Clinicians’ perceptions of the health status of formerly detained immigrants

Abstract

Background In the past decade, the U.S. immigration detention system regularly detained more than 30,000 people per day; in 2019 prior to the pandemic, the daily detention population exceeded 52,000 people. Inhumane detention conditions have been documented by internal government watchdogs, and news media and human rights groups who have observed over-crowding, poor hygiene and sanitation and poor and delayed medical care, as well as verbal, physical and sexual abuse. Methods This study surveyed health professionals across the United States who had provided care for immigrants who were recently released from immigration detention to assess clinician perceptions about the adverse health impact of immigration detention on migrant populations based on real-life clinical encounters. There were 150 survey responses, of which 85 clinicians observed medical conditions attributed to detention. Results These 85 clinicians reported seeing a combined estimate of 1300 patients with a medical issue related to their time in detention, including patients with delayed access to medical care or medicine in detention, patients with new or acute health conditions such as infection and injury attributed to detention, and patients with worsened chronic or special needs conditions. Clinicians also provided details regarding sentinel cases, categorized into the following themes: Pregnant women, Children, Mentally Ill, COVID-19, and Other serious health issue. Conclusions This is the first survey, to our knowledge, of health care professionals treating individuals upon release from detention. Due to the lack of transparency by federal entities and limited access to detainees, this survey serves as a source of credible information about conditions experienced within immigration detention facilities and is a means of corroborating immigrant testimonials and media reports. These findings can help inform policy discussions regarding systematic changes to the delivery of healthcare in detention, quality assurance and transparent reporting.

Pregnant Migrant Latinas at the US Border: A Reproductive Justice Informed Analysis of ICE Health Service Policy During “Zero-Tolerance”

“…These facilities were operated by the US Department of Homeland Security (during the Trump administration this department was run by Kirstjen Nielson) (EO 13,768). These facilities experienced considerable growth in detained persons, accompanied by the rise in use of private prisons for detention, and they operate with inadequate numbers of support staff and medical staff (APHA, 2020 ; Hampton et al, 2022 ).…”

“…Men, women, and children were all detained and often separated from one another and held in different facilities (Hampton et al, 2022 ). Since children cannot be imprisoned with parents or family members, children were separated from parents and caregivers and separately placed into the federal custody of the US Department of Health and Human Services (Southern Poverty Law Center (SPLC), 2022 ).…”

Medical Mismanagement in Southern US Immigration and Customs Enforcement Detention Facilities: A Thematic Analysis of Secondary Medical Records

“…As the number of detained individuals has increased, civil and human rights organizations have raised concerns of substandard conditions in detention facilities across the country. Several published reports have highlighted overcrowded and unsanitary living conditions, physical and sexual abuse, inadequate nutrition, medical mismanagement, neglect, and abuse; leading to exacerbation of chronic medical conditions and/or development of new health conditions [ 2 , 3 , 8 , 9 ]. A study evaluating deaths of individuals in ICE detention facilities demonstrated that 71 individuals died while in ICE custody over a 7-year period, many of whom were young (mean age of 42.7 years at the time of death) with no or minor pre-existing conditions [ 10 ].…”

“…A study evaluating deaths of individuals in ICE detention facilities demonstrated that 71 individuals died while in ICE custody over a 7-year period, many of whom were young (mean age of 42.7 years at the time of death) with no or minor pre-existing conditions [ 10 ]. Mental health care in ICE facilities has been of particular concern with suicide accounting for a number of deaths for at least 2 decades, and ongoing reports of the improper use of solitary confinement for those with mental health disorders (which in fact negatively affects physical and psychological health) [ 9 , 11 – 16 ]. Historically, ICE has engaged in other unsafe mental health care practices including detaining individuals with significant mental health conditions despite court ordered requirements for inpatient mental health treatment [ 17 ].…”

The United States detention system for migrants: Patterns of negligence and inconsistency

“…Current research on the topic of migration and detention illustrates the wide-ranging issues migrants face while detained, including the increasing suicide rates of migrants, experiencing abuse and mistreatment while in detention, and the effects of forced family separation, particularly on migrant children's mental health ( Marquez et al., 2021 ; Becerra et al., 2022 ; Erfani et al., 2021 ; Hampton et al., 2022 ; Hampton et al., 2021 ; Wood, 2018 ). The COVID-19 pandemic further exemplified the risk of rapid transmission of communicable diseases while living in overcrowded facilities, indicating the need to consider alternative measures to detaining migrants to prevent outbreaks and avoid infection and death ( Casanova et al., 2021 ; Tosh et al., 2021 ; Lopez et al., 2021 ).…”