An Occupational Therapy response to immigration detention & family separation in Canada

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As many of you are likely aware, recently there has been a huge outcry regarding the separation of families at the Mexico and U.S. border, and the horrific imprisonment of children in cages while their parents are detained under criminal charges for crossing the border ‘illegally’ – because they have no other options.

The attention directed toward this issue in the United States has prompted a closer scrutiny of Canada’s policies toward asylum seekers who claim refugee status once within our borders.

This blog post will provide some context and an overview of current issues relevant to occupational therapists in Canada.

Is there anything similar occurring in Canada?

Yes. Although arguably not to the same degree, migrating people are frequently detained in immigration holding centres (as well as in prisons), unaccompanied minors are regularly detained, and the separation of migrating families does occasionally occur in Canada.

The Sherpa Research Centre reports that “over the past 6 years, Canada has held approximately 45,000 people in immigration detention, and [2018] is projected to reach the highest number of immigration detainees since 2012.” In 2017, the Toronto Star produced a 3-part series called “Caged by Canada”, which highlights a few of the troubling stories of refugee claimants who have found themselves behind bars for years. It is reported that “since 2000, at least 16 people have died while incarcerated in Canada’s system of immigration detention.”

Very recently (~July 20th, 2018), the Canadian Government released a highly critical external audit of the Immigration and Refugee Board (which assesses refugee claims) and the Canada Border Service Agency (CBSA), conducted in 2017/2018.

Josh Paterson, executive director of the BC Civil Liberties Association, is quoted by the CBC as saying:

“The audit reveals alarming misconduct on the part of CBSA, including misleading the immigration tribunal, some CBSA officers conducting themselves in a way that intimidates tribunal members, and failing in their duty to ensure that people are treated fairly and are deprived of their freedom only as a very last resort.”

The federal audit, which can be read in full here, calls for major reforms regarding the ways that Canada works with refugee claimants who are detained.


What is an appropriate occupational therapy response to immigration detention and family separation?

The profession of Occupational Therapy is founded on the understanding that human beings are occupational beings whose health and wellbeing is dependent on their occupational engagement. When the broader social, political and physical environments restrict people’s capacity to participate and engage in life-giving activities that are meaningful to them, this is an occupational justice issue that occupational therapists have a professional obligation to respond to.

Wilcock and Townsend (2009) define occupational justice as “the right of every individual to be able to meet basic needs and to have equal opportunities and life chances to reach toward her or his potential but specific to the individual’s engagement in diverse and meaningful occupation.” (p. 193)

Immigration detention and the separation of migrating families is an occupational justice issue where basic needs for autonomy and attachment are denied, and families do not have access to equal opportunities and life chances to reach toward their potential through the conduit of meaningful occupation.

People can be detained under Canada’s Immigration and Refugee Protection Act by CBSA (Canada Border Services Agency) officials if the person is believed to be a flight risk, a danger to the public, or if they are unable to sufficiently prove their identity (Red Cross). This broad policy leads to many innocent people and families being put behind bars – sometimes in actual prisons when space in an immigration holding centre is not available. Parents can choose to have their children put into foster care when faced with detention, or children may be removed from their care if there is a perceived safety risk.

Canada’s three immigration holding centres are located in Vancouver, Montreal, and Toronto, and closely resemble medium-security prisons.

On June 27th, 2018, Catherine Solyom reported for the Montreal Gazette:

“Between April and Dec. 31, 2017, about 155 minors were detained with their parents in Canada, including 102 in Quebec. Eighty-seven were under five years old, and 35 were between six and 11. They were kept in detention for an average of 16 days. Six children were kept as long as 90 days in detention, and another eight were kept up to 180 days.”


On June 27th, 2018, a diverse group of over 2,000 Canadian healthcare providers joined advocacy efforts by Canadian Doctors for Refugee Care by signing an open letter to the Government of Canada, requesting that it end immigration detention (including child detention and family separation). They are also requesting that the Government of Canada end the Safe Third Country Agreement, and apply pressure to the United States to end their practice of child and family detention.

The following is an excerpt from their open letter (which can be read in full here).

“In Canada, immigration detention of both adults and children, and family separation, have been a long-standing and grave concern. Canadian research and reports have repeatedly shown the severe mental health impacts of even short-term detention on both adults and children, including elevated rates of depression, anxiety and PTSD symptoms in adults. Children also suffer severe symptoms such as regression of developmental milestones, sleep disruption, anxiety and depression.”

“As healthcare providers we urge our federal leaders to take action on this issue and consider how history will look back on what we as a country choose to do right now. While Canada’s practice of detaining migrant children is not new, the general public is now rapidly becoming more aware of it. It is hypocrisy to criticize the United States when children are being detained and separated from their families here in Canada, causing similar severe psychological trauma that physicians and other mental health experts are now speaking out about.”


Immigration concerns are only going to become increasingly urgent and pressing as more and more people flee the United States due to its new immigration policies under President Trump. The Pew Research Center indicates that “more people sought asylum in Canada in 2017 than at any point in at least a quarter-century,” and this is largely credited to people crossing the Canadian border from the U.S. to apply for refugee status.

A significant barrier to people securing refuge in Canada via the U.S. – Canadian border, is the Safe Third Country Agreement.

The Canadian Government explicates the Safe Third Country Agreement as follows:

“The Safe Third Country Agreement between Canada and the United States (U.S.) is part of the U.S.–Canada Smart Border Action Plan. Under the Agreement, refugee claimants are required to request refugee protection in the first safe country they arrive in, unless they qualify for an exception to the Agreement.”

