In relation to detention conditions, the Reception Decree provides as a general rule that full necessary assistance and respect of dignity shall be guaranteed to the detainees. Separation of persons in respect of gender differences, maintaining, where possible, the family unity and the access to open-air spaces must be ensured. Detention conditions are monitored, inter alia, by the Human Rights Commission of the Senate, the Inquiry Commission on the reception system set up by the Chamber of Deputies, as well as the Guarantor for the rights of detained persons.
The decree-law 130/2020 expressly provides that adequate sanitary and housing standards must be ensured in the CPR. Regarding the former, as pointed out by the Guarantor of prisoners in his reports, the protection of the right to health and adequate assistance is strongly influenced by the organisational factor as the law reserves a secondary role for the National Health System and entrusts the performance of health services within the CPRs to the managing body. The Guarantor has repeatedly called out for the urgent establishment of MoU between CPR’s and local health authorities (ASL), but these are not yet in place in all CPRs.
Decree Law 130/2020 introduced the possibility of making requests or complaints in written or oral form to the National Guarantor and to the regional or local Guarantors of the rights of detained persons. However, as the National Guarantor underlined in his latest report, the effectiveness of this provision is limited by the absence of information on this point and by the limits set by the CIE Regulation which provides that the delivery and use of pencils is forbidden inside the housing modules; and in any case it takes place under the supervision of the managing body which is responsible to collect them after use.
Serious regulatory protection deficits remain with respect to the actual prison regime. These regards, for example:
- the lack of a mechanism that allows family members to be notified in case of need, a circumstance that has made it extremely difficult to notify the families of people who have lost their lives in detention;
- the absence of a mechanism for monitoring prison conditions entrusted, as for prisons, to the judicial authority;
- the absence of a strong role of public health and the decisive role left to the managing body for the protection of health.
The Reception Decree states that foreigners detained in CPR shall be provided by the manager of the facility with relevant information on the possibility of applying for international protection. The asylum applicants detained in such facilities are provided with the relevant information set out by Article 10(1) of the Procedure Decree, by means of an informative leaflet.
The right of detainees to be adequately informed of their rights and of the possibility to apply for asylum is expressly provided for by the Interior Ministry Directive of 19 May 2022, that abolished the previous CIE Single Regulation. The CPR managing body is in charge of organising a “normative information provision” service, funds for which however have been drastically cut via the draft tender specifications prepared by the Ministry of Interior in 2018 and confirmed in 2021. There was, in fact, a decrease in the number of hours dedicated to this activity: (i) by 66% (for Centres with up to 50 places); (ii) by 70% (for Centres with up to 150 places); (iii) by 78% (for Centres with up to 300 places). This had inevitable repercussions on the effective protection of the right to information of detainees.
The Council of Europe’s Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) made a periodic visit to Italy from 28 March to 8 April 2022. However, the visit did not concern detention facilities for foreign nationals, as reported by media sources.
It is necessary to recall here that, as previously mentioned, in 2016 the ECtHR in the Khlaifia judgment condemned Italy for the arbitrary detention of foreign citizens in the Centre of Aid and First Reception (CSPA) — now renamed hotspots — of Lampedusa. The Court was also heavily critical regarding the lack of effective remedies against this deprivation of liberty and related living conditions. Since then, the Italian government has not filled this critical gap in Italian legislation and has kept on detaining people (even minors and vulnerable people) without the required validation from a judge. Some NGOs (including CILD, ASGI, and A Buon Diritto) have actively taken part in the judgement’s implementation supervision procedure before the Committee of Ministers of the Council of Europe. From 2018 to the end of 2021, they redacted around ten observations reports demonstrating that the Italian government had done next to nothing to end the systematic violation of human rights in these places. Notwithstanding, the implementation supervision procedure has been closed in December 2021. Civil society expressed concerns over the closure of the procedure and stressed again the urgency of addressing the need for adequate legal, procedural and reception standards in immigration detention.
