CCPR/C/116/D/2233/2013 changes to the view of self, concentration and memory disturbances, persistent anxiety and high rates of depression and post-traumatic stress disorder.5 3.16 The impact of detention on the authors’ mental health is exacerbated by the physical conditions of the detention facilities, and evidenced by a large number of incidents of selfharm. For instance, the Department of Immigration and Citizenship reported 1,100 incidents of threatened or actual self-harm in 2010-2011. 3.17 The Australian Human Rights Commission has expressed concern, inter alia, about the extremely restrictive environment at Villawood Immigration Detention Centre, with the use of extensive high wire fencing and surveillance. Christmas Island Immigration Detention Centre was similarly described as prison-like. The Commission has also expressed concern about the possibly excessive use of force in detention facilities and about inadequate mental and physical health-care services. The Commission heard complaints about the distressing use of restraints, such as handcuffs, on detainees travelling to medical appointments from Villawood, where restraints were not removed when a detainee needed to use the toilet. Health-care centres were found to suffer from insufficient staffing, which had an impact on the quality and timeliness of health care. At Villawood, a high number of prescriptions were being issued for psychotropic medications, including antipsychotics and antidepressants given as sedatives for sleeplessness. Arrangements for preventing or responding to self-harm were also inadequate at Villawood. 3.18 Unrest, protests and violence by detainees is a symptom of the acute frustration and mental distress felt by many detainees. In April 2011, for instance, there were protests at Villawood, with some detainees occupying the roof of a building for many days. Remedies sought 3.19 With respect to the claims under article 9, the authors request that the State party acknowledge the violations of the Covenant, grant the authors immediate release, apologize to them and provide them with adequate compensation, including for the mental distress and psychological distress that they have suffered. The authors argue that where the State party believes it is necessary to continue to detain the authors, it should provide an individual assessment of the necessity of detaining each author; consider less invasive alternatives to detention as part of such an assessment; reasonably inform the authors of the substantive reasons for their detention beyond a purely formal assertion that they fall within the terms of a particular legal category; provide a procedure for the periodic independent review of the necessity of continuing to detain any author; and provide for the effective judicial review of the necessity of detention. 3.20 Concerning the claims under articles 7 and 10 (1), the authors consider that the State party should acknowledge that the circumstances of the authors’ detention are inhumane and degrading and should apologize to the authors and provide them with adequate compensation for their inhumane treatment, including for the mental distress and psychological suffering they experienced. 3.21 In terms of the guarantees of non-repetition, the authors suggest that the Australian law should be amended to: eliminate mandatory detention; require an individual assessment of the necessity of detention; inform detainees of the substantive reasons for their detention; require periodic independent review of the necessity of detention; require consideration of less invasive alternatives to detention; and provide for substantive and effective judicial review of detention and of adverse security assessments. 5 6 Guy J. Coffey and others, “The meaning and mental health consequences of long-term immigration detention for people seeking asylum”, Social Science & Medicine, vol. 70, No. 12 (June 2010).