife because he thought if they were orphans in Australia they’d get properly cared for.

And then the children would be witness to their parents behaving self destructively. One boy, a single child, I think he was 10 or 11 at the time, father had been very, very psychotic and essentially – that was relatively early in their time at Woomera. I think he became psychotic within the first year or so, a very high-functioning man prior to that.

He recovered from his psychosis after a while but basically was mute and completely unavailable to the family after that for years in detention and he was getting no care at all. He was at this stage in his illness prone to doing bizarre things like taking off his clothes and the mother was suicidal at that stage. The kid was trying to stay awake at night so that nothing terrible happened to his parents, and he was drinking coffee to stay awake at night to kind of keep an eye on them.

So that’s the kind of profile of parents we’ve seen. A young couple who were living in one of these dongers that I described and other detainees were complaining about the noise that their baby was making, so they put Elastoplast over the child’s mouth to keep it quiet. So the quality of parenting was terrible and we had no reason to believe that any of these people had any problems with their parenting prior to coming into detention centre. This was something that had been done to them by the detention experience and was being done to their children.

The babies were – it was hard to tell how well the babies were surviving there. The one who had Elastoplast over her mouth was obviously quite disturbed. She would cry for comfort a lot and her mother couldn’t comfort her and she’d go to strangers, which was unusual for a child of that age and be a bit comforted by them. So there was that level of disturbance.

Some of the kids just showed more of a pattern of deprivation. They seemed healthy enough on you know, limited assessment but they were very deprived and subsequently actually we followed up some of those kids after they been released from detention, they didn’t do very well. Even the ones who seemed to have the good outcomes.

The older kids, lot of aggression, lot of violence. One little kid who when given toys would tear them up and chew them and stuff and was a four-year-old, quite unusual behaviour and was very sexually aggressive towards people and swearing in English and his parents didn’t speak English, so presumably can only get that from the guards.

Actually that kid ultimately was, just prior to the family’s release from detention, was sent to kindergarten. They decided they’d let the kids go out to school and kindy and the kindy teacher had understandably quite a bit of difficulty managing this – he was basically feral, this child, wild. And she described him as being a very poor ambassador for his people which I thought showed a fairly poor appreciation of child development.

MS DEAN Yes, and a lack of understanding it’s systemic. What you’re describing is in your article talks about this (indistinct) is really systemic environmental abuse, isn’t it, you disrupt the structure of family and get completely different patterns of development. I’m jumping ahead a bit so we’ll go back to what you’re talking about but I’m how many of these children in your experience managed to find some so-called normal development over years with ongoing treatment, do they get ongoing treatment once they’re outside of detention?

MR JUREIDINI Yes, some of them seem to be doing quite well but it’s hard to tell really. The effects of this might declare themselves later on. I think it would be really important to follow them up but trying to get, trying to do that both practically and ethically is very difficult.

Some of the families have made it quite clear that they never want to have any contact with mental health services again. Not because they feel that that’s been a bad experience but just that they want to put that whole part of their life behind them and I think in some cases that’s been quite a bad judgement for them to make. But you know, I don’t think we’ll ever know what the long term outcome of it is.

MS DEAN Are there any free services for detainees provided by governments or State Government, Federal?

MR JUREIDINI Yes, all of the services that were provided by our service were free and we provided follow up for anybody who wants it for free and there are other services around, mainly State Government services.

MS DEAN Going back to the child that you were describing who was drinking coffee to stay awake to look after his parents, what sort of ongoing impact has it had on a child to try and look after a parent in that way?

MR JUREIDINI Just about every family that had a long time in detention you could write a book about. You certainly write a book about that family. Some of the detainees became very difficult people over and above their kind of mental health symptoms. It damaged them in a way that made them very hard to deal with and hard to help.

I don’t know how that boy’s doing now but he put a lot of barriers in the way to people trying to help him and you could see where he was coming from. He’d had adults hurt him and hurt his family for a long time and he had to become hard to try to protect himself and his family and that hardness didn’t serve him well in the time after he got out of detention. It drove people away and made it hard for the school to engage with him and so on and I don’t know how he’s doing now, but you know if he’s not doing well then I think that would be partly because of the way in which he was damaged.

MS DEAN Can you tell me specifically some of the mental health issues that children were suffering from like post-traumatic stress?

