Migrating to Mental Hell: the mental health crisis hiding in plain sight

By Riley Judd

The stories are harrowing, heartbreaking, and deeply disturbing. A man discovered by ICE officials with a “sock lodged in his throat and a nine-centimeter piece of a toothbrush handle in his stomach.” A physically disabled and suicidal woman locked in an isolated cell, denied of her crutches, menstrual products, and her dignity as “she slid around on the floor for days, covering herself and the cell in menstrual blood.” A woman with post-traumatic stress disorder and severe depression kept in solitary confinement for 372 without adequate care or supervision. 

On any given day, Immigration Customs Enforcement (ICE) holds up to 50,000 immigrants in more than 200 jails and prisons across the country, where oversight and accountability are minimal. Despite rhetoric that they are ‘dangerous criminals,’ the overwhelming majority of immigrant detainees have no criminal record, and most detainees with criminal records have committed only minor offenses like traffic violations. In fact, many are asylum seekers — forced to flee violence, persecution, or war and make arduous, often perilous, journeys in search of safety. Yet in the United States, they are treated as criminals, imprisoned in immigration detention centers that are unsafe, unsanitary, and rife with abuse. These conditions exacerbate the mental health issues that many immigrants have developed due to prior traumatic experiences. Chronic staffing shortages, insufficient resources, and other organizational failures within ICE compound the mental health crisis at detention centers. Only 21 of the 230 — less than 10% — of ICE detention facilities offer any kind of in-person mental health services. Unsurprisingly, 73% of detainees report having unmet psychological needs. Such statistics illuminate the inadequacies and incapacities of detention facilities to deal with the acute mental health issues immigrants face.

Detaining immigrants who do not pose a flight risk or threat to the community is inhumane, expensive, and unnecessary. Alternative to detention (ATD) case management programs are less costly for the government and less costly for immigrants’ mental health. In these programs, immigrants are not neglected, abused, or isolated like they are in ICE detention centers; instead, they are educated about legal requirements and equipped with essential services, including mental health support. 

Not only do ATD programs improve immigrants’ mental health, but they also reduce costs. For example, ICE’s Family Case Management Program (FCMP), a pilot program launched under the Obama administration, cost $38.47 per family per day — significantly less than the $237.60 it costs per day to detain a family.

Some argue that immigration detention is necessary to ensure that immigrants in removal proceedings comply with requirements and court decisions. However, there is substantial evidence that ATD programs achieve high rates of compliance. In the Family Case Management Program (FCMP), 99 percent of participants complied with immigration court proceedings and check-in appointments. Despite its success, Trump terminated FCMP in 2017. However, Senator Catherine Cortzes Masto introduced a bill to restore this program and require the use of community-based ATD programs for vulnerable populations. In August, the Department of Homeland Security (DHS) announced a new Case Management Pilot Program (CMPP). The program is still being developed, but based on available information, it seems that CMPP will improve and build upon FCMP. Notably, instead of contracting with a private prison company, as it did for FCMP, DHS will grant funds for nonprofit organizations and local governments to administer comprehensive case management services. 

FCMP and CMPP provide a promising model of managing immigration in a humane, cost-effective way. However, shifting from our current privatized detention system to a community-based case management system will not happen overnight. We need to enhance and expand ATD case management programs while also addressing the immediate crisis in immigration detention facilities. Democratic lawmakers have introduced legislation to advance these goals through various reforms, including prohibiting solitary confinement and increasing oversight of ICE. Several states and local governments have ended the use of private detention facilities and limited cooperation with ICE officials to protect low-risk immigrants from being detained. 

The coronavirus pandemic has sparked crucial conversations about mental health. However, key voices have been absent from these conversations: detained immigrants. We must speak up for the tens of thousands of people who are crying out but cannot be heard, trapped in the mental hell of immigrant detention.