Terrorizing Latina/o Immigrants: Race, Gender, And Immigration Politics in The Age of Security by Anna Sampaio

Policy Statement on the Incarceration of Undocumented Migrant Families: Society for Community Research and Action Division 27 of the American Psychological Association.

Social workers have always been at the forefront of work with immigrants. From our profession's earliest days working with immigrants at the Hull House in Chicago to the current immigration debate, our commitment to social justice has driven both our service and policy positions regarding immigration. Our values have not changed, neither have some of the more divisive and destructive aspects of the immigration debate. Historically a nation created by immigrants seeking respect for individual freedoms, the United States has a history of anti-immigrant rhetoric and public policies criminalizing immigrants or viewing them as a threat to U.S. security. The same themes that were raised in the 1800s are being raised today, but now with a focus on Latino immigrants and under the jurisdiction of the Department of Homeland Security (DHS). Since March 2003, the functions of the Immigration and Naturalization Service were transferred to the new DHS as three bureaus: Citizenship and Immigration Services, Customs and Border Protection, and Immigration and Customs Enforcement (ICE). Following immigration protests in May 2006, DHS and ICE have increased their raids, arrests, and deportations, creating a hostile climate for all immigrants regardless of their legal status and making undocumented immigrants, their families, and communities especially vulnerable. Given the heated debate on immigration, it would seem that the United States would have extremely high numbers of immigrants. In fact, only 11.7 percent of the current population is foreign born (U.S. Census Bureau, 2004), and of them 30 percent are naturalized citizens (Passel, Capps, & Fix, 2004). Children in immigrant families make up 20 percent of U.S. children, and four-fifths of them were born in the United States and are therefore citizens. Although people from all nationalities immigrate to the United States, the majority of immigrants are from Latin America. In fact, more than 53 percent of all foreign-born individuals are from Latin American countries, primarily Mexico (U.S. Census Bureau). Between 80 percent and 85 percent of the immigrants from Mexico initially enter the country as undocumented immigrants (Passel, 2005). It is this undocumented population that has led to controversial state and federal proposals. NATIONWIDE PROPOSALS Across the country, state legislatures and localities are grappling with immigrant policy. In 2007, more than 1,400 bills were filed addressing immigrant policy at the state level (National Conference of State Legislatures, 2007). Much of the state legislation has focused on increasing employer sanctions and denying public benefits on the basis of immigration status. In Texas, a bill was filed that would deny public benefits, such as state health insurance, to children born in the United States to undocumented immigrants. Arizona passed legislation to create harsh employer sanctions for businesses who hire undocumented workers. We believe both these bills are an attack on the Latino populations in these states. In addition to state legislation, the attack on immigrants has also surfaced within local communities. A suburb of Dallas, Texas, voted to prohibit landlords from renting to undocumented immigrants, who are primarily Latino in that area. When municipalities have moved to create local ordinances offering rights or protections to immigrants regardless of status, such as New Haven, Connecticut's, creation of a municipal card for city services or Chelsea, Massachusetts's, passing of a Sanctuary ordinance, ICE raids and detentions have immediately increased. Perhaps the most prominent debate over the past several years has occurred at the federal level. Ignited by fears of terrorism, immigration proposals have been considered that fail to balance security concerns with respect for constitutional protections, human rights, or equality. In 2005, Congress passed the Border Protection Anti-Terrorism and Illegal Immigration Control Act, which would have made it a crime to assist undocumented immigrants. …

