interpretation is often not available. Detainees often have no clear information about their situation, how long they will be detained, or how to contact families or legal representation, which in turn hinders their access to rights and exacerbates their vulnerable condition. The monitoring experts underlined that it is crucial that there are updated registers in places of detention, notably to report critical events and injuries. 3. Access to healthcare and social services The physical and mental health of immigration detainees is particularly important and access to healthcare should be guaranteed, regardless of their legal status. First of all, immigration detainees may suffer from trauma, in particular victims of torture, who need to be identified upon admission to a detention facility. According to the CPT, whenever injuries are recorded that are consistent with allegations of ill-treatment, such information should be brought to the attention of the relevant prosecutor16 and a person alleging previous torture should be referred to an independent medical examination free of charge, in accordance with the Istanbul Protocol.17 At the same time, regular access to psychological care should be provided. Medical screening upon arrival is therefore key to detecting those needs. Second, there is a high chance that immigration detention has a detrimental impact on physical and mental health. Monitors should pay particular attention to this and to the consequences of a lack of access to healthcare, especially in light of the specific needs of certain groups or individuals (children, women, victims of torture and people with disabilities). Participants also discussed the seemingly higher rate of suicide attempts in immigration detention and how to monitor the risk assessment and protective measures which ought to be developed by the authorities. Participants noted that preliminary medical screenings are often scarce and superficial; contagious diseases and mental health are not properly assessed in many cases but in particular in the so-called “unofficial places of detention,” and healthcare services for women are lacking in many institutions. In some OSCE participating States, there is a functioning procedure where migrants receive specialized care in local hospitals. However, monitors have observed that in some cases migrants were shackled during the transfer and examination. Healthcare assessments also allow for the crucial process of identifying torture victims among migrant and refugee populations. The exact numbers of torture survivors among those populations is unclear and varies between different sources - especially between CSOs and states. It is however widely accepted that migrant populations include a certain percentage of torture survivors whose special needs should be addressed, including by referring them to specialized rehabilitation services.18 CPT, Factsheet on Immigration Detention (2017), page 8. Committee against Torture (CAT), General Comment No. 4 (2017), para. 18 (d). 18 For more information on the right to rehabilitation of torture victims in the context of migration, see outcome report of ODIHR’s workshop for OSCE participating States (2018), https://www.osce.org/odihr/446380?download=true; see also the ODIHR/CTI practical tool for States on how to provide rehabilitation services to torture victims at https://www.osce.org/odihr/385497?download=true. 16 17 11