As reported by ASGI’s InLimine Project as a result of its monitoring and legal assistance activities, in the summer of 2021, during the period of peak arrivals, people have been de facto detained, even for up to one month, in the Lampedusa hotspot without validation by a judge and without the application of proper hygienic measures, including those directed at preventing the spread of COVID-19. Detention conditions were inhumane; migrants were hosted in potentially risky settings and hotspots were overcrowded, even reaching a point where 1,000 people were accommodated in a location with an official capacity of 250 people. Even vulnerable persons were informally detained for an extended period of time, lacking any adequate mechanism of assistance, referral and/or priority transfer for people who had survived the shipwreck, human trafficking, gender-based violence, torture or who were fragile for any other reason. Such informal and prolonged detention also involved minors, whose transfers were often slowed down by the unavailability of places in centres for sanitary isolation. In particular, there were reports of people being subject to informal and extended detention in the Lampedusa hotspot even when they suffered from medical and/or psychological illness. As an example, a family consisting of two minors and a mother who had suffered from a carcinoma was kept in the hotspot under inadequate conditions including a lack of access to appropriate medical treatments, from 12 July to 12 August 2021, when the family was finally transferred to a centre for fiduciary isolation. Another family consisting of two minors, one of whom suffered from a severe illness that causes motor disability, and of a father who had requested international protection, was kept in a hotspot from 1 July to 10 August 2021.
In September 2021, MSF, who had deployed teams to provide medical and psychological assistance at landings and in the hotspot during the summer, providing help to over 11,000 persons, ceased its activities in Lampedusa, citing the inadequacy of the emergency approach adopted and the need for structural interventions to ensure the respect and protection of fundamental rights.
This situation remained unchanged through 2022, as showed by data collected through ASGI’s InLimine Project.
The Pozzallo hotspot is located in the premises of the former customs office in the port of Pozzallo. It is enclosed by a barrier about 3 metres high and has a constantly manned entrance. The structure consists of three large dormitories, divided according to gender and age. During 2019, it mainly welcomed people awaiting transfers to other European countries in the context of the so-called voluntary relocation. Such redistribution procedures usually involved long-term stays within the centre. From March 2020 to the end of 2021, due to the pandemic, the hotspot has been used for the execution of quarantine and fiduciary isolation periods for arriving foreign citizens, including minors. This use raises critical issues as the hotspots are not, in fact, compatible with the implementation of measures aimed at the prevention and spread of COVID-19 for obvious structural reasons, since these places are unsuitable for long-term stays. Inspectors sent by the Sicily Region in September 2020 highlighted multiple sanitary criticalities such as common toilets, not proportionate for the real capacity and insufficient sanitation. In July 2021, migrants protesting in the hotspot caused a fire in the building, a few migrants escaped from the hotspot but were traced by authorities.
The Taranto hotspot is located a few metres from the entrance to the commercial port of the city, close to the gigantic industrial area. The proximity to the former Ilva steelwork factory and other polluting industrial plants is made evident by the thick patina of red dust that covers the tensile structures and containers that make up the centre’s structure. In 2019, ASGI, ActionAid and Oxfam visited the hotspot and reported inadequate structures creating situations of promiscuity and the lack of adequate medical services and support for vulnerable persons. In November 2020, protests in the hotspots culminated in the escape of 16 persons and, one year later, in the arrest of one migrant held responsible for the protests and for resisting to the police.
The Messina hotspot is made up of a series of containers of zinc sheets and tensile structures capable of hosting up to 250 people. During 2019, the Messina hotspot mainly welcomed people awaiting transfer to other European countries in the context of the so-called voluntary relocation. In 2020 it was mostly used as quarantine facility.
As already noted, in October 2020 and again in April 2021, ASGI reported that the first line reception facility of Monastir, in Sardinia, was being used as a de facto hotspot, despite not being defined as a hotspot facility. The Monastir reception centre is located in a military area surrounded by large fences. Although the legal configuration of the centre is not clear, the same evidently has functions attributable to those defined by the hotspot approach; all the typical hotspot procedures are also carried out int the centre, such as health screening, pre-identification via news sheet, identification, fingerprinting and control in databases for the purpose of defining the legal status of the foreign citizen on the territory and for channelling them into asylum procedures or towards repatriation. The same structure has been used for periods of fiduciary isolation and quarantine. With regard to the conditions of stay, it was reported that an area housed 25 people in quarantine, with a single toilet equipped with a shower, and other chemical toilets outside the building.
In 2021, ASGI reported many criticalities in Pantelleria, where newly arrived migrants are also channelled in hotspot-like procedures. Those arriving on the island are hosted in a structure largely unsuitable for reception that previously hosted military barracks. It is a transit centre without any precise legal configuration and with many criticalities in terms of reception conditions and protection of rights. As mentioned above, the new inspection conducted by ASGI in May 2022 confirmed the critical issues that emerged the previous year.
