IRCT REGIONAL REPORT 2016 Healthcare and rehabilitation Article 19 of the Reception Conditions Directive establishes the parameters for the provision of health care to asylum seekers. It notes that Member States “shall ensure that applicants receive necessary health care which shall include, at least, emergency care and essential treatment of illnesses and of serious mental disorders”. Article 19(2) directly refers to the provision of healthcare for vulnerable asylum seekers. It stipulates that Member States “shall provide necessary medical or other assistance to applicants who have special reception needs, including appropriate mental health care where needed”. Article 25 of the Reception Conditions Directive directly addresses the needs of torture victims and violence. This is a welcome provision in the Reception Conditions Directive as it recognises the special medical and psychological needs of torture victims. It notes that Member States “shall ensure that persons who have been subjected to torture, rape or other serious acts of violence receive the necessary treatment for the damage caused by such acts, in particular access to appropriate medical and psychological treatment or care.” The IRCT centres participating in this report noted that due to restrictions on healthcare, lack of knowledge and pressure on existing services, many torture victims are not able to access the necessary rehabilitation support in their countries. There are both formal and informal barriers to torture victims accessing healthcare and rehabilitation. These barriers include restrictions to healthcare in the law or practical barriers, such as lack of knowledge or training for those working with torture victims, lack of translation services in medical facilities, cost reduction mantra of many authorities and firms delivering healthcare and due to capacity and funding constraints of NGOs providing rehabilitation services. Detention The Reception Conditions Directive also establishes the grounds under which an asylum seeker may be detained. It stipulates that detention may only be used when it is “necessary and on the basis of an individual assessment”, but also lists a rather extensive number of circumstances whereby states may detain an applicant. This list includes grounds such as determining or verifying an asylum seeker’s identity or nationality 35. Article 11 of the Reception Conditions Directive contains the rules for detaining vulnerable asylum seekers with special needs. The provision stipulates, “where vulnerable persons are detained, Member States shall ensure regular monitoring and adequate support” of that asylum seeker. Deprivation of liberty has long-term, debilitating effects on the mental and physical health on vulnerable asylum seekers, many of whom have suffered from traumatic experiences in their countries of origin. Research has shown that detention has a detrimental impact on asylum seekers and in the case of torture victims, can aggravate existing mental health conditions, potentially re-traumatising them.36 Furthermore, the detention of torture victims is fundamentally incompatible with their right to rehabilitation as enshrined in international law and irreconcilable with the requirements under the Reception Conditions Directive to provide vulnerable asylum seekers with adequate support and necessary treatment for torture victims. page 42