U nlocking Human Dignity: A Plan to Transform the US Immigrant Detention System addresses one of the most troubled features of the US immigration system and highlights the need for fundamental changes to it. The report comes six years since the inception of the Obama administration’s detention reform initiative. In the interim, the number of immigrant detainees per year has risen to more than 400,000, the administration has opened immense new family detention centers, and the overwhelming majority of persons in the custody of the Department of Homeland Security (DHS) have remained in prisons, jails and other secure facilities where they are subject to standards designed for criminal defendants and, in many ways, treated more harshly than criminals. The report’s overarching recommendation is that the US immigrant detention system be dismantled and replaced with a network of supervised release, case management, and community support programs, designed to ensure court appearances. It recognizes that detention may be necessary for short periods and in certain cases, but it rejects detention as a central immigrant “management” tool, and argues that detention should only be used as a last resort if less harmful strategies and programs—viewed on a continuum beginning with the least restrictive and moving to release programs with different levels of supervision, monitoring, and support—cannot reasonably ensure court appearances or (in rare cases) protect the public. It opposes the detention of pregnant and nursing women, bona fide asylum seekers, the very ill, the disabled, the elderly, and other vulnerable persons. It calls for the substantial contraction of detention facilities and “bed space.” As the first step in this process, the report urges Congress to commission a comprehensive study on the benefits, challenges, cost, and time frame for creating a civil immigration detention system. It also proposes that the administration create a full menu of court compliance programs, with varying degrees of supervision, reporting, oversight and monitoring. In order to realize this vision, it offers several additional recommendations. T he Obama administration should desist from using detention as a “deterrent” to illegal migration and de facto refugee flows . DHS should close its family detention centers in favor of community-based supervision and support programs for immigrant families. The vast majority of families would appear for removal proceedings with appropriate orientation, supervision and community support. The growth of an immense family detention infrastructure will not (as intended) deter imperiled persons from seeking refuge in the United States, but will invariably lead to the return of de facto refugees to their persecutors in violation of international law. C ongress should pass legislation to repeal mandatory detention in all but the most egregious criminal and national security cases . US mandatory detention laws cover lawful permanent residents, asylum seekers, petty offenders, and persons with US families and other enduring ties to the United States. By definition, they prevent individualized release determinations based on family ties, employment, housing, criminal history, and other factors. In the overwhelming majority of cases, immigration judges or judicial officers should be permitted to consider the full range of equities and release options for persons in removal proceedings, whether formal court proceedings or non-court, administrative and summary processes. P r ivate corporations should have a more limited, regulated and modest role in a shrinking detention system . The federal government has increasingly ceded responsibility for detention to entities whose loyalties run to their shareholders, not the common good. By some estimates, for-profit prison corporations administer more than 60 percent of the “beds” in the US immigrant detention system. Rather than expanding its reliance on for-profit prison companies, the federal government ought to decrease the use of detention, develop greater government expertise, and strengthen oversight of private contractors. D etention reform should include a significant expansion of Alternative to Detention programs (ATD) . Detention should only be used sparingly, for brief periods (when necessary), and as a last resort when less restrictive strategies cannot reasonably ensure appearances during the adjudication and removal process and cannot protect the public. ATD programs can offer effective, humane alternatives to detention. However, they should not be used to expand detention capacity. Like detention, intensive reporting and monitoring programs can stigmatize and incapacitate persons. If necessary, ATD programs should be treated as a form of custody, which would open them to mandatory detainees. Immigration and Customs Enforcement (ICE) should undertake a comprehensive analysis of its information systems . The proposed review should identify the information ICE tracks on those who are subject to its custody; how, when, and which officials collect, enter, and can access this information; its quality control procedures; and the accessibility of information to congressional oversight committees, government watchdog agencies, relevant ICE officials, and the public. D etained immigrants—those who do not qualify for release or ATD programs—should be held in non-penal settings which reflect the conditions of normal life to the extent feasible . DHS should provide generous access to international organizations, faith-based groups, nongovernmental organizations (NGOs) and the press, to all of its facilities. Immigration judges should adjudicate removal cases now handled through administrative, informal and non-court processes, and should make release and custody determinations soon after their detention for all persons in DHS custody . They should also regularly revisit custody decisions for detainees. However, these responsibilities—added to an immense yearly workload and a daunting backlog of more than 440,000 cases—will require increases in funding and staffing by an order of magnitude. As it stands, the immigration court system receives less than two percent of the combined funding of Customs and Border Protection (CBP) and ICE. The cost of “right-sizing” the immigration court system may well be offset by reductions in DHS detention funding and diminished federal court expenses from habeas corpus petitions. U nrepresented, indigent persons in removal proceedings should be provided with legal representation at the government’s expense . As numerous studies have revealed, legal counsel is one of the most important factors, even more important than the strength of the underlying legal claim, in influencing asylum and other case outcomes. Representation also increases court appearance rates and leads to decreased overall costs to the government due to reduced use of detention, more efficient court proceedings, and less frequent placement of the children of detainees in foster care. More importantly, it contributes to the right decisions being made under the law. Migration and Refugee Services of the US Conference of Catholic Bishops (MRS/USCCB) and the Center for Migration Studies (CMS) approach the detention of immigrants from a pastoral perspective. Each day US Catholic institutions minister to detained immigrants, represent them in removal proceedings, tend to the material and spiritual needs of their families, and witness the pain of traumatized children and the anguish of divided families. Because of the detention system’s devastating effect on the lives of millions of persons each year, MRS/USCCB and CMS strongly support the transformation of this system and urge the Obama administration and Congress to proceed with the proposed reforms with all deliberate haste.

