Working with victims of torture in detention

Victims of torture are regularly found in places of detention

It is thought that over 30% of asylum seekers are victims of torture. Experiencing torture makes an individual more vulnerable in detention due to having a damaged ability to trust and perhaps increased mental health issues. Specific experiences in detention can also trigger powerful re-traumatising memories of the person’s torture experiences. This can lead to a revival of symptoms caused by the original torture, such as worsening flashbacks, nightmares, irritability or withdrawal. For some victims of torture trusting state officials (even those in a different country) can be difficult, this can be especially problematic for professionals trying to develop a strong therapeutic relationship, as the individual might not trust anyone in the detention setting.

Considering the specific vulnerabilities of victims of torture a group of experts set about creating quality standards for healthcare professionals working in this environment.

The healthcare professionals who work with victims of torture (HMVT) group

The HMVT working group was established by the Faculty of Forensic and Legal Medicine (FFLM) and is a collaboration of experts from the Helen Bamber Foundation, Freedom from Torture, Medical Justice, UK Association of Forensic Nurses, the Royal College of Psychiatrists, and the British Association for Sexual Health and HIV. The group recently combined their expertise to create the quality standards for the recognition and management, by all healthcare professionals, of the healthcare needs of victims of torture and ill treatment in all places of detention.

The Launch of the Quality Standards

These standards are guided by the following principles:

  • –    Detention is acknowledged to be harmful to the health of victims of torture
  • –    Healthcare professionals have an obligation to identify and report torture
  • –    Torture victims have a right to rehabilitation
  • –    Rehabilitation cannot be effectively undertaken whilst in detention

With the aim of:

  • –    Identifying, documenting and reporting victims of torture
  • –    Improving treatment of health conditions whilst in detention
  • –    Reducing the frequency of self-harm and suicide attempts
  • –    Improving quality of life whilst in detention
  • –    Helping healthcare professionals to maintain their ethical obligations to their patient if in conflict with the requirements of the detention authorities
  • –    Reducing vicarious traumatisation of healthcare professionals
  • –    Patients are given a positive experience of care


Twelve Quality Statements

1. Identification:  Detained victims of torture are identified so that torture can be reported and their healthcare needs can be met.
2. Ethical obligations: Healthcare professionals working with detained victims of torture understand their ethical obligations.
3. Consent and confidentiality: The principles of medical information management are maintained by healthcare professionals working with detained victims of torture.
4. Communication: Healthcare professionals ensure accurate communication is facilitated for detained victims of torture in all clinical assessments for those not fluent in the primary language of the area in which they are detained, or with other communication challenges.
5. Mental capacity:  Detained victims of torture whose autonomy may be compromised receive appropriate assessment.
6. Access to healthcare:  Pending release, detained victims of torture can access appropriate services or treatment equivalent to that available in the community.
7. Vicarious traumatisation:  Healthcare professionals working with detained victims of torture receive support to prevent vicarious traumatisation and burnout, and promote self-care.
8. Training:  Healthcare professionals who work with detained victims of torture have the required training and competence.
9. Assessment required by detention processes:  Victims of torture required to go through specific detention processes receive appropriate assessment of their vulnerability.
10. Children:  Healthcare professionals understand their responsibility to safeguard the wellbeing in detention of children and young people who are victims of torture.
11. Mental health:  Detained victims of torture receive appropriate assessment so that their mental healthcare needs can be met.
12. Sexual violence:  Detained victims of torture who have past experiences of sexual violence receive appropriate assessment so that their healthcare needs can be met.


These standards provide an important link between international guidelines and everyday clinical practice. It is important that healthcare professionals working in detention with victims of torture are supported and provided with training, evaluation and accreditation.

If you would like more details on the quality standards please click HERE.


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