Section two Focus on detention issues As part of their monitoring, the NPM expects mental health services in England to have implemented the new guidance in the Code of Practice, but in a number of visits NPM members have already found no evidence that post-incident debriefings have been held. Conclusion Isolation can cause distress to detained patients and those in care settings. The practices identified by NPM members illustrate that, in many cases, procedures designed to ensure appropriate use and oversight of isolation are not followed or evidenced. All detained patients are vulnerable as a result of suffering from severe mental disorder, which makes safeguards of extreme importance. Focus by health inspectorates on the physical and mental health consequences of seclusion has led to more specific scrutiny of the environment and regime where it occurs. It is welcome that the new MHA Code of Practice strengthens the protections of patients in England who are isolated in the short-or long-term, and raises standards for the conditions for such isolation. The acknowledgment in the Code that seclusion always has the potential to be traumatising, so that patients need support after it, and that seclusion rooms need to have a visible clock, are a direct result of observations from NPM monitoring. At the same time, the routine introduction of isolation through night-time confinement, without the possibility for the review requirements of other forms of isolation, is of concern. The NPM mental health forum will consider ways to strengthen the monitoring of isolation and solitary confinement – including through full implementation of the MHA Code of Practice in England – through their monitoring and regulatory powers. Some positive developments in standards and awareness have undoubtedly been achieved, and NPM members can play an important role in ensuring these are sustained, and introduced in areas they have not been. Immigration detention Immigration detention across the four nations of the UK is monitored by HMI Prisons and the IMBs, with other NPM members providing specific monitoring of health and education provision. Evidence was contributed to this review from three inspections of immigration removal centres (IRCs). Background The differentiation of immigration detention (a form of administrative detention) from punitive forms of detention should be clear in the conditions in which detainees are held.84 The non-punitive purpose of IRCs in the UK is clearly set out in the Detention Centre Rules (2001), which emphasise that there should be a relaxed regime with as much freedom of movement and association as possible, consistent with maintaining a safe and secure environment.85 This principle should govern the use of any practices amounting to isolation in IRCs. 84 UN Special Rapporteur on the human rights of migrants, Report to the UN Human Rights Council A/HRC/20/24, 2 April 2012, para 31. 85 The Detention Centre Rules 2001, 3(1), at: http://www.legislation.gov.uk/uksi/2001/238/made (accessed 14/10/15). 39