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The Rau scandal.

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Wednesday 23 February 2005

Louise Newman, NSW Institute of Psychiatry


The Rau Scandal  


The tragic case of Cornelia Rau has triggered a resurgence of concern about both the treatment of the mentally ill and the treatment of asylum seekers in immigration detention. Both are vulnerable groups and both experience misunderstanding, stigma maltreatment and human rights abuses. Their fate tells us much about our community’s capacity to deny the obvious suffering of others and also about Governments callous disregard for individual rights in the face of perceived political benefit. 


As a person experiencing schizophrenia, Cornelia Rau appears to have had a delusion that she was someone else - in this case a so-called illegal immigrant of some sort. This was taken at face value, and she found herself in a system far harsher than the psychiatric hospital and one where she continued to be seen as guilty in some way and held first in prison and then in Baxter Detention Centre. Her illness was unrecognized, she had no appropriate treatment and her disturbed behaviour was interpreted by the untrained guards as purposeful and disruptive. She then found herself in the now notorious “Red One” behavioural management unit and periods of virtual solitary confinement. It is hard to imagine the impact of this experience on someone already experiencing delusions and paranoia. 


Many details of this sequence of events remain unknown but there are some fundamental questions to be asked about the failure of several systems of case to recognize and treat severe mental illness. 


As a psychiatrist, I visited Baxter detention centre in late December 2004 and assessed several long-term detainees on request of their lawyers. I was told about Cornelia Rau’s disturbing condition and the detainees had correctly diagnosed her condition. I assessed a man, also in the Red One Unit, who was suffering a psychotic disorder and needed an immediate transfer to hospital. He was similarly undiagnosed and receiving no treatment. 


What are we to make of these cases? Whilst the community has maybe responded with alarm as we have an example of an Australian resident being poorly treated, it is clear that others are subjected to a regime that can only be seen as punitive, despite Government statements to the contrary. We as Australian’s do not like to see ourselves as condoning arbitrary punishments yet it has taken a shocking example to make us relook at the detention system. The system of behavioural management and solitary confinement currently under scrutiny is one that clearly violates international human rights conventions and is not sanctioned for the treatment of detainees or prisoners of war - yet it happens here.  


The Australian government is clearly made uncomfortable by community concerns. We have heard statements that “Red One” is an appropriately supervised treatment programme and that psychological experts are available at all times - which begs the questions as to how Cornelia Rau and others have been kept for so long and not been recognised as unwell. The Government has engaged in a dispute with researchers who have found high rates of mental disorders amongst detainees, and that the experience of prolonged detention itself is a significant causal factor. Our research group has argued that the policy of mandatory detention itself needs rethinking. It is not surprising that human beings cannot tolerate indefinite periods of isolation, uncertainty and harsh treatment. What is surprising is that Government appear to want to disguise and minimise the degree of human suffering and even more perversely to argue that it is irrelevant. 


The detention centres operate as closed and total institutions according to an internally defined logic and penal model. In this Kafkaesque environment, the innocent are guilty of unspecified crimes, madness equals badness, and any questioning of the system is intolerable. Inmates have few avenues of protest and extremes of behaviour emerge as a last resort. Death becomes for some the only possibility of escape, as for a young man I spoke to who dug his own grave in the dessert sand and attempted to bury himself.  


Something is fundamentally rotten in this system. Only a truly independent judicial review has any hope of unravelling the truth and degree of dysfunction. Only legislative reform and dismantling of indefinite mandatory detention will prevent further abuses. It is time for all those in detention with mental illness to be released into psychiatric care and for an end to inhumane treatment.  


Guests on this program:

Dr Louise Newman  


NSW Institute of Psychiatry