“…To date, the U.S. is the only country that is designated as a safe third country by Canada under the Immigration and Refugee Protection Act.”

At the time of this writing, the website for the Canadian Government states: “The United States continues to meet the requirements for designation as a safe third country.”

The Canadian Council for Refugees (CCR) disagrees with this continued designation because of the changes that have taken place since Trump’s presidency making it unsafe for many people (particularly undocumented people) to continue living there; causing upward of 20,000 people to flee the United States into Canada via the Quebec and Manitoba borders (The Globe & Mail, March 19, 2018). It is estimated that about 150 per day, for example, are crossing the border from the U.S. into Quebec (CTV News, April 5, 2018).

While the CCR  – along with Amnesty International, the Canadian Civil Liberties Association, and the many healthcare providers previously mentioned – are strongly advocating for a suspension of the Safe Third Country Agreement with the U.S. Most recently on July 3rd, the CCR, Amnesty International, and the Canadian Council for Churches, filed extensive evidence to support their legal challenge of the Safe Third Country agreement, initially launched in 2017. You can read their media press release here.

It should also be noted that other political representatives have asked for the government to secure Canada’s borders by making the Safe Third Country Agreement stronger (Global News, March 14th, 2017; Global News, July 24th, 2018). Currently there is a so-called ‘loophole’ in the legislation that allows people entering Canada from the U.S. via unofficial border crossing points, to file an application for refugee status after they are detained – rather than being turned away from the border immediately (which is what can occur at official port of entry points on the border).

Providing they are released from detention, these refugee claimants then have access to (or at least are entitled to) legal aid, a temporary work permit, public education and healthcare services, while they wait for their claim to be processed and assessed.


While this access to services is positive, more resources are need to support the cities that are currently hosting the majority of refugee claimants, such as Montreal and Toronto. According to an article by The Star (June 27, 2018):

“…there are now about 3,300 refugee claimants housed in Toronto’s already-strained shelter system… Toronto needs support and money from higher levels of government to deal with all this. But so far it’s been left to cope on its own.”

“…Meanwhile, the clock is ticking. About 800 migrants are housed temporarily in dormitories at two Toronto colleges, Centennial and Humber, but students start returning on Aug. 9 and the colleges will need the spaces back.”

This situation is creating some increasing tension between the Ontario Provincial Government and the Federal Government, in regards to the need for additional funds and housing options (see the Ottawa Citizen July 12th, and July 21st 2018 for more on this). It is complicated because, while housing is primarily considered a provincial responsibility to manage, immigration is primarily a federal matter.

The risk that the increase in refugee claimants arriving in Canada from the U.S. will further inflame anti-immigrant sentiment in the country, is a real possibility. It is a risk that should be warded against through effective management of the situation in ways that simultaneously supports claimants in feeling safe and able to participate in meaningful occupations.


It has been acknowledged that occupational therapists may have difficulty directly connecting the aims of their profession to matters of justice. The following excerpts, written by those at the forefront of developing the concept of occupational justice, seek to further establish the professional obligation of OTs to respond to occupational injustices and mobilize around a health advocacy agenda based on global thinking” (Nilsson & Townsend, 2010, p. 58)…

“The central point is that occupational injustice is an outcome of social policies and other forms of governance that structure how power is exerted to restrict participation in the everyday occupations of populations and individuals.” (Nilsson & Townsend, 2010, p. 58)


[Migrating people] may be disadvantaged by refugee protocols, even to the extent of being segregated in detention centers while seeking right of entry. During formal immigration processes, most people will have access to a very restricted range of occupations. They continue to experience occupations that are far from health giving and that are unjust in terms of either human rights or health needs. Quality of life, empowerment, and social inclusion in occupations are matters of justice and of health. (Wilcock & Townsend, 2009, p. 197)


Questions for Reflection:

  • What is an appropriate occupational therapy response to immigration detention, family separation, and the Safe Third Country Agreement?
  • How can OTs effectively advocate against immigration detention and family separation policies that deny basic needs, as well as access to meaningful occupational engagement?
  • How can OTs, especially in cities such as Montreal and Toronto where the majority of refugee claimants are currently residing, support these newcomers while they live with uncertainty in a precarious situation?
  • How can OTs provide helpful health and occupation-based knowledge and expertise to policy-makers and decision-makers in their cities and communities, as to how to best support newcomers without status, or with transitional status?


Selected References

Global Dentention Project. (2008). Immigration Detention in Canada: Important Reforms, Ongoing Concerns. Retrieved from

Immigration and Refugee Board of Canada. (2018). Report of the 2017/2018 External Audit (Detention Review). Retrieved from

Nilsson, I., & Townsend, E. (2010). Occupational Justice – Bridging Theory and Practice. Scandinavian Journal of Occupational Therapy, 17, 57-63.

Wilcock, A.A. & Townsend, E.A. (2009). Occupational justice. In E.B. Crepeau, E.S. Cohn & B.A. Boyt Schell (Eds.), Willard & Spackman’s Occupational Therapy (11th ed., pp. 192-199). Baltimore: Lippincott Williams & Wilkins.

One thought on “An Occupational Therapy response to immigration detention & family separation in Canada

  1. Pingback: Newcomers in the News, November 2018 | Occupational Justice for Newcomers Network

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