MR JUREIDINI Yes. I’m not a big fan of those kinds of psychiatric diagnosis but you know, I guess they have a purpose and as a king of shorthand, and every kid we saw had attracted psychiatric diagnosis of that kind of depression, post-traumatic stress disorder, anxiety disorder. Really what that meant was that they were hurting and they were functioning poorly and I don’t think it’s a hell of a lot more scientific than that really.

These kids were very badly damaged from a point of view from their psychological functioning and they were very distressed and what that grows up in to, for some of them it will be scars that heal and make them stronger I hope, but for many of them they’ll be vulnerabilities and sources of continuing distress and dysfunction.

MS DEAN Can you describe your professional relationship with these families in detention and children. Is it the same as what you would be dealing with every day in your practice?

MR JUREIDINI No, because – I mean, the first interview I did with a young man who was then maybe 14 or so but who was functioning more or less as an adult in the society of detention, in that he was involved in escapes and protests and climbing on the roof and all that kind of stuff.

We talked for a while and he was – especially from the beginning and after 10 or 15 minutes he’s like, what’s the point of this, what can you possibly do for me, and what’s this got to with psychiatry, and I said you’re absolutely right, it’s got nothing to do with psychiatry really. You’re being hurt by these circumstances. What can I do for you as a psychiatrist, nothing. But it was clear that something had to be done and some kind of advocacy was demanded really.

You had to keep saying until somebody would listen, you can’t keep doing this to children and fortunately, there were people who were already saying that and it was just a matter of joining with those existing voices to try to get somebody to listen, but that was the point really from the beginning. We knew that we couldn’t do anything like – you know, people try things, they gave drugs. Giving drugs was really just taking the edge off people’s pain and you could see that as a compassionate thing to do or you could see it as dampening down protest and while it might make that individual feel better, was it kind of colluding with the corrupt system to shut up protest and I felt very uncomfortable about prescribing any medication for that reason.

You could listen to people’s stories. You could try to do therapy. You could go back in and we did. We did all of that, we tried it. We tried to work with the staff in there. We tried to set up meetings as a kind of consultation liaison model that you’d use in a hospital where you’ve got kids who’ve got cystic fibrosis and you work with the nurses and doctors who are caring for their cystic fibrosis to try to develop a team approach to try and do what’s best for people and you try to do that with the nurses and so on who are in there.

But they were either institutionalised into the system and you know, there were quite nasty people working in the health service from time to time who would undermine what we were trying to do. We’d feel quite threatened. Presumably they thought that we were critical of their role as health care workers and indeed we were, not hopefully critical of them as individuals but critical of that role to say that my view was if you’re a nurse, don’t go and work in Baxter because you colluding with the system. You can’t work independently there and try and do good for people. The system is bigger than you are.

MS DEAN Did your management and treatment plans that you ever attempted to implement be implemented?

MR JUREIDINI Not with any consistency. We couldn’t rely on it being implemented. So that was another problem.

MS DEAN Certainly not psychiatry.

MR JUREIDINI Yes, but in a sense that didn’t really make a hell of a lot of difference because the treatment plans that we were trying to implement were pretty pathetic in the sense that this was what was hurting people. The place was driving people mad. We were trying to take the edge off that to some extent but we were never going to be able to do very much about it.

MS DEAN You talked earlier too about prescribing drugs. Was there a lot of prescription drugs being handed out in detention?

MR JUREIDINI Yes, we tried to find out – we tried to get an audit of what drugs people were on. We never met anybody who wasn’t on drugs of some sort. We could never find out how much but our impression was that they were being over-prescribed. You put doctors into situations where they can’t do anything, they’ll usually reach for the prescription pad.

A lot of the mental health stuff was being done by GPs and in Woomera days there was actually a GP providing a service to the detention centre or a number of GPs who were there, you know, not full-time but who got to the detention centre environment and had some capacity to try and do something about what was happening there.

I think Simon Lockwood at Woomera did achieve some ends in terms of making some changes. I think he was involved in getting the unaccompanied minors out of Woomera. But by the time it went to Baxter they had learnt that they needed to keep the medical voice as quiet as they could, I think [A portion of this interview has been removed for legal reasons].

MS DEAN Did you ever to know what medical treatment plans are already available. Was there any kind of conversation between the GPs that were employed by ACM and yourselves?

MR JUREIDINI No. We approached the general practices and said we’d like to work with you, but we never heard back from them. We sometimes got to look at the case notes in the health service and we’d see the psychiatrist’s notes. They began to contract with outside psychiatrists to provide – initially they contracted with the state psychiatric service in adults.

