A former adviser to the federal government on mental health in detention has slammed Labor's immigration policy. Louise Newman says the majority of asylum seekers on Nauru will develop psychiatric disorders.

Originally published at New Matilda.

Omid, a 35-year-old Iranian man, has been on hunger strike for 50 days, refusing food and fluids in protest against his indefinite detention by the Australian government on Nauru. He is reportedly close to death. This week he has been moved between a tent, where he was surrounded by security guards, to the island's hospital. Yesterday, asylum seekers told the Refugee Action Coalition (RAC) they did not know where he was, but issued a statement calling for him to be brought back to Australia.

UPDATE 4:20pm: The Refugee Action Coalition spokesperson, Ian Rintoul, told New Matilda that he had heard from his sources on Nauru that a medivac ambulance was being refuelled on the Nauru tarmac and Omid was being brought back to Australia.

Louise Newman, Professor of Development Psychiatry at Monash University and Convenor of the Alliance of Health Professions for Asylum Seekers, told New Matilda she was aware that doctors treating Omid on Nauru had advised the government to bring him to Australia for treatment. She described Nauru as an "explosive situation", and said that evidence from other detention centres showed these events were "highly predictable and therefore should have been prevented".

Despite a spokesperson for the Department telling Fairfax media yesterday that it would act on medical advice, so far Omid has not been transferred. The Greens have also called for Omid to be immediately transferred to Australia.

Since the reopening of Nauru earlier this year, the Salvation Army has been contracted to provide "basic welfare and support services" to detainees, including education, recreation and respite. NM spoke with Salvation Army spokesman Major Paul Moulds, who described Omid as a "brave man, a man of integrity".

"We have an excellent relationship with [Omid]," Moulds said. "But he has chosen a course of action and at this point in time he's determined to follow through with those sorts of actions".

Moulds describes Nauru as a "difficult situation." He declined to comment on Omid's medical treatment or whether he had made specific appeals to the Department of Immigration about having him transferred to Australia:

"Well obviously we're consistently making representations to the Immigration Department about many many issues related to the care and wellbeing of the asylum seekers in that place. We're... consistently asking the immigration department to move forward the processing and see conditions and facilities improve. I mean, Omid's demands are no different to many others. Certainly his actions are possibly the most extreme thus far. His protest, that determination to see things improve. But his demands are no different to many others."

Nineteen other asylum seekers remain on hunger strike, some refusing water. Self-harm among asylum seekers has escalated with the Department of Immigration acknowledging that 10 asylum seekers had hurt themselves in one day. There have been at least two attempted hangings this week.

On Wednesday night, a brawl broke out between asylum seekers and detention centre guards. According to Ian Rintoul from the RAC who spoke to NM by phone this morning, the catalyst was the announcement of bridging visas for asylum seekers on the mainland. Five asylum seekers who were removed from the detention centre following the unrest allege they were beaten by Wilson security guards, Rintoul told NM.

He describes the situation as a "complete meltdown", such that Salvation Army workers were acting as guards to try and quell the violence. One Nauru worker told Rintoul it was "the worst it has ever been". Photos of asylum seekers playing soccer, published in The Australian, have exacerbated the situation, leading to a boycott of recreational "excursions".

"No one will go on an excursion now. We are not going outside. We want the media to come and see what is happening to us," one asylum seeker told the RAC.

Since Amnesty International visited and inspected flooded tents housing up to 14 people, it has continued to rain heavily with more storms on the way. In the stifling heat, the physical and mental health of other men is deteriorating.

Newman said that the asylum seekers are protesting because they "feel abandoned and utterly desolate". She and many others in Australia's mental health community say that given current processing times these events are predictable. She is concerned that "the collective memory about what happened a decade or so ago [on Nauru] is pretty weak, where we saw similar outbreaks of mass protest and quite serious self-harming behaviours. But at the moment the department is seemingly not wanting to address the broader systemic issues that are contributing to this".

The Minister for Immigration, Chris Bowen made a statement last week that detainees were receiving the "best care possible in the circumstances". Newman said," I am not sure what he is comparing it to but it is not the case. There are real concerns about the capacity of the hospital on Nauru to respond and treat effectively people who are potentially shutting down and at risk of dying of voluntary starvation and dehydration... reliable sources tell me that it is likely [Omid] will be transferred but we'll wait and see and that needs to be done fairly quickly."

Until August, Newman was the Chair of the Detention Expert Health Advisory Group, an independent body providing advice to the Department of Immigration on the health needs of asylum seekers. The committee wound up in August, around the time when the Houston Expert Panel advising the government on refugee policy gave its report.

The Department is setting up a new group, the Health Advisory Group, which will include representatives of professional health bodies. It has taken nominations but Newman is deeply concerned about the delay.

"Now we are facing a significant crisis where you would assume independent advice would be welcomed," she told NM.

In the meantime, the government is setting up a Joint Oversight Committee which Newman says lacks the necessary medical or psychiatric knowledge. It is chaired by Paris Aristotle, one of the three members of the Houston Panel. Newman believes Aristotle has "a conflict of interest," as he is one of the "architects of this appalling situation". He is being "asked to review the damage that his own recommendations have created. I think that is deeply troubling," Newman said.

The committee includes one highly qualified mental health nurse but apart from that there is no medical personnel. "They cannot give the level of advice needed and are not independent because they are ministerial appointees," she said.

"[The Department] are clearly in need of independent expertise at the moment — we are facing hunger strike; we have children on Manus Island where they are exposed to multi-drug resistant tuberculosis and malaria; we know there have been outbreaks already of voluntary starvation. There is no pediatric and child psychiatry input at all."

Newman believes that if Nauru is not closed the demand for medical services will increase "dramatically after 12 months". She argues that medical evidence shows that the health of asylum seekers will deteriorate markedly after 12 months, until the majority have a psychiatric disorder as well as physical health problems. "We could throw a thousand psychologists and a thousand psychiatrists into detention but people would still want to die in detention," she said.

The National Director of Uniting Justice Australia, Reverend Elenie Poulos agrees with Amnesty International that Nauru should be shut down immediately. She told NM that she finds it hard to believe that, "as a rich and secure country we are deliberately putting people in situations which we know will lead to self-harm... We talk about saving lives but we are deliberately harming people in ways that they will live for the rest of their lives. They may still be alive but they will suffer for the rest of their lives".

Poulos argues that by putting people in indefinite detention and by releasing others without work rights, Australia is losing "any moral high ground it had in dealing with a regional solution". Our capacity to implement the Houston Panel report by working with Malaysia and Indonesia to reach a regional solution is at risk, Poulos said.

Protesters outside Immigration Minister Chris Bowen's office. Photo supplied by Marijke Hoving.

Yesterday, around a dozen members of the Sydney University Anti-Racism Collective attempted to occupy Bowen's office in Fairfield, Western Sydney, but found the door blocked when they arrived. Police were called and two protesters were arrested. One of the protestors, Marijke Hoving, told NM, "there is a man starving in Nauru and it is not in my name... Omid is on his deathbed and Bowen could easily bring him to Australia, but he will not do that because he says other people will go on hunger strike".

"These 400 people are being used as political footballs. If Bowen was seriously interested in saving lives, he would process people in Indonesia and Malaysia," Hoving said.