As already mentioned, immigration detention continued during the COVID-19 pandemic and the related lockdowns, notwithstanding the fact that no transfer could take place and concerns raised by civil society. It has been noted – including by judges while not validating detention in CPRs – that detention applied while transfers were blocked is without legal basis: detention in CPRs is supposed to be exclusively preparatory to repatriation and if this is not possible, any detention is considered illegitimate. A first MoI circular urging reception managing bodies to adopt appropriate measures to prevent COVID-19 contagion in CPRs was issued in March 2020. Adequate measures have not always been put in place and detainees felt abandoned inside the centres, where distancing was virtually impossible, while also being exposed to very precarious living conditions. No official data is available on access to vaccines for persons in CPRs. As of September 2021, vaccination activities had not yet kicked off in CPRs in Rome, Bari, Trapani. In Potenza’s CPR, the lack of adequate prevention measures and proper internal information provision led in March 2020 to hunger strikes and protests, which were violently repressed; two parliamentary interrogations were presented on conditions in the centre.
In providing for a distribution of CPR on the entire national territory, Decree Law 13/2017, implemented by L 46/2017, specified that this should have followed an accentuation of the role of the Guarantor for the rights of detained persons, and an extension of the power of access for those who do not require authorisation, and an absolute respect for human dignity. A further expansion of the role of the National Guarantor on monitoring of all places of detention has been foreseen by L. 173/2020. The National Guarantor, in the context of its dedicated focus on immigration detention, has repeatedly noted the lack of an adequate legal framework for detention in CPRs. More recently, the Guarantor has highlighted the importance of the ongoing review of the consolidated regulation for CPRs, currently being undertaken by the MoI’s Department of Civil Liberties and Immigration. Even if the regulation does not suffice to ensure a legal basis for detention, it could provide for a more solid central governance of immigration detention and the evolution of the system towards higher standards of protection.
CPRs detain people with very different legal statuses, from those coming from prisons to applicants for international protection. According to the law, asylum seekers detained in CPR should be placed in a dedicated space. The National Guarantor has reported on the overall lack of distinctions made on this respect in CPRs, where separation of persons in different conditions is often not possible due to lack of adequate spaces, affecting the safety of the detention environment.
“Modalities of detention seriously and physiologically problematic” was the wording used by the National Guarantor to describe the structural issues affecting the immigration detention system in Italy. The National Guarantor describes regulatory gaps, structural problems, and issues in the management of detention facilities. CPR facilities and resources are generally described as lacking at best, resulting in a very poor quality of life for detained persons. The National Guarantor also describes worrying practises compromising the ability of detained persons to communicate with the outside world. The Guarantor has therefore repeatedly called out for the improvement of detention facilities and of their connection to local services (especially in terms of access to the National Health System) as well as of the ability of detained persons to communicate freely through their mobile phones.
Concerning overall conditions of detention in CPRs, several issues have been reported, mainly regarding:
- The privatised management of CPRs (even for health-related services) is one of the most controversial issues in administrative detention. In recent years, the social cooperatives that manage these facilities have been gradually joined by multinational corporations, which manage detention centres or services in prisons all over Europe;
- The tendency to minimise the costs of managing the CPRs in favour of profit maximisation is evident in the outline of the tender specifications prepared by the Ministry of the Interior in 2018, and partially confirmed in the new outline of the same description in 2021. This has resulted in a drastic decrease in all services for people within CPRs, a reduction in the hours staff employed by the Centres’ managing bodies (operators, information and mediation services, health personnel) and has thus led to a structural lack of staff in the various CPRs, with pathological drifts recorded in some facilities;
- In some cases, the square metre size of single rooms does not comply with the minimum living space standard set by the European Court of Human Rights. Further critical issues observed in CPRs concern the lack of natural light in the sleeping rooms, deriving from the presence of screened windows; the lack of possibility for detainees to directly turn lights on or off; in some instances, the presence of cockroaches and non-insulated rooms, of worn-out, mouldy mattresses;
- In some facilities, there is an inadequate number and/or very poor hygienic conditions of sanitary services, which are often without doors and thus do not ensure any privacy;
- The poor quality of food, lack of compliance with food safety regulations and menus which do not always take into account diets for religious or medical reasons;
- The total lack of common living spaces and activities for detainees;
- Freedom of communication is often partially and completely limited: in most CPRs, the number of landline telephones, which according to the legislation should be present in a number not lower than 1 for every 15 people, was insufficient; in many CPRs, the possibility to make video calls with family members during COVID-19 was not given. Furthermore, the illegitimate practice of seizing mobile phones of detainees upon entrance in centres continues in Torino, Potenza, Roma, Trapani, and Macomer. In February 2021, the Civil Court of Milan accepted the urgent appeal presented by a Tunisian asylum seeker held at the CPR of Milan, in order to obtain the return of his mobile phone which, according to the current practice also in other CPRs, he was prevented from using inside the centre. The Court observed that the impossibility of accessing one’s mobile phone constitutes a limitation of the right to freedom of communication of the detainees, not permitted by Italian law, but can also constitute a violation of the right of defence of detainees. In the case of the applicant, the impossibility of communicating with his lawyer before the hearing to validate the detention, prevented him from being able to avail himself of his assistance there. The Court further observed that freedom of correspondence cannot be guaranteed through the availability of fixed or portable devices, generally present within the centre.