O n an overcast September morning that seemed like any other, twenty-year-old Steve Li woke up early and began getting ready for his classes at the City College of San Francisco. He ignored the unexpected ringing of the doorbell, until it was replaced by an urgent pounding at the door. Moments later, as he stood in the bathroom, he heard his mother’s voice as she answered the door. What happened next is a nightmare familiar to some 11 million undocumented people who reside in the United States, many of whom live day to day with uncertainty. Deportations are on the rise. According to data from the Department of Homeland Security, last year they hit a record high of nearly 410,000, a rate double what it had been over the previous ten years. And that number doesn’t include “voluntary returns” — mostly people who are picked up by border patrol and forced to leave. Under the two Obama administrations, U.S. Immigration and Customs Enforcement (ICE) has deported more people than during Bush’s presidency. Nearly half of those deported in fiscal year 2012 had no criminal record, like Steve Li. Of those with criminal convictions, most were convicted of low-level offenses such as forgery, driving without a license, or drinking in public. Too often, individuals facing deportation have endured this process in isolation, sometimes further isolated by feelings of shame. But with increasing frequency, communities — often those with the fewest legal rights — are organizing to expose and resist the violence of deportation. It is an understatement to say that it is difficult to stop a deportation. Legal codes regulating immigration and deportation can be arcane and esoteric, and are described as among the most complicated of U.S. laws. Nevertheless, victories are possible. One ad hoc defense group convinced a state senator to intervene in a deportation. Another campaign halted a seemingly irreversible final removal order at the eleventh hour — the procedural equivalent of slamming the brakes on a train and watching it come to a screeching halt at the edge of a cliff. Other times, victory manifests in meaningful but less measurable forms: a box full of letters, an extension granted in an appeals process, or a packed room full of supporters.

The United States has long struggled with the practice of detaining immigrant families and over time, most reform efforts have flagged, if not failed. This paper examines the impact of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA) through an exploration of the evolution of the family residential center (FRC) for families in immigration custody, established prior to the 9/11 terrorist attack by the Immigration and Naturalization Service (INS), and expanded by Immigration and Customs Enforcement (ICE) in its aftermath. The paper provides an inside look at how policymakers, at various points in the Obama administration, sought to roll back its most infirm practices and the fate of those efforts. It begins with a brief history of family detention in the United States, continues with a summary of the reforms undertaken both early and late in the Obama administration, and examines the significant challenges it faced and the less progressive positions it adopted during its first and second terms in office.The paper concludes with a discussion of reasons for the rapid reversal of its previous reforms and provides recommendations to achieve a civil, civil system of immigration enforcement for families and all others, which means nothing less than the transformation of the immigrant detention system from a criminal to a civil paradigm, consistent with the population and legal authorities.[1] The need for such an effort is all the more urgent in light of executive actions taken in the early days of the Trump administration and their initial outcomes. Among those thwarting admissions are orders to Customs and Border Protection (CBP) and US Citizenship and Immigration Services (USCIS) to seal the US borders, shun refugees fleeing from war-torn regions until “extreme vetting” measures are put into place, and reassess others who have already been issued visas. Additional orders issued to ICE expanded and expedited the removal of persons whose conduct could result in charges or convictions as well as those with criminal charges or convictions, resulting in a 38 percent increase in arrests by ICE agents within the first 100 days of the Trump administration (Dickerson 2017b; Duara 2017). [1] For further discussion of the concept of a civil, civil system of immigration enforcement, see Schriro (2009).

