ratified by the Netherlands] repeated attempts at expulsion to a country which is not guaranteed to admit the individual concerned may amount to inhuman or degrading treatment”.109 If, as happened almost certainly in the case of one of the interviewees, a bilateral deal is struck to return someone despite his or her statelessness, “[g]uarantees that the individual will be treated in accordance with international human rights law and, where nationality is not on offer, the standards set out in the Statelessness Convention would surely be appropriate”.110 82. The adverse connection between the interviewees’ inability to establish their identity and the likelihood of detention has already been emphasized. This is particularly true for the situation after 2004, when a general obligation to carry personal identification was introduced in the Netherlands. Another consequence of a lack of means of identification pertains to difficulties in accessing healthcare that should by law be available to all residents in the Netherlands.111 Various interviewees indicated that they had been either refused essential care, or that they had postponed important check-ups for fear of being “discovered”. A majority of respondents struggled with psychological issues, often related to post-traumatic stress disorder (PTSD) and depression. These mental issues were either a manifestation of traumatic experiences in the past, or had been caused or aggravated by the apparent lack of judicial or other means to resolve their situation. Many interviewees repeatedly expressed the desire to be treated “as a human being”. Those who were fortunate enough to be assisted by an NGO experienced considerably fewer problems, as these organizations regularly paid for essential treatment. Nevertheless, although the Aliens Act 2000 mentions that all aliens should have access to “medically necessary healthcare”,112 the line between necessary and optional is not clear and appears to be applied in an unpredictable and ad hoc fashion. 83. Even stateless people, who were still in an (asylum) procedure and were thus lawfully resident in the Netherlands, experienced trouble establishing their identity themselves. Several interviewees should in theory have been entitled to a W2 identity document, but had nonetheless not been provided with this crucial piece of documentation. This was because, as the former State Secretary of Justice explained in a letter to the National Ombudsman in 2007, no ID documents were (or are) issued during the procedure of persons who had claimed to be stateless. The rationale behind this was that “issuing an aliens’ passport or identity document will remove the incentive to fully commit to acquiring a passport”.113 If the person in question was later officially found to be stateless but not granted a residence permit, no aliens’ passport or identity document would be granted either.114 The National Ombudsman took up the case of one stateless person of Latvian origin and concluded that the State Secretary ought to reconsider her position, as the person concerned deserved a means of identification on the basis of Article 27 of the 1954 Convention.115 This recommendation has so far not resulted in any change in policy. 36 109  . Mandal, “Discussion Paper no. 4: What Status Should Stateless Persons Have at the R National Level?”, Discussion papers series for the establishment of a UNHCR Handbook on the Determination of Statelessness (2010), 20. 110 Ibid., 25. 111  his inaccessibility of healthcare to stateless persons has previously been reported in the case of T Roma individuals. See Dokters van de Wereld, “Stateloos maakt radeloos. De situatie van stateloze Roma in Nederland 2009”, (2010), section 6.4. 112 Aliens Act 2000, Article 10(2). 113  etter of the State Secretary of Justice to the National Ombudsman, 29 June 2007. Report L 2007/328. 114 A. Busser and P.R. Rodrigues, “Staatloze Roma in Nederland”, 386. 115 Nationale Ombudsman, report 2007/328. Mapping statelessness