Especially dire conditions have been reported in Turin’s CPR, whose infamous sanitary isolation section (so-called Ospedaletto) was closed in September 2021 upon insistence of the National Guarantor, following the tragic suicide of Moussa Balde a few months before.
Several cases of self-harm and/or suicide attempts in CPRs have been reported in Milan, Turin, and Bari. Revolts over detention conditions in CPRs are frequent; in 2021, detained persons protested and revolted in Turin and Milan. In May 2021, a protest over lack of food in Milan’s CPR was violently repressed by riot police, resulting in 8 persons harmed and followed up by hunger strikes and cases of self-harm.
Very limited information on “locali idonei” is available. According to information acquired by ASGI via FOIA, the 6 Questure of Bergamo, Bologna, Brescia, Milan, Parma and Rome have implemented detention in such spaces. Between July 2019 and July 2020, at least 393 persons were held in these locations. Most represented nationalities appear to be Morocco, Albania and Tunisia. Guarantees on information provision, right to defence, access to the asylum procedures and contacts with the exterior appear to be left at the ample discretion of authorities.
The National Guarantor has visited, between December 2020 and January 2021, the “locali idonei” in Immigration Offices in Parma and Bologna. The former has 2 holding chambers, in which 38 persons were held in 2020 pursuant to Art. 13 para 5-bis TUI; no critical events were reported. The latter uses the so-called “sale accompagnati” as locali idonei, although the Guarantor pointed out that no renovation of the rooms was ensured prior to their conversion for this use. In 2020, 17 people were held here pursuant to Art. 13 para 5-bis TUI; among these, 6 were held for 2 nights, 4 for 3 nights, 2 for nights. Regarding Parma and Bologna, the Guarantor noted that many standards were not complied with: both have dirty walls and are almost empty, with a bench – to be used as sitting in daytime and bed at night, with only a blanket as bedding – being the only place of furniture. Sanitary services are external and can be used only upon request to police. There are no external spaces for yard time. In Bologna, the rooms have a glass wall, meaning persons held have no privacy at all. Based on inadequate detention conditions observed in Parma and Bologna, the National Guarantor has asked the Department of Public Security circulates clear indications to ensure the suitability of detention premises, as well as called upon visited Immigration Offices for the prompt improvement of detention conditions as per the Guarantor’s recommendations. The Guarantor has also noted how neither in Parma nor in Bologna rights of persons held were adequately protected. In both premises, detainees’ phones are seized upon entrance, leaving held persons unable to freely communicate. Regarding freedom of communications, the Guarantor stressed how the right to realise phone calls must be granted, recalling the already cited 2021 judgement by Milan’s Court. No adequate information provision materials or activities are in place. Judicial validation of detention is not always rightly ensured, as different cases in which persons were held without the authorisation of the judge, pending the transfer to CPRs, were reported. When detention validation orders are present, they are not always well motivated, as it appears that judges are not aware of detention conditions in the locali idonei. Issues with the recording of presences were also noted.
As mentioned above, in May 2022 ASGI had access to locals used by Milan’s Questura, which allowed them to understand the procedure of detention and its timing, the places used and certain critical issues related to the right of defence of persons detained. This visit followed Lombardy’s Administrative Tribunal precautionary order issued following the appeal filed by ASGI after the Questura of Milan rejected the request for access to locali idonei.
