Self-Mutilations and Hunger Strikes: The Mental Health Crisis Inside French Migrant Detention Centres

On a Saturday afternoon, three kilometres away from Charles de Gaulle airport at the edge of Paris, a self-service phone rings in one of the telephone booths at the Mesnil-Amelot migrant detention centre.

A man picks up the phone and, in a monotone voice, introduces himself.  “Hello, I’m Khalid*, a detainee here,” he says in a perfect French accent.

Once he learns I’m a journalist, other detainees crowd around the receiver and start shouting.

“We’re kept like animals here,” Khalid yells.

“At this point, animals have more rights than us,” shouts Moussa, another detainee in the background.

“We’re desperate,” cries Nicolae when the phone is passed on to him.

When things start to quieten down, Khalid gets back the receiver. “I’ll answer any questions you have,” he tells me, “we all will.”

A black wrought-iron gate marks the entrance to the centre where the detainees are speaking from. The compound is surrounded by green fences topped with barbed wired, marking out a small courtyard. On top of tall metal pillars, bundles of CCTV cameras watch over the communal spaces from multiple angles.

The conditions in the centre have grave implications for the mental health of detainees – and, in the absence of regular psychiatrists, things are getting worse every day.

La Cimade, which operates on the premises of the Mesnil-Amelot detention centre, is the biggest association in France that provides legal and political support to migrants.

“The situation of confinement has an impact on the psychological health of the people that goes beyond the period of detention,” says Louise Lecaudey, a legal advisor for La Cimade who works at Mesnil-Amelot.

Migrant detention centres like Mesnil-Amelot are places where foreigners subject to deportation can be legally kept pending their forced removal. Detention is decided by the local authority, then possibly extended by a judge, when the immediate departure of the foreigner from France is impossible. Detainees aren’t charged with a crime. Their detention only serves administrative purposes, and, as the law requires, should be applied only if authorities determine a risk of flight.

Although France has regulations in place that prevent the detention of vulnerable people, over 45,000 are detained each year in the 24 centres peppered around the country, many with pre-existing mental health issues.

Detention has a direct effect on the mental health of detainees, many of whom attempt suicide, self-mutilate or go on hunger strike during their time at the centre or even after.

France has one of Europe’s oldest – and largest – administrative migrant detention regimes. Since 1981, the year it adopted its first immigration detention law, the country has passed some 30 immigration laws. But there’s a European body of law – the Dublin Regulations – that currently governs, together with national laws, the conditions for asylum claims, administrative detention and immigration.

Last Wednesday, EU chief Ursula von der Leyen announced that the Commission will present new migration laws on the 23rd of September that will replace the existing Dublin Regulations. Established in 1990, and reformed twice since then, the Dublin Regulations determine, among other things, that the EU country in which migrants first arrive is responsible for examining their asylum claims.

The way they are now, EU migration laws often place migrants like Khalid, Moussa and Nicolae in detention, pending their deportation to the first country they made an asylum claim or to their native country, where many were persecuted or tortured. This way, the current EU migrations laws disproportionately place responsibility to provide asylum on countries like Italy and Greece, where most asylum seekers first enter Europe.

With stronger migration laws, the EU could change the experience of seeking asylum for hundreds of thousands of migrants like the ones detained at Mesnil-Amelot.

These much-awaited reforms came in the wake of a fire that destroyed a big migrant camp on the Greek island of Lesbos.

France retained – until recently – one of the lowest time limits on detention among EU member states: 45 days. But a 2018 law extended the period of detention to 90 days and decreased the time frame in which an applicant can claim asylum, from 120 to 90 days.

According to La Cimade’s Lecaudey, after the law that extended the period of detention to 90 days came into practice at the start of 2019, the impact on people's mental health has been apparent: increased stress related to the idea of spending three months in detention, an increased number of suicide attempts and acts of self-mutilation.

Mesnil-Amelot can hold up to 240 people at once and is comprised of two centres: one for men, and one for women, children and families. According to the most recent data, 2018 saw more than 2,800 people passing through the centre, with an average detention period of 18 days. Each building at Mesnil-Amelot is equipped to house 20 people, all of whom share two showers and four toilets. But, in reality, the number of detainees is far higher.

Camille Martel, a graduate student who has conducted research in partnership with La Cimade at Mesnil-Amelot, confessed that the sanitary facilities struck her the most.

Marie Scotto, who worked with Martel at the centre, recalls detainees telling her about a TV room they appropriated as a place for prayer. According to them, once the guards noticed, rows of benches were screwed to the ground, leaving no room for those who wanted to practice their religion.

