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Medical Treatment in Detention Facilities

New York, NY

The Women’s Commission for Refugee Women and Children urges immediate action to address the unacceptable level of medical care in migrant detention facilities. Recent reports have highlighted a pattern of terribly poor care and inadequate oversight at facilities across the country. The news that at least 65 people have died in ICE custody raises especially grave concerns about the quality of care. Detainees should receive adequate medical care; they should not be dying of treatable illnesses due to a lack of care.

Issues related to the quality of medical care have plagued the detention system for a number of years. In its work with vulnerable women and families in detention, the Women’s Commission has documented numerous instances of highly inadequate medical care. This has included denial of needed medical care, delays in treatment of medical conditions, including suspected cancers, and poor pre-natal care. When we visited the newest family detention facility in late 2006, detainees reported they were discouraged from seeking medical care and were sometimes provided with medicines inappropriate for their medical needs. Only after our visit, did the facility contract with a local clinic to provide regular prenatal screenings and care.

The provision of adequate mental health care in detention facilities is also a serious and ongoing issue. Many migrant women and girls become victims of sexual assault on their journey to the United States and adequate mental health services are essential for their recovery. At our most recent visit to a detention facility—the family detention center in Texas—one of the two mental health providers was not licensed at the time of our visit. Detainees reported that mental health services were not regularly provided and they were discouraged from accessing these services.

The Women’s Commission urges the Administration and the Congress to work together to ensure that adequate health care, including mental health care, is provided at detention facilities across the country. Codified standards and effective oversight mechanisms must be put in place at privately and publicly operated centers. System-wide reform is required, and we strongly support a plan of action that includes the following key elements:

• Mandate the codification of standards governing the conditions and treatment of all immigration detainees.

• Modify the DIHS Detainee Covered Services Package to ensure appropriate medical care to detainees. Care should be consistent with ICE Detention Standards on Medical Care, correctional health standards upon which the detention standard is based, and established principles of constitutional law.

• Properly fund medical, mental health, dental and vision care services, as well as translation assistance in all facilities detaining immigrants.

• Permit on-site treating clinicians to make medical judgments about the appropriate care for detainees. The current process results in unacceptable delays in the provision of care and incorrect decisions.

• Require immigration authorities to report every death of a detainee in its custody and require the Department of Homeland Security’s Inspector General to conduct an immediate investigation of the circumstances of the death and release Reports of Investigation promptly to the public.

• Provide for the nationwide expansion of alternatives to detention, including the expansion of release and parole, to ensure immigrants are detained only when necessary.

• Abolish the detention of asylum seekers in all but the most extraordinary of cases, as being imprisoned has proven to compound the mental anguish and trauma they have previously suffered.

We hope these issues will receive the urgent attention they require and that needed reforms are made so that the medical care provided to migrant detainees is consistent with America’s core values of concern and care for the must vulnerable among us.