So we were doing the child and adolescent and stuff and the adult psychiatric services were doing the adult stuff, and then they decided to contract their own independent psychiatrists to do it. The psychiatrists were of variable quality and took varying stances in relation to the work they were doing. Some of them protested quite strongly. Others just kept quiet and took the money and

MS DEAN Did you have to sign contracts in what you would say to media or anything?

MR JUREIDINI No.

MS DEAN No, so that was more something perhaps the medical GPs might have done?

MR JUREIDINI  Yes. When I initially asked for permission from the Women’s and Children’s Hospital to speak, I was approached by a television station to talk about the work there and I checked, which in retrospect I wish I hadn’t because they told me I couldn’t do it. But then I began to do media work by saying that I was speaking on behalf of Justice For Refugees rather than my workplace and then gradually I just stopped doing that and started just to identifying myself according to my workplace and nobody ever objected about it.

In fact, the Board of the Women’s and Children’s Hospital as it then was, were very supportive and the hospital executive kind of just turned a blind eye to what I was doing so I was never under any pressure to keep quiet.

MS DEAN Did you find that in Woomera or Baxter that any changes were made at your request for individuals that you were working with?

MR JUREIDINI Little things. I can’t recall anything off hand but no, it was very difficult to get any changes made. You know, the changes we were asking for were quite major. We were saying this child can’t be treated in detention. There was a clear proviso within the Immigration Act or whatever covered the detention centres which said that anybody with a medical condition that couldn’t be treated within a detention environment needed to be removed from the detention environment.

Every kid we saw fit those criteria and we said that but it was never acted on. No single recommendation by us was ever – of those at that level was acted on. Sometimes the little things that we suggested like, while you are waiting could you do X, Y and Z, sometimes that was acted on.

MS DEAN What were the sort of things again that you mentioned earlier, but go into a bit more detail, that children were witnessing within their families and just within the detention centre itself.

MR JUREIDINI Suicide attempts. The violence of the riots that people saw on television. In those riots we have heard stories about children being separated from their parents for days at a time. Most kids had witnessed their parents to do some kind of suicidal activity. Things like protests that didn’t get seen by the outside world. It was quite common for detainees to cut themselves and write in blood on the walls. At one stage men were burying themselves. There was the lip sewing that was going on, some of the kids were involved in that.

We saw self-cutting in kids. It’s not rare to see adolescents cut themselves. It is rare to see primary school age kids cutting themselves and they were doing that. They were seeing terrible things and seeing their parents manifestly unable to cope.

MS DEAN What was happening when the parents, either a mother or father or both were being placed in hospital to the children. Were they being looked after appropriately back at detention or ?

MR JUREIDINI  There was a family there, a single parent family, the mother was in hospital. The youngest child – there was quite an age difference between the children, just guessing but maybe the younger child at this stage was three or four and the older one was 12. So the older child, the boy was looking after his little brother, and he was abused during that time and the intervention was to tell the kid to keep away from the people that abused him like that was the protective intervention.

One family where there was a girl of maybe 11 who had five brothers under five, five and under and she was the primary care giver for the kids. Neither of the parents was capable of caring for them. She tried to kill herself by drinking shampoo. That was how I met her.

These kids seemed at the time to be surviving just by a kind of a litter mentality, that they were kind of getting their attachment needs met from each other to a certain extent, although that was a family in which at least two of those little boys proved to be quite disturbed by the time they got out of detention.

That little girl, when the mother and six children were released from detention, next thing the mother’s got a new baby which the girl has to look after and then she has got her own baby, so she – her age which the family was telling us was 12 or 13, suddenly went up to 16 or 17. She’s got a baby. She goes straight from caring and spending her childhood caring for her little brothers to having a baby of her own to care for. What’s her future going to be like and that child’s future going to be like?

MS DEAN (Indistinct) isn’t it. You mentioned earlier and we’ll go back to it, the sort of experience as a clinician that you had, was it. How did you feel about seeing refugees in detention centres. I guess what I am asking is in the article you talked about the clinician’s experience of being despairing and so on.

MR JUREIDINI  Because I had a voice, it was easier for me than my colleagues who were quietly going about their business of trying to help these people, and they didn’t feel confident enough or safe enough to be able to speak out about it. I think being able to speak out was really important for my kind of coping with what I was seeing and doing and the family support and that kind of stuff.