Research ObjectiveSince 2017, intensified deportation efforts against immigrants have increased the population in Immigration and Customs Enforcement (ICE) detention nationally. ICE assumes responsibility for the health and safety of individuals in their custody for the duration of detention, as mandated by their Performance‐Based National Detention Standards (PBNDS). Following the death of an individual in detention, the ICE Office of Detention Oversight produces Detainee Death Reviews (DDR). DDRs evaluate circumstances surrounding the death and determine whether PBNDS were violated. To gain a more comprehensive understanding of ways in which health systems factors may have contributed to deaths in ICE detention facilities, we systematically analyzed the text of 55 DDRs conducted between 2011 and 2018.Study DesignA total of 55 DDRs from 2011 to 2018 were obtained via a combination of the Official Department of Homeland Security ICE Freedom of Information Act website and from civil rights organizations. Data was extracted from each DDR using a standardized tool. Data extracted described the deceased's demographic information, immigration, criminal, and medical histories, objective medical data, and any PBNDS violations identified and acknowledged in each death report.Population StudiedIndividuals who died while in ICE detention.Principal FindingsThe research team successfully obtained DDRs for 55 (92%) of 69 reported deaths5–7 among individuals in ICE detention between 2011 and 2018. Individuals who died were predominantly male (86%); averaging 42.7 years of age at the time of death. The deceased had lived in the United States for a mean of 15.8 years prior to entering ICE detention and spent a median of 39 days (range 1–1865; mean 120) in ICE custody prior to death. Individuals who died had relatively low burdens of pre‐existing disease as illuminated by Charlson Comorbidity Index (CCI) scores of 0 (33%) or 1–2 (27%). Markedly abnormal vital signs were documented prior to 51% (28) of deaths, with 71% (20) of deaths preceded by abnormal vital signs during multiple encounters prior to death or hospital transfer. Most deaths (n = 47, 85%) were attributed to medical causes, while 8 (15%) were attributed to suicide. None of the individuals who committed suicide were on suicide watch at the time of death; though half had been at some time during their detention. Among 55 death summaries, a total of 86 counts of PBNDS deficiencies were noted across 7 categories. Overall, 43 (78%) of DDRs identified PBNDS deficiencies related to Medical Care, with a mean of 3.16 deficiencies related to Medical Care per case (Range 1–13).ConclusionsFindings suggest that substandard medical care occurring within ICE detention facilities may have contributed to or failed to prevent deaths of multiple individuals in ICE detention between 2011 and 2018. Additionally, the detention death review process found the majority of detention facilities had violated ICE's own medical standards repeatedly.Implications for Policy or PracticeThese results highlight the need for further independent investigations into medical and psychiatric care provided to individuals in ICE detention facilities, and greater mechanisms for external accountability.Primary Funding SourceHaas JR Foundation.

