Report Documents Lack of Care for Immigrants with Chronic Health Conditions, Including Mental Illness

As the Trump administration continues its aggressive crackdown on immigration, a growing number of people are being locked up in overcrowded detention facilities and denied the medical care they need. This has particularly harsh effects on people whose needs may be the greatest – those already suffering from chronic health conditions, including mental illness and addiction, according to a new report from New York Lawyers for Public Interest.

The legal rights group has been documenting persistent and systemic medical violations in immigrant detention centers for more than a decade. In October, it released its most recent report, “Denied Care, Denied Dignity,” which found a pattern of inadequate medical treatment among 19 people detained at Orange County Jail in Goshen, New York, whose medical records they reviewed. 

From January to July of this year, the jail, located about 70 miles northwest of New York City, detained 353 immigrants on behalf of the federal Immigrations and Customs Enforcement agency (ICE), according to a report in the Albany Times Union. ICE contracts with jails and private prisons to hold detained immigrants.

“ICE has manufactured a system sustained through its use of detention that strips away humanity and creates a public health crisis. Case after case reveals individuals with chronic illnesses or urgent medical needs denied even the most basic care,” said a statement from a group of doctors included in the report. 

“We know from our work that this system often targets people who are already traumatized, many of whom are fleeing violence and persecution,” the doctors added. “Rather than find welcome here, they are retraumatized through inhumane detention conditions and inadequate healthcare.”

Among other findings, the report found that: 

• The facility frequently neglected or delayed recommended follow-up care.
• People with chronic conditions like glaucoma or diabetes didn’t get the eye exams or blood pressure tests they needed to manage their illness.
• People held at the facility were frequently denied medication or given the wrong drug or the wrong dose.

These failures magnified the suffering of several people grappling with mental health and substance use issues, the report found. One, referred to as Edward R., struggled with addiction and mental health issues, but didn’t receive addiction support or counseling. Another, Leonel S., experienced extreme anxiety from being left alone in a unit with no other Spanish speakers, but wasn’t connected to a mental health care provider.

To learn more about the mental health issues at the facility we spoke via email with Sophie Dalsimer, NYLPI’s co-director of Health Justice and the lead author of “Denied Care, Denied Dignity”.

Josh McGhee: What kind of mental health care is available at these facilities?

Dalsimer: In my experience as a deportation defense attorney and from NYLPI’s work monitoring medical care in ICE detention, there is little to no mental health care available in most immigration detention facilities.

How has the lack of mental health care affected those in immigration detention?

Immigration detention is extremely taxing on people psychologically. There is never a certain end date to one’s detention, unlike people serving prison sentences for fixed terms. There is also extreme uncertainty about the outcomes, particularly in this moment when the departments of Homeland Security and Justice are making frequent changes to policy. These changes are draconian and, in many instances, unlawful. Finally, facing the prospect of deportation and separation from one’s home, family, and community is deeply distressing both for people who have lived here many years and for people who came more recently seeking asylum. Many people have genuine fears of persecution or torture if they are deported. But people in immigration detention have almost no resources available to support them in navigating these complex and terrifying realities.  

Has that changed over the years of your reporting?

No, the lack of healthcare has been persistent. There was very minimal programming (such as substance abuse counseling) that existed at OCJ before and has since been eliminated, but that happened several years ago. But mainly, the lack of mental healthcare is constant, while the intensity of enforcement, and the cruelty with which it is carried out, has increased. As a result, more and more people who are deeply traumatized are being subjected to detention without any access to adequate mental health care.  

Immigration enforcement and detention have always been immoral under all administrations. The Biden administration capitulated in many ways by cutting off access to asylum for many people and failing to shut down ICE detention centers. But there is no doubt that the level of immigration enforcement and detention has increased under Trump. The way this administration is carrying out its immigration operations is so much more violent, racist, cruel, and widespread in ways that we have not quite seen before.

Are things different under the Trump administration this time, compared to his first term?

This time around the administration has made no effort to uphold the Constitution or comply with the laws in carrying out their immoral deportation agenda. They are violating the rights of the people they detain and tearing apart so many families and communities in the U.S. at a scale that we have not seen before.  

Conditions within OCJ have been consistently bad under both administrations. There is no evidence of any improvement and from our reporting and anecdotal experience, conditions appear to be worsening. 

Your report mentions suicidality. How often is this occurring and what does it stem from?

We have not covered this in detail, but I can share my professional experience. Many years ago, I had an asylum-seeking client detained at Orange County Jail who attempted suicide. They did so after feeling hopeless. They never imagined that they would come to the United States seeking freedom and protection but face shackles and incarceration instead. I have to imagine that other people struggle with these feelings of hopelessness and disillusionment in ICE detention. The lack of mental health care also does not help. 

 Any other points you’d like to make? 

One thing that comes up a lot when we review medical records is a notation that people in ICE custody “refused” care. In my experience working with clients as an immigration attorney, I have often found this to be erroneous. Instead, people in detention sometimes do not hear when the medical staff comes into their housing unit, or proper interpretation is not used to explain a medication or treatment, or someone may be experiencing an acute mental health crisis. It’s my guess that medical staff in these facilities regard the people they are meant to care for with some disdain and this often leads to misinterpretations and a jump to conclusions that can be erroneously described as “refusal of care” — but are more likely the result of some failure on the part of the medical staff at the facility.