In transit zones, people are arbitrarily detained in grossly inadequate conditions and in the absence of the basic guarantees accorded to persons deprived of their liberty. Detention takes place in premises that are structurally unsuitable for the purpose, isolated from the outside world, without access to fresh air, with little opportunity to consult a lawyer, without any detention order being issued and therefore without any validation by a judge. Such deprivation of personal liberty is enforced in the absence of a legal basis, a maximum period of detention and a judicial review of the legitimacy of the detention, in inadequate conditions. Persons detained in airport transit zones have extremely limited possibilities of getting in touch with organisations, protection bodies, family members and lawyers – as their access to such areas is strictly limited.
In 2021, 6,153 persons were pushed back at borders (3,578 air border, 167 land border, 2,408 sea border). The main nationality registered was Albanian, with 4,007 people refused entry at the borders (65% of the total).
The National Guarantor reported as of 31 December 2021, 305 persons were detained in the areas of Bergamo Orio Al Serio, Milan Malpensa and Rome Fiumicino airports: the detention time lasted from 2 days to as long as 7-8 days in some cases registered at Roma Fiumicino.
According to information acquired by ASGI via FOIA, by 31 October 2022, 980 persons were pushed back at Fiumicino airports, of which 208 were Albanians (21%). In the same period, there were 105 asylum applications, 28 from Turkish people (27%).
According to article 4(m) of the new Directive of the Ministry of the Interior of May 2022 – in line with the Article 4(h) of the CIE Regulation it substituted -, social, recreational and religious activities shall be organized in the centres, and to “this end the manager shall prepare a weekly calendar of planned activities, to be brought to the attention of all foreigners present.”
In practice, it has been reported that in most CPRs, apart from unequipped outdoor concrete courtyards, there are no: (i) football fields or libraries; (ii) places of worship; (iii) recreational and cultural activities; (iv) agreements with civil society associations that can provide additional services and activities. The shortage of recreational activities in CPR bears especially negative impact on living conditions of people staying in the CPR 24 hours a day for prolonged periods, thus being one of the main factors entailing distress among people in detention. As pointed out by the National Guarantor, these shortages mean that CPRs are “empty shells”, where people are reduced to bodies to be held and confined.
The security approach to administrative detention makes CPRs places of extreme social marginality and isolation from a community which is prevented from entering detention facilities and creating relationships with detainees. The people detained in CPRs live in a condition of permanent forced idleness, where even small daily life choices, such as reading a book, writing, or playing sports are limited and regulated.
Health care and special needs in detention
Access to health care is guaranteed to all persons in detention. The law provides, as a general rule, that full necessary assistance and respect of dignity shall be guaranteed. The law further states that the fundamental rights of detained persons must be guaranteed and that inside detention centres essential health services are provided.
Moreover, the Reception Decree provides that asylum seekers with health problems incompatible with the detention conditions cannot be detained and, after the amendment made by Decree Law 13/2017 and L 46/2017, it also establishes the incompatibility of detention for vulnerable people, as defined by Article 17 of the Reception Decree. Within the socio-health services provided in the CPR, a periodical assessment of the conditions of vulnerability requiring special reception measures must be ensured. The Prefectures are obliged to ensure coordination with local health authorities to ensure access to medical services ex art. 35 of the Consolidated Act on Immigration. Art. 3 of the new Directive of the Ministry of the Interior of May 2022 provides for a medical examination of suitability for life in the CPR to be issued by the competent ASL prior to entry into the facility, or in case the person enter without having had the visit “the examination must be repeated within 24 hours of entering the CPR by the doctor from the ASL with which the Prefecture headquarters of the CPR has entered into a special protocol.” The certification of the medical visit shall be forwarded to the Judge’s file of the validation of detention.
Health care inside CPRs should be considered “complementary” (not substitutive) to services provided by the National Health Service, implying a necessary link with the latter. This connection should be guaranteed by the above-mentioned MOUs between the relevant Prefecture and the local ASL, which are essential to guarantee a timely access of the detainees to ASL health facilities and periodical inspections of the health authority inside the centres. However, these MOUs are often not adequately implemented. In Turin and Brindisi, despite the existence of MoUs, no inspections have ever been carried out by the ASL in the Centres to verify the hygienic and sanitary conditions, the quality of sanitary services and of the food administered. In Milan, for a long time the absence of a MoU has impaired access of detained persons to health services; only in July 2021, after countless interventions by the National Guarantor, civil society associations and some parliamentarians, the Prefecture of Milan signed two MoU with the ASL of Milan: one being aimed at the detainees’ access to the SSN and inspection activities by health authorities. This MOU run from 1 July 2021 to 31 December 2021. The other is aimed at issuing a STP code to detainees who do not have it and runs from 1 July 2021 to 30 June 2022. However, it is not clear why such strict time limits have been set for their validity. It seems unreasonable to have waited so long for the finalisation of a MOU between the health authorities and the Prefecture of Milan and then to only provide for a period of operation of six months and one year respectively, of those instruments.
