In reply: We thank Goldney for his thought-provoking response. We recognise that self-harm has multiple determinants, including mental disorders, but that it also attempts to influence or communicate. Acknowledging the political context that has created and sustains this issue, we also note long traditions of politically motivated self-harm and suicide, for example, by self-immolation or hunger strike; and that political protests using these methods — lip-sewing, cutting and self-burial — have occurred in Australian immigration settings.
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Michael Dudley is a member of the Detention Health Advisory Group (DeHAG) Mental Health Sub-group and Chair of Suicide Prevention Australia. Nicholas Procter is a member of the DeHAG Mental Health Subgroup and Council for Immigration Services and Status Resolution. Louise Newman is Chair of DeHAG, providing independent advice to the Department of Immigration and Citizenship, and Convenor of the Alliance of Health Professionals for Asylum Seekers. All authors have received meeting sitting fees and Nicholas Procter has also received grant funding from the Department of Immigration and Citizenship.