COMMUNITY CURRENTS

No Care, No Rights, No Home: The Mentally Ill on ICE

By Ross Pudaloff, Contributing Writer

The immigrant and the mentally-ill person share much. Each has trouble understanding and being understood in a world that the majority takes for granted. Neither speaks the language, literally and otherwise, of the dominant culture. Even worse, both are often regarded by members of the majority as threats (personal, economic, social, cultural, and political). Moreover, both the immigrant and the person with mental illness typically lack coping skills and knowledge to defend themselves and what limited rights we might acknowledge that they possess. They are alien to the rest of us and we treat them that way.

Imagine, then, the plight of an immigrant who suffers from mental health problems. How can he or she navigate a nearly incomprehensible world in order to get the help he or she needs? Even worse, consider the immense added difficulties if he or she is detained and subject to deportation by Immigration and Customs Enforcement (ICE). Detainment, pending deportation, is a bad enough situation for anyone, but a worse one for those facing barriers based on mental health issues. What happens to those with mental health problems while in custody of ICE would appall most ordinary folk, even those hostile to undocumented immigrants and otherwise uncaring about the mentally ill. Instead of receiving something that resembles a reasonable level of diagnosis and care, the immigrants in question often suffer neglect and, in many cases, what can only be described as abuse.

Such mistreatment is well documented.[1] It is revealing that one of the core policy recommendations of the report is that ICE provide “sound medical care” for those it detains. Justice for Immigration’s Hidden Population and the Times stories tell heartrending tales of mentally ill people in custody and subject to deportation who did not receive anything like the care they needed and deserved. For example, there is the woman who fled China after she was forcibly sterilized. She was suicidal and delusional, problems that ICE neglected while holding her in custody under threat of deportation. Unsurprisingly, her mental health deteriorated further. That was not the end of it, however. She had to face a deportation hearing in front of an immigration judge without legal assistance. Since deportation is a civil rather than a criminal proceeding, she was not entitled to free legal counsel. Overall, according to the report, 84% of detainees do not have legal counsel. At best, she and all others are provided with a list of agencies that offer legal assistance pro bono bono or at reduced cost. But, as San Francisco immigration lawyer Donald Ungar points out, the demand for legal help overwhelms the limited supply. Moreover, this particular woman did not have access to legal counsel, despite being recognized by the court as not competent to represent herself.

Even when ICE classifies a person as incompetent because of mental disabilities and therefore entitled to some form of representation, it turns out just about anyone will do. Representation does not necessarily have to be provided by a lawyer. According to the report, judges have even allowed employees of detention centers to appear as representatives in some cases. When informed of this practice, Ungar expressed shock and dismay.

No one denies that this woman was not competent to defend herself. No one asserts that she received adequate care—indeed, the amount of care she received was negligible—while incarcerated by ICE. She and others with mental illness do not receive adequate care even ICE’s own minimal standards. The agency seems more focused on meeting numerical quotas for deportations, according to a 2009 ICE memorandum cited by the Times in a story dated May 4, 2009.

Neglect is evident in other areas as well. Texas Appleseed found multiple instances in which the developmentally disabled remained undiagnosed for lengthy periods. In effect, those persons were punished for behaviors that simply were expressions of their developmental state. Not until IQ tests were finally administered did ICE even begin to respond appropriately to those individuals.

Diagnosis, or rather the lack thereof, is only the start. Treatment, when given, is skimpy and inadequate. Indeed, ICE has only had specific guidelines for treating the mental health problems of those in detention since 2008. There are, perhaps inevitably, gaps between guidelines and practice. One particularly horrifying example concerns a physically disabled woman with mental health problems. She was left naked on the floor of her cell for several days, lying in her menses.

As horrifying as that instance is, it is by no means unique. Moreover, even if an individual is one of the few to receive care, the care may be almost as bad as neglect. In one case, a man with schizophrenia was sent to a facility for treatment. His family was not told where he was or even that he had been moved to receive treatment elsewhere. Only after six months in a facility in South Carolina was he able to call them and tell them where he was. Even then it took two and a half years before he was returned to the regular immigration system and his case resumed. Dramatic changes are clearly needed both in policy and practice. Justice for Immigration’s Hidden Population provides an extensive listing of needed changes and offers multiple specific recommendations. Many focus on the need for protections for this “particularly vulnerable population,” including, but certainly not limited to, effective and adequate legal representation. Until these are implemented, persons with mental disabilities will continue to be iced.

1 If you are interested, you can read about the horrendous conditions for those being held for deportation and suffering mental illnesses in The New York Times stories over the last couple of years by reporter Nina Bernstein. If you would like a survey of the problem and have a strong stomach for graphic descriptions, continue your reading with the 2010 report, Justice for Immigration’s Hidden Population: Protecting the Rights of Persons with Mental Disabilities in the Immigration Court and Detention System. In this report, a group called Texas Appleseed tells the larger story of inadequate care, lack of concern, and what many would simply call injustice.  

PWDF Profile

Who We Are

People With Disabilities Foundation is an operating 501(c)(3) nonprofit organization based in San Francisco, California, which focuses on the rights of the mentally and developmentally disabled.

Services

Advocacy: PWDF advocates for Social Security claimant's disability benefits in eight Bay Area counties. We also provide services in disability rights, on issues regarding returning to work, and in ADA consultations, including areas of employment, health care, and education, among others. There is representation before all levels of federal court and Administrative Law Judges. No one is declined due to their inability to pay, and we offer a sliding scale for attorney's fees.

Education/Public Awareness: To help eliminate the stigma against people with mental disabilities in society, PWDF's educational program organizes workshops and public seminars, provides guest speakers with backgrounds in mental health, and produces educational materials such as videos.

Continuing Education Provider: State Bar of California MCLE, California Board of Behavioral Sciences Continuing Education, and Commission of Rehabilitation Counselor Certification.