Administrative Detention Undermines the Right to Health

The recent evidence brief published by the World Health Organization (WHO) systematically analyzes the available scientific evidence on the effects of administrative detention on the health of migrants, highlighting how this measure represents a negative structural determinant for physical and mental health. The document also aims to guide public policy and administrative practice. The evidence brief situates these centers within the framework of international human rights law, reaffirming that they should be used only as a last resort, in compliance with the principles of legality, necessity, and proportionality, and based on an individual assessment of each case. However, the WHO notes that, in practice, administrative detention is increasingly used on a large scale and for prolonged — sometimes indefinite — periods, in contrast with international standards that specifically prohibit arbitrary detention.

The document’s starting point is the assertion that migrants’ health is a fundamental human right, belonging to all people regardless of their legal status. Yet despite the legal limits described above, administrative detention is increasingly used worldwide in an extensive and prolonged manner. The brief closely examines the health consequences of detention, highlighting the material and social conditions typical of detention centers: overcrowding, poor hygiene, inadequate nutrition, isolation, lack of activities, and uncertainty about the duration of detention and one’s own future all constitute negative structural determinants of health. The evidence gathered shows a significant increase in infectious diseases linked to the detention environment, a worsening of pre-existing chronic conditions, and, above all, a very high prevalence of mental health disorders such as anxiety, depression, and post-traumatic stress disorder. A key finding is that the longer detention lasts, the worse its effects on health become, and that these effects often persist even after release.

Groups considered particularly vulnerable — such as women, survivors of torture or trafficking, LGBTQ+ people, and, very markedly, minors — are central to the report. Women in detention report higher levels of poor physical and mental health than men, with a significant incidence of depression, anxiety, and stress disorders. Pregnant women or those in poor health face additional risks, worsened by a lack of adequate healthcare services, absence of privacy and medical confidentiality, and insufficient access to specialist care such as obstetric assistance. The brief also highlights the risk of exposure to physical and sexual violence and to forms of intimidation by other detainees and staff, with a higher risk for women in detention. It further stresses the particular vulnerability of women who have experienced sexual violence or human trafficking, who are often not properly identified or assisted, resulting in self-harming behavior and other forms of serious psychological distress. The WHO also recalls the well-established position of United Nations bodies that detaining children for migration-related reasons is never in their best interests and constitutes a violation of their rights, even when it occurs together with their parents or for short periods. Detention of minors is associated with severe and lasting psychological, emotional, and developmental harm, and the WHO explicitly states that states should eliminate it entirely, adopting non-custodial alternatives for the whole family unit instead.

The report also addresses access to healthcare within detention centers, highlighting serious systemic problems. Care is often fragmented and inadequate, with shortages of medical staff and language interpreters. Health management is frequently outsourced to private providers, leading to problems of oversight, lack of continuity of care, and conflicts of interest, with the risk that profit-driven and cost-cutting logics prevail at the expense of services for migrants. Added to this are language barriers, distrust of staff, and fear of negative consequences for one’s immigration proceedings, all of which discourage detained people from seeking healthcare.

Furthermore, COVID-19 made the structural problems of detention even more evident: in many contexts the pandemic worsened overcrowding, isolation, and the use of prolonged detention, increasing health risks and psychological distress, while in some cases the use of alternatives to detention showed positive effects in reducing the risk of contagion.

In its conclusions, the WHO states that the body of available evidence shows that administrative detention has an intrinsically harmful impact on health, one that is difficult to mitigate even by improving material conditions. For this reason, the document reiterates that detention should be avoided as much as possible in migration proceedings and replaced with non-custodial alternatives, especially for those considered vulnerable. When detention is nonetheless used, states are obliged to guarantee high standards of health protection, dignified conditions, adequate health screening, and effective access to care, in accordance with the right to health and human dignity.

In light of the evidence gathered over time by international bodies, UN agencies, and independent monitoring mechanisms, it clearly emerges that administrative detention is a practice structurally incompatible with the protection of fundamental human rights. For years, and with growing insistence, calls have been made for the closure of CPRs (repatriation detention centers), pointing out that they function as veritable black holes shielded from effective oversight, characterized by opacity, systemic shortcomings, and recurring human rights violations. Every new report, including the WHO’s, confirms an already well-established picture: migrant detention centers function as zones of legal shadow, within which the right to health, dignity, personal liberty, and the protection of vulnerable individuals is systematically undermined. These are not isolated or occasional incidents; the violations found appear to be structural consequences of the detention-based approach itself. In this sense, the growing accumulation of scientific and legal evidence cannot support the idea that these centers might simply be reformed, but instead inevitably reinforces the need to move definitively beyond the paradigm of detention.