The lack of adequate supervision by local health authorities resulted even more evident in the context of the COVID-19 pandemic. ASGI and other civil society organisations have repeatedly called out local health authorities to play a more active role in the supervision of health and sanitary conditions in CPRs.
It is to be noted that in CPRs health care is de facto – especially in the light of the absence of adequately implemented MoUs with local health authorities – managed by private parties, being entrusted to the managing body of the CPRs and not to the National Health Service (SSN).
The SSN is merely assigned, at a regulatory level, the task of carrying out the preliminary medical examinations to verify the suitability of the detainee for life in a restricted community. However, this provision is, in most cases, disregarded in practice: it has been indeed found that the certificate for this purpose is issued: by a doctor of the managing institution in the CPRs of Turin, Milan and Potenza; by the health staff of hotspots or quarantine ships in the case of Brindisi, Bari, Caltanissetta, Trapani and Gradisca d’Isonzo. Medical examinations to verify the suitability of detention for an individual are not, in most cases, carried out in an adequate manner; they are generally rushed, and the medical records of the person concerned are often not properly assessed. The presence of law enforcement personnel during medical examinations also appears to be very frequent in CPRs, despite this practice contradicting what is required by the CIE Single Regulation and what is prescribed by the CPT, as absence of “medical confidentiality” is one of the factors preventing the detection of possible ill-treatment. As a result, the detention of people unsuited for detention conditions, including persons undergoing methadone treatment on a sliding scale, persons suffering from serious diseases and/or mental health issues, has been reported.
According to the National Guarantor, the organisation of health services within CPRs appears to be “particularly critical”, due to lack of staff adequately trained in medicine related to migration, and to the absence of risk prevention protocols, despite the numerous episodes of self-harm occurring in the Centres.
Additionally, the new scheme of contract specifications has led to a drastic decrease in the number of hours per week dedicated to personal services, starting with health services. More specifically, between 2017 and 2018-2021 there has been a serious cut of hours for medical and psychological services in all centres: 40% cut for medical and 55% cut for psychological assistance in CPRs with a capacity of 50 places; 27% for medical and 33% for psychological assistance in CPRs with a capacity between 51 and 150 places; 70% for medical and 55% for psychological assistance in CPRs with a capacity of more than 150 places. As a result:
- In Milan’s CPR (140 places), for each detainee: (i) medical assistance is guaranteed for 15 minutes per week and (ii) psychological assistance for 6 minutes per week. Moreover, it was noted that, in this facility, there is a long list of detainees waiting for a visit with the psychologists of the centre, one of whom is also the Director of the Centre itself;
- In Turin’s CPR (180 places), for each detainee: (i) medical assistance is guaranteed for 14 minutes per week and (ii) psychological assistance for 8 minutes per week. The inadequacy of the service offered by the managing body was such that, in February 2021, the latter signed a memorandum of understanding with the order of doctors of the province of Turin. According to the National Guarantor, this protocol could not overcome the criticalities observed in this centre, with particular reference to the provision of specialist services within the competence of the territorial services;
- In Macomer’s CPR (50 places), medical assistance was provided for only 3 hours a day and psychological assistance for 8 hours a week. However, after only three weeks of opening the Centre in February 2020, the internal health staff threatened to strike and resign due to the lack of conditions that would allow them to work safely. In March 2020, the National Guarantor found that the number of health workers present in the structure was insufficient. This led the Prefecture of Nuoro to increase the medical assistance service to 5 hours a day, while psychological assistance, according to the lawyers assisting detainees in the Centre, continues to be “non-existent”.