The public focus on domestic violence has been one of the most successful campaigns of the modern women's movement. This success was achieved in part through the creation of strategic alliances among agencies and organizations responding to partner violence. One of the most contested of these alliances involved partnering with the criminal justice system. While representing an advance in holding police accountable in protecting all citizens (Coker, 2006), this alliance has had problematic consequences, particularly as it has extended state power into the lives of women of color (e.g. Richie, 2005). This problem is exacerbated by new collaborations between law enforcement and Immigration and Customs Enforcement (ICE). Federal mandates like the Secure Communities program bring together local law enforcement and ICE throughout the United States, to increase deportation rates (Immigration and Customs Enforcement, 2009). As a result, many recommendations by domestic violence advocates to survivors now potentially include the presence of ICE in that referral. This dissertation explores how domestic violence advocates within the tri-county area of Portland, Oregon are responding to law enforcement-ICE partnerships. Advocates remain understudied in the domestic violence literature, in spite of the complexity of their roles. This dissertation fills this research gap in examining the processes advocates employ in responding to dilemmas faced by marginalized survivors. A total of twenty-five advocates from three separate agencies participated in the study, which centered on focus groups carried out in the agency settings. The dissertation pursues three research questions: 1) How do advocates work through a key dilemma that has emerged in their practice? 2) What are the discursive strategies enlisted by advocates in addressing a dilemma at the border of domestic violence and immigration politics? 3) What is the relationship between each group's proximity to working with undocumented survivors and their decision-making process? A case study methodology was used to evaluate proximity to work with undocumented survivors and the organizations' general orientation to domestic violence work. Transcripts of the focus groups were analyzed using a discursive method centered on identifying how the groups worked through a set of dilemmas presented in the focus groups, which involved a crisis call scenario involving an undocumented woman and an agency practice common to many domestic violence service providers. In the analysis of discursive strategies of the groups, a key finding centered on the groups' use of a decision-tree heuristic to work through dilemmas of practice presented in the two scenarios.

The United States has long struggled with the practice of detaining immigrant families and over time, most reform efforts have flagged, if not failed. This paper examines the impact of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA) through an exploration of the evolution of the family residential center (FRC) for families in immigration custody, established prior to the 9/11 terrorist attack by the Immigration and Naturalization Service (INS), and expanded by Immigration and Customs Enforcement (ICE) in its aftermath. The paper provides an inside look at how policymakers, at various points in the Obama administration, sought to roll back its most infirm practices and the fate of those efforts. It begins with a brief history of family detention in the United States, continues with a summary of the reforms undertaken both early and late in the Obama administration, and examines the significant challenges it faced and the less progressive positions it adopted during its first and second terms in office. The paper concludes with a discussion of reasons for the rapid reversal of its previous reforms and provides recommendations to achieve a civil, civil system of immigration enforcement for families and all others, which means nothing less than the transformation of the immigrant detention system from a criminal to a civil paradigm, consistent with the population and legal authorities.2 The need for such an effort is all the more urgent in light of executive actions taken in the early days of the Trump administration and their initial outcomes. Among those thwarting admissions are orders to Customs and Border Protection (CBP) and US Citizenship and Immigration Services (USCIS) to seal the US borders, shun refugees fleeing from war-torn regions until “extreme vetting” measures are put into place, and reassess others who have already been issued visas. Additional orders issued to ICE expanded and expedited the removal of persons whose conduct could result in charges or convictions as well as those with criminal charges or convictions, resulting in a 38 percent increase in arrests by ICE agents within the first 100 days of the Trump administration (Dickerson 2017b; Duara 2017).

This book tells the story of the long-term impacts on children raised in an age of enforcement by outlining the generational problems that unfolded after 2003, when the United States reorganized immigration services. During much of the twentieth century, the Immigration and Naturalization Service (INS) oversaw immigration matters under the purview of the Department of Justice. Changes following the 2001 World Trade Center attacks created the Department of Homeland Security, housing the Secret Service and the Federal Emergency Management Agency (FEMA), among others, and three agencies to manage functions previously handled by INS. One focuses on overseas immigration regularization services—U.S. Citizenship and Immigration Services (USCIS)—and two focus on migratory control: U.S. Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE). The author explains what happened after ICE was established to operate throughout the county’s interior. Stories shared by over one hundred young adults born and raised in New York show how the modern approach to migratory control has had significant intergenerational effects, not for immigrants, but for their children, who are U.S. citizens or future citizens. They provide a glimpse into what the future holds, and the social problems that occur when policies target members of children’s families and communities while providing few pathways for regularization.

This study describes the deaths of individuals in Immigration and Customs Enforcement (ICE) detention between FY2021-2023, updating a report from FY2018-2020, which identified an increased death rate amidst the COVID-19 pandemic. Data was extracted from death reