LatinaLista -- Texas Appleseed, a public interest law center working for greater educational, economic and social justice through research, advocacy and pro bono partnerships recently released a study based on a year-long review of the immigration court and detention system in Texas. It follows the national Appleseed study, Assembly Line Injustice: Blueprint to Reform America's Immigration Courts, released last year.
The 88-page report titled: Justice for Immigration's Hidden Population: Protecting the Rights of Persons with Mental Disabilities in the Immigration Court and Detention System examines how the nation's immigration court and detention systems fail to address and accommodate the basic needs of people with mental disabilities -- and how this failure compromises humane treatment and just adjudication of immigration cases for this vulnerable population.
The following is a condensed version of the full report.
A quarter of all immigrants apprehended each year in the U.S. are sent to detention facilities in Texas. The problems documented in the report are not unique to Texas, however. Poor quality care in detention, arbitrary transfer to detention facilities far away from family and other community and mental health supports, and due process failures are major challenges facing immigration detainees with mental disabilities.
The detained immigrant population includes asylum seekers, persons who have entered the United States without authorization, U.S. permanent residents who may be subject to deportation for having committed criminal acts (the vast majority of which are non-violent and many of which are relatively minor), and others who simply have no documented right to remain in the U.S. Immigrants in detention range in age and include women, men and entire families.
Detainees are held in "facilities largely designed for penal, not civil, detention," ICE recently acknowledged. Not surprisingly, immigrants in the civil detention system are often treated like criminals: they are typically required to wear prison uniforms, housed in cells or "pods," allowed only limited contact with the outside world, and monitored constantly.
The responsibility for detainee health care varies depending on the type of facility. As the Government Accountability Office found in 2009, "ICE's organizational structure for providing health care to detainees is not uniform across facilities."
Health care is particularly important for immigrants in detention, as screenings at detention centers showed that 34 percent of detainees suffer from chronic conditions, including hypertension, diabetes and/or mental health issues.
Responses to our FOIA requests indicate that ICE keeps scant system-wide data regarding immigration detainees with mental disabilities. One estimate is that at least 15 percent of immigration detainees have a mental disorder.
The Director of the Division of Immigration Health Services (DIHS) noted in the spring of 2009 that "demands on DIHS to provide mental health care services for detainees continue to grow with the size of the detainee population." In FY 2008, ICE recorded a total of 29,423 mental health interventions for detainees in DIHS care, 13 percent of the total number of DIHS intake screenings for the same year.
DIHS apparently keeps few, if any, meaningful statistics concerning immigrants with mental disabilities in detention. Through the Freedom of Information Act, we asked DIHS for all records relating to the number of persons in detention receiving mental health care annually since January 1, 2006, as well as specific requests relating to drugs prescribed.
The only data DIHS provided was an aggregated total number of psychotropic drug prescriptions in facilities where DIHS provides health care services, for the period of January 1, 2005 through June 1, 2009. During this period, 14,859 immigrants in detention nationwide received an average of more than five prescriptions for psychotropic drugs.
Steven Schulman, Akin Gump's firm-wide Pro Bono Partner, said, "Immigrants with mental disabilities are detained in a system ill-equipped to care for them and often arbitrarily transferred away from their communities, denied basic due process in a complex immigration court system, and released from detention or removed from the U.S. with little concern for their safety and well-being."
"There is precedent under the law to extend special legal protections to vulnerable populations, and such special protections should be extended to persons with mental disabilities in the immigration court and detention system," he said. Other major Texas Appleseed recommendations include:
Immigrants with mental disabilities should be placed in the least restrictive setting -- and allowed to continue receiving mental health services in the community or in a hospital while their immigration cases are adjudicated.
Immigration Customs Enforcement (ICE) should improve and establish consistent procedures for screening and diagnosing mental disabilities, improve mental health care in detention, and provide timely access to medical records.
"When immigrant detainees do not receive timely or appropriate medication, many decompensate to the point that they cannot comprehend their situation or participate meaningfully in deportation proceedings," said Texas Appleseed Senior Policy Analyst Ann Baddour.
Over 80 percent of detained immigrants have no attorney, and currently there is no process for establishing competency in immigration court. The U.S. Department of Justice should adopt consistent procedures for recognizing immigrants with mental disabilities and adopt standards to accommodate these disabilities in immigration courts, including standards for appointing counsel.
ICE should develop and follow clear procedures to ensure safe domestic release or repatriation of immigrants with mental disabilities.
Through our field research, Texas Appleseed learned that two immigrants admitted to the South Texas Detention Center in Pearsall, Texas, were never treated for their manic depression and schizophrenia. One detainee, a legal permanent resident, had been diagnosed with bipolar disorder, post-traumatic stress disorder, and severe depression prior to her detention. Her mental health issues were not diagnosed when she was first detained by ICE in August 2006, and during her 18-month detention her mental illness continued to go undiagnosed and untreated. Guards at the South Texas Detention Center ridiculed her by telling her she was not truly sick, that she was faking her illness, that she had no rights in the United States, and that she would be deported to Mexico.
According to an August 2007 review by the Detention and Removal Operations San Antonio Field Office, personnel at the South Texas Detention Complex left a physi- cally disabled woman with mental illness naked on the floor in solitary confinement, bleeding from her menstrual cycle. She was left in this state for several days with no sanitary napkins, according to the report. A physician's assistant at the facility noted that "the facility is not equipped to provide the proper mental treatment for the detainee."
Andre Osborne was detained by ICE in New York in 2008 for removal from the U.S. based on a 15-year-old drug charge. After being transferred to the Willacy Detention Center in Texas, he was diagnosed with severe depression and was put on new drugs even though he had been previously diagnosed in his community.
Osborne said he "was very depressed because I was dealing with an issue of a disabled wife at home. I was in mandatory detention with no possibility of receiving a bond....I took the medicines into the dorm...washed up, brushed my teeth,...came to my bunk, opened a magazine and started to read like I do every night and that was the last thing I remember until I woke up the next day at 4:30 p.m." While unconscious from the medications, he fell out of a top bunk and severely injured his face. He was taken by ambulance to a local hospital.
He slept through the entire 19-hour episode. After he awoke, he asked the facility counselor what had happened. "When she gave me the time between the actual medical emergency call,...and the time when I came back to the facility...I am asking myself only one question: 'How could I not know all of this?' And she said, 'Osborne, you were overmedicated. You were heavily sedated, and that's why you don't remember anything.'"
He refused further medication and was released to his wife in late 2009 after nearly two years in detention.
An immigration attorney described a case in which a client with schizophrenia was transferred to Columbia Care once the judge adjourned his immigration hearing and ordered DHS to obtain a competency assessment. The immigrant's family was not told about the transfer to Columbia Care. His mother went to visit him after his court hearing and was told he was no longer in detention.
The immigration officials refused to give her any information. "[His] mother feared that [her son]had disappeared. After more than six months of not knowing where her son was, [his] mother finally received a call...[he] told his mother that he had been taken to a prison hospital in South Carolina and had not been allowed to use the phone or contact anyone."
Two and a half years passed before he was brought back to San Diego and had his immigration case re-opened.