MS DEAN  Does the debriefer get a debrief?

MR JUREIDINI  Yes, just telling the stories really. You’d see people change when you told them the story, like people couldn’t believe how bad it really was, like I hadn’t been able to before I went there. I knew it was bad but it was bad that you could put over here rather than being bad, that you had to do something about.

MS DEAN Where are most of the refugees and families of children that you have seen in detention now?

MR JUREIDINI They are mostly in the community, although, some, I think – I don’t know, I couldn’t tell you with certainty but I think most of them are on permanent protection visas now. Some of them are still on TPVs.

MS DEAN Are you seeing any more in an ongoing way?

MR JUREIDINI Any new ones you mean?

MS DEAN Or any of the people that you were seeing while in detention?

MR JUREIDINI Yes, I still have some contact with three or four families, I guess.

MS DEAN One of the things we didn’t talk about was how often you were seeing families while they were in detention.

MR JUREIDINI I don’t think I was ever going up there more than once a month. But one family who were in detention in Glenside Hospital for six months, I saw three or four times a week during that six months and then once they were released I kept seeing them two or three times a week for a couple of years, so in at least that one case the contact that was very intensive.

MS DEAN Were you ever asked to do things that were out of the ordinary in considering a professional relationship?

MR JUREIDINI By detainees, you mean?

MS DEAN Yes. I guess I am thinking of perhaps making contacts with legal, sort of finding out how to do paper work, form filling or anything.

MR JUREIDINI Yes, I was asked for advice and help on those kinds of issues, but I wouldn’t necessarily see that as out of the ordinary. I might have a kid with cystic fibrosis who, you know, I turn out to be the right person for him to ask for help about getting a Centrelink allowance or something like that, so it wasn’t outside of what I would normally do.

Sometimes when we have trainees coming to working in consultation liaison psychiatry they say, what you are talking about is social work, it’s not psychiatry and I say, well, maybe but you actually have to be fairly sophisticated to be able to, you know, they’re commons sense things, they’re helping people through common sense situations.

There wasn’t much common sense about detention but – you know, like they are ordinary things but you have to have a level of sophistication in order to be able to keep your head in the face of all of the, you know, the shit that’s going on around to be able to, so I’d see it as kind of legitimate psychiatric intervention to be able to help somebody through something that – you know, it’s not about prescribing drugs or doing therapy.

MS DEAN Your abiding thought about the effect of dealing with bureaucratic and systemic kind of – I was going to say violence but that’s kind of, to give you and answer of the system itself or a (indistinct) of Immigration or detention.

MR JUREIDINI The effect on me or ?

MS DEAN The effect on you first and then just perhaps the impact if you can sum it up on detainees.

MR JUREIDINI That was what hurt the detainees the most, I think, was what put them in the situation where they did the things that hurt themselves, was just the frustration with the system and the fact that, you know there was no decency to the way they were treated, no common compassion, courtesy, respect, those kinds of things and I suppose that kind of fit my view of the way in which bureaucracy can be.

I just feel really angry that that’s what’s allowed to happen, and that is clearly an unequivocally the Prime Minister’s and the two Ministers for Immigration’s responsibility. They knew all about it. They were told over and over again what was happening and they chose to do nothing about it.

MS DEAN Have you seen over the time you have worked with refugees or detainees any policy and structural changes that has made you work any easier?

MR JUREIDINI Not policy changes. Obviously getting kids out of detention was a good thing but it wasn’t done in any way that took any responsibility and involved a change in policy. It just was – they were kind of sneaked out through the back door really. So I don’t think any policy change has made a significant difference because I don’t think there has been a significant policy change. There’s been boasts about changes but I don’t think anything’s changed.

MS DEAN Did the housing that was well guarded make it any easier for some of the people you were visiting?

MR JUREIDINI Trivial difference really because the disadvantages balance the advantages. Men couldn’t be there so you had to break up your family in order to go to residential housing and it was detention. It was all surrounded by wire and everything and sure you’ve got your own space but you didn’t even have a house, a family didn’t even have a house to themselves. It’d be two or three families in a three bedroom trust house.

They could cook for themselves, that was good, and a lot of the things that they were allowed to do had nothing to do with being in a residential housing program. They just chose to take those people out shopping. They could’ve taken the people from Baxter out shopping.