Books are only provided in a few languages and need to be paid for. There are no facilities for sports and detainees are often left with nothing to do pending their deportation. The lack of activities and services, together with the absence of privacy and free space, puts increasing psychological strain on detainees.

“I don’t see the difference between this and a prison,” says Damien Carême, a French MEP who visited the centre.

On the 24th of June 2019, when the situation became dire, La Cimade and 21 other associations sent a letter to the Ministry of Interior. It noted that “psychiatric disorders cannot be treated in these places, which on the contrary, aggravate them”.

Less than two weeks later, two detainees attempted to commit suicide at the Mesnil-Amelot detention centre. Under treatment for psychiatric disorders, one of the men swallowed medication he had been hoarding for several days.

The other detainee, who was in the centre for almost three months, swallowed a nail clipper and 15 dominoes. Several months before, he had already tried to end his life by throwing himself in the Seine. A week after the two events, three men threatened to throw themselves off the roof of a building.

After these events, La Cimade chose to withdraw their workers from the centre for three weeks to protect their own mental health – the first time since their work began there in 1984. They eventually returned but withdrew again in December after they barely saved a detainee who tried to strangle himself in their office using the cable of a lamp. While such incidents were prevalent before the new migration law came into force, Lecaudey explains, their number increased significantly after. When the extension of the detention period was announced, the administration of Mesnil-Amelot decided to build an additional isolation room.

This room contains a thin yellow mattress spread on a concrete block, serving as a bed, just two steps away from a toilet sealed to the floor. The hollow cube of concrete has no natural light or view of the outside. It is used for the confinement of detainees who have seizures, panic attacks or become violent due to their psychological conditions.

In the cramped room, detainees have no contact with anyone for several days – including their families or lawyers. The practice is often used in the centre as “treatment” for detainees with severe psychological issues or for those who have attempted suicide.

The Contrôleur Général des Lieux de Privation de Liberté, an independent public body in charge of checking all the places where people are deprived of liberty, has deemed the isolation rooms to constitute inhumane and degrading treatment – a violation of international law.

While the use of such punitive measures is common at Mesnil-Amelot, the detention centre is one of the only ones in France that is required to provide, at least twice a week, psychiatric and psychological services for detainees.

But, according to Lecaudey, who works in the centre every day, weeks or even months can pass before anyone shows up. Without a psychiatrist on call, medicine can’t be distributed, and mental health disorders are often left untreated.

“In prison, where there were criminals, conditions were much better than in here,” says Moussa, one of the detainees, over the crackling phone. “There are no medical services, no psychologist, nothing, there’s nothing here. We have no rights.”

La Cimade employees often end up providing detainees with psychological services, in the absence of a qualified medic provided by the administration of the centre.

Because detainees arrive and leave the centre every day, a medical follow-up is near impossible. The medical staff do not have access to files that show the medical history of those monitored outside the centre. Because of this, the detention acts as a break in the monitoring of the mental health of detainees.

“I’m scared, we live in execrable conditions with people who have serious mental illnesses and psychological issues,” he explains, “they shouldn’t be here, none of us should.”

Christina Alexopoulos, a pro-bono psychologist who often visits detainees at Mesnil-Amelot, believes that the detention centre can traumatise people with no history of psychological disorders.

“If they aren’t traumatised, they become it,” Alexopoulos says. “The conditions there are that bad.”

“The people I saw there were in a state of absolute despair. The conditions are dehumanising, it’s no wonder they feel like animals,” she adds.

The psychologist explains how traumatising experiences, like torture or past instances of violence, are often rekindled by their detention. This often leads to detainees reproducing violence during their incarceration, creating an unsafe environment for everyone, according to her.

La Cimade and many other civil society movements and organisations have been calling for the abolition of detention centres, but French authorities have recently announced the construction of three new ones.

“This just shows our lack of respect for human rights. We are capable of building detention centres but not welcoming centres,” says MEP Carême, who works with immigration associations in France.

“It revolts me, it is truly pitiful,” he adds.

Nicolae left the detention centre one week after our initial conversation. His wife, who used the little resources they had to get legal counsel and get him out of the centre, confessed to me she’s never been happier to see him. “I know my experience doesn’t compare to his, but mentally, it was very hard for me too,” she said.

Not all are as lucky as Nicolae. While EU bureaucrats are nailing in the last details of the new pan-European migration law, many detainees still wait to hear if they’ll be put on flights back to countries some of them haven’t lived in for 15 years.

“I can only thank God I got out of there,” Nicolae said, “I hope no one has to experience what it means to be locked up in there.”

*Names have been changed to protect their idenity.