Villawood 12d - Failure of IHMS


The Failures of the Health Service

The day after his arrival at Villawood, Ahmed Al-Akabi was prescribed the antidepressant medication, Mirtazapine. He was given another prescription on 28 June. The following day he was reviewed without an interpreter and prescribed ongoing Mirtazapine 30mg for insomnia. On 3 August it was noted that the Mirtazapine had not assisted his insomnia and a subsequent referral noted that several months of Mirtazapine treatment had not been helpful. International Health and Medical Services continued to prescribe Mirtazapine. On 30 August Ahmed Al-Akabi was diagnosed with Adjustment Disorder with Anxiety/Depression. The expert report by Dr Suresh Sundram  notes that ‘Mirtazapine is an antidepressant with only an approved indication for the treatment of Major Depression. It is clear from the material provided that it was being used as a hypnotic and that its prescription at this time did not follow an assessment for Major Depression.’ The inquest reports of two other detention centre casualties, Hayder Sayed (Curtin IDC) and Meqdad Hussain (Scherger IDC), reveal that they were also prescribed Mirtazapine. Health care in all of these Australian detention centres is provided by IHMS.

In a forthcoming paper, academics Suvendrini Perera and Joseph Pugliese argue that the failures of care in offshore detention are neither aberrant or accidental, rather they are the result of the system working exactly as it is designed.

‘At work in Australia’s immigration policies and practices is the intertwining of militarism and punishment working hand-in-hand with the compromising of detainees’ healthcare by the drive to secure profits,’ they write.


‘The Commission is concerned about the high levels of prescription and use of psychotropic medications, including antipsychotics and antidepressants, for their sedative effect in order to manage the high levels of sleeplessness among people in detention…This would appear to be a poor pharmacological solution to an environmental problem…’

Australian Human Rights Commission, 2011

An artwork painted in Villawood IDC using coffee. A man is shown in silhouette, kneeling, face looking down to the ground. The sun shines in the centre of the painting, behind the figure.

[imagecaption] Alwy Fadhel, ‘Endurance’, coffee on paper.[/imagecaption]

‘Mr Al Akabi was probably misdiagnosed and medicated, his records were both lacking in detail and apparently not consulted. He in fact did make clear to officials that he was depressed and in a poor state both physically and mentally, and that he was extremely fearful and concerned about his family in Iraq and himself if he were to be returned. Very little action or assistance was offered to him. IHMS did not take adequate steps to make DIAC or Serco aware of his true level of risk.’

M. Jerram (State Coroner)




Please Read

Aboriginal and Torres Strait Islander viewers are respectfully advised that this website contains images of and references to deceased persons.

All viewers are respectfully advised that the site contains images of and references to the deaths in custody of Indigenous peoples, Black people and refugees that may cause distress.