It wasn’t anything about being in residential housing that was any better and the other thing was that – the thing for me though, you know, when I went there and had a look at it and tried to see whether it was going to be any better, the fact was that a guard could walk into any bit of the house, any time of the day or night. So you didn’t really have your own space. If a guard decided that they were going to come into your bedroom at three o’clock in the morning they were perfectly at liberty to do that or into your toilet or whatever.

MS DEAN Which seems extraordinary given, I imagine, the sort of religious background of many people with the gender separations and things like that. Did anyone speak about that with you at all?

MR JUREIDINI I don’t know whether they spoke to me about it but certainly I’ve heard people talk about that.

MS DEAN And finally, Jon, we’ve moved through this quite quickly. Would you like to add anything about your experience that we haven’t covered or anything, any further comments?

MR JUREIDINI Well, you know, there’s a hundred stories that we could talk about. I think those stories need to be told. I think one thing that needs to be thought about is the impact of this on the people who worked in the detention centres and will continue to work in the detention centres. In the Palmer Inquiry, one of his conclusions was that there wasn’t too much nastiness. The people who were working in the detention environment were trying to do what was best for people in there and I think probably that’s true. As I’ve said, there was some cruel people but I don’t think most of them were.

So then you have to think, what’s the affect on those people of working being institutionalised into this. I don’t think many of them, their dream job was to work in Immigration detention. They drifted in there because probably the money’s pretty good and there’s not a hell of a lot of other opportunities in some of the places where the detention centres are.

I think they’re going to one day realise what a terrible thing they’ve been involved in and wonder what their part’s been in that and whether they should have ever done it and I think that’s going to be damaging to them. I think we’re going to see people who’ve been damaged by that experience.

And then I think there’s the effect on the community of having had this happen in our community and how do we come to terms with that and – I don’t know. Maybe the social situation is so bad that this is just not going to make any difference, we’re all so kind of motivated by fear and grief that we’re never going to face up to it but I’d like to think we can.

But if we do then that requires that the people who are in charge acknowledge it. If there’s going to be recovery as a community from it, then the people in charge will have to take responsibility. I find myself feeling less and less – I used to get a kind of feeling of righteous anger out of that and I just find myself you know, mouthing it now because I don’t actually believe that anything like that is remotely possible to happen.

I think the community, the most likely thing is that people just forget and any damage will be part of – absorbed into the kind of general damage that we’re doing to the community by the way that we’re organising our society and living as a society.

MS DEAN Do you believe you’ve got something to offer former detainees or detainees given the treatment in the system that you’ve talked about?

MR JUREIDINI Yes. I think I can still generate enough anger about what’s going on to protest. That first boy that I ever saw was a very angry young man and one day after I’d been seeing him on and off for maybe nine months or something, when I turned up to see him they said he’s better. Better was not angry anymore and he was quiet and withdrawn and had given up.

So protest is the appropriate – angry protest is the appropriate response to those kinds of things and I think I’m still mostly in that phase of my response to it but just listening to myself having spoken for the last few minutes I kind of wonder whether there’s a part of me that has given up about it.

But no, I think we can keep speaking out about it and it’s just a matter of time before circumstances change and the detention centres fill up again and the question is whether we’ve all got the energy to go another round. Hopefully there will be a new generation of lawyers and mental health professionals and so on prepared to take up the fight. Lawyers have been incredibly important in this process. I think it’s been amazing. The changes wouldn’t have happened if it hadn’t been for the role of lawyers.

MS DEAN Just in conclusion, you were co-author of an article. I wonder if you could mention for the (indistinct) so, that anybody who’s listening to this in the future could go and look for themselves?

MR JUREIDINI Yes, Sarah Mares who was a child psychiatrist in Sydney and I wrote up the experience of the first ten families that we had referred to us from Woomera, just to try and document the level of psychiatric disturbance that we saw. They were all psychiatrically disturbed, many of the kids that we saw.

If they were old enough to be assessed and the parents – and there’s no reason to believe that wasn’t a reasonably representative sample of the kids and families that were in Woomera and Baxter because we got all of these referrals within – most of them within one six-week period. Just because there was a psychologist working in Woomera who was prepared to stand up and say how terrible it was and refer and so – after she left we never got any more referrals, and in fact they retracted some of the ones that had been made.

MS DEAN And that general article is in the Australian and New Zealand Journal of Public Health Volume 28 number 6 in 2004. Thanks Jon for taking the time to speak with us today.

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Posted in Advocate, Baxter, Child Psychiatrist