The monitoring of psychiatric cases and the administration of psychotropic drugs is often managed by psychologists and nurses appointed by the managing body, with no involvement nor supervision of local health authorities. It has been noted how the percentage of detainees subjected to the administration of psychotropic drugs and anxiolytics is very high. As an example, in Milan’s CPR, this percentage reaches – according to the managing body itself – 80% of the total detainee population. This situation is made even more concerning by the lack of connection with the local ASL and, therefore, the total absence of adequate psychiatric assistance. The critical nature of the situation is well illustrated by the recent survey on the abuse of psychotropic drugs within the Italian CPRs, which found that at the Milan CPR, in the period between October 2021 and February 2022, while spending on psychotropic drugs exceeded 60% of the total amount of drugs purchased, only 8 psychiatric visits were made to detainees. In Turin’s CPR, according to the medical director of the facility, “psychotropic drugs are used by the litre”, but without adequate monitoring, considering that throughout 2020 no psychiatrist has ever visited the facility. In 2021, collaboration with the Mental Health Centre of the local ASL resumed; regardless, visits in these cases are also on call, so there is no constant care of the patient, which tends to be replaced by the constant and continuous administration of psychopharmacological therapies. In Rome’s CPR, according to the competent health authority, the percentage of detainees who are given psychotropic drugs and anxiolytics is 65-70%. In Gradisca’s CPR, according to data provided by the regional Guarantor, 70% of the detained population is subjected to therapies requiring the administration of psychotropic drugs and tranquilisers. The abuse in the administration of psychotropic drugs, which is apparent in most CPRs, can be traced back to the absence of a connection with the national health system and to the management of health services entrusted to private bodies, with the risk of bending medical and pharmacological intervention to the needs of discipline and security of the facilities.
Access to medical records is difficult. Even though the legislation provides for the right of the detainee to see and obtain a copy of his/her medical file, practises impairing this right have been reported in CPRs. In the Turin centre, not even lawyers, delegated by the detainees, are allowed to have a copy of the medical documentation Furthermore, in most cases medical records are not adequately compiled. Already in 2017, the CPT had found that in the CPR of Turin, the medical staff of the managing institution were filling in medical files of each detainee in a very general, broad way, with a noticeable absence of detail, especially in registration of possible injuries (necessary to verify possible ill-treatment). The issue has been reported also in 2021 by the National Guarantor, who recommended that the medical records of each detainee should be always properly filled in, including the records of possible complaints of ill-treatment and beatings suffered by the detainee.
There is still no reliable, effective and complete system in place within the CPR network to record critical events (e.g. suicides or attempted suicides; episodes of self-harm; hunger strikes; deaths), despite this deficiency being identified and brought to the attention of the Italian Government by the European Committee for the Prevention of Torture already in 2017. In addition, the National Guarantor has been recommending, for several years, that a standardised and centralised system of recording critical events be introduced, which would allow overseeing bodies to have rapid knowledge of the most relevant events occurring in the Centres and ensure greater transparency regarding the functioning of these places of detention.
Provisions regulating CPRs do not foresee solitary confinement (for justice, health, disciplinary or security reasons), but only the possibility to place detainees in sanitary “observation” rooms, in case the existence of elements that may reflect the incompatibility of a detainee with restricted community life, which did not emerge during the initial certification of suitability for detention, is noted by the personnel. The most striking example of how this provision can lead to severe violations as regards respect of human dignity was the so-called Ospedaletto within Turin’s CPR, which, according to the National Guarantor, looked like the “old section of a zoo”. In these premises, detainees were put in isolation for a wide range of reasons (from disciplinary reasons to alleged needs of “protection”), without a maximum time limit being fixed, which in some cases reached 5 months. Two detainees have died in Ospedaletto in 2019 and 2021 respectively. Following the suicide of Moussa Balde in May 2021, and the insistent requests by the National Guarantor, the Ospedaletto was finally closed in autumn 2021. The broader issue of confinement in sanitary rooms in CPRs remains to be addressed.
It is necessary to note that the number of deaths in CPRs has never been as high as in recent years. Between June 2019 and December 2022, ten foreign nationals lost their lives whilst held in administrative detention, two just in the last 5 months of 2022. The specific instances differ in terms of causes and circumstances, but what is common between them is a lack of clarity about the circumstances of their deaths, doubts about the suitability of these persons to be placed in this restricted community setting in the first place, and the risks arising from inadequate protection of the health of detainees.
 Article 7(1) Reception Decree.
 Article 14 (2) TUI as amended by Article 3 (4 a) of Decree Law 130/2020.
 Article 14 (2 bis) TUI.
 Article 6(4) Reception Decree.
 Ministero dell’interno, Direttiva recante “Criteri per l’organizzazione e la gestione dei centri di permanenza per i rimpatri previsti dall’art. 14 del decreto legislativo 25 luglio 1998, n. 286 e successive modificazioni”, available in Italian at: https://rb.gy/wfqcv5.
 ASGI, L’hotspot di Lampedusa: alcuni riscontri dalla pubblica amministrazione, May 2022, available in Italian at: https://rb.gy/bdh5l0; see also ASGI, Report Lampedusa 2022: le criticità, August 2022, available in Italian at: https://rb.gy/litjw5.
 Ragusa Oggi, L’HotSpot di Pozzallo, ma anche il centro San Pietro, bocciati dagli ispettori regionali: “inadeguato per prevenire il covid e per la quarantena”, September 2020, available in Italian at: https://bit.ly/3D1uNEZ.
 ASGI et al, Emergenza COVID-19. L’impatto sui diritti delle/dei cittadine/i straniere/i e le misure di tutela necessarie: una prima ricognizione, March 2020, available in Italian at: https://bit.ly/3qac6JW.
 The Specialised Section of Rome in a decision dated March 2020 did not authorise the extension of the detention of an asylum seeker from Bangladesh detained in the Ponte Galeria CPR by assessing the reasonableness of detention in the pandemic emergency context. That same day, the Court of Trieste issued a ruling in which it did not validate the detention of an asylum seeker detained in Potenza’s CPR, stating that detention was not justifiable as it had lost the purpose of being “strictly functional to enable the timely processing of applications for international protection and the subsequent and possible execution of the expulsion”. CILD, Migrant detention in Covid-19 times, August 2020, available at: https://bit.ly/3KTAvvf.
 Francesca Esposito, Emilio Caja, Giacomo Mattiello, “No one is looking at us anymore” – Migrant Detention and Covid-19 in Italy, Border Criminologies, November 2020, available at: https://bit.ly/35YDTGq.
 Article 6(2) Reception Decree.
 ASGI, The Black book on the Pre-Removal Detention Centre (CPR) of migrants in Turin – Corso Brunelleschi, September 2021, available at: https://bit.ly/3CQZQD5; National Guarantor for the rights of detained persons, Chiuso l’Ospedaletto del Cpr di Torino: accolta la Raccomandazione del Garante nazionale, September 2021. Available in Italian at: https://bit.ly/3MVVKOz.
 Altreconomia, Un altro morto nel Cpr di Gradisca d’Isonzo, “buco nero” del Friuli-Venezia Giulia, September 2022, available in Italian at: https://rb.gy/qbjhs5; Ansa, Incendio in Cpr Brindisi, muore un migrante, dicembre 2022, available in Italian at: https://rb.gy/a2qnwx.
 ASGI, I “locali idonei” al trattenimento dei cittadini stranieri: le criticità del dettato normativo, i rilievi mossi dalle autorità di garanzia e i dati raccolti da ASGI, April 2021, available in Italian at: https://bit.ly/3MXOtxI.
 ASGI, Il punto sulle strutture idonee nella disponibilità delle autorità di pubblica sicurezza per il trattenimento dei cittadini stranieri in attesa dell’esecuzione del rimpatrio: il monitoraggio di ASGI presso la Questura di Milano, November 2022, available in Italian at: https://rb.gy/wfl5po.
 National Guarantor for detained persons, Report of 12 April 2021, 6.
 Article 14(2) TUI.
 Article 21(1) and (2) PD 394/1999.
 Article 7(5) Reception Decree.
 Art. 3(2), Directive of the Ministry of the Interior of May 2022.
 Intended as Doctors who are specialized in the assistance and treatment of migrants (such as SAMIFO or INMP in Rome) or S.I.M.M. (Italian society of Migration Medicine).
 Altraɘconomia, Rinchiusi e sedati: l’abuso quotidiano di psicofarmaci nei Cpr italiani, 1 April 2023, availabe in Italian at: https://rb.gy/489u4. See also, Il Riformista, Migranti rinchiusi e sedati, tutti i soldi spesi dallo Stato per stordirli e tenerli buoni nei Cpr, 7 April 2023, available in Italian at: https://rb.gy/5woo2.
 Garante per i diritti delle Persone private della Libertà personale del Comune di Torino, Dott.ssa Monica Cristina Gallo, Relazione annuale attività 2022, 27 March 2023, available in Italian at, https://rb.gy/p030i.
 CPT, Report to the Italian Government on the visit to Italy carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 7 to 13 June 2017, available at: https://bit.ly/3InPE6e.
 National Guarantor for the rights of detained persons, Chiuso l’Ospedaletto del Cpr di Torino: accolta la Raccomandazione del Garante nazionale, September 2021. Available in Italian at: https://bit.ly/3Jmspuu.