Intervention in detention. Psychological, ethical and professional aspects

The psychological stressors in detention, besides being a frequent cause of distress, are also significant obstacles to effective intervention. Conditions for detention in South Africa, laid down by law, have been described as psychological torture. These legal conditions for detention conflict with the ethical principles of autonomy, non-maleficence and beneficence and by compromising ethical principles result in inadequate clinical standards. It is therefore not possible to provide an adequate mental health service for detainees. Attempts to formulate minimum standards for the psychological treatment of detainees do not address the problem that the conditions of indefinite detention are incompatible with providing mental health care services. Professional ethics are subverted by legalising unethical practice, and attempts to criminalise ethical practice should be resisted. It is important for the mental health professional to address these issues so as not to abrogate his responsibilities to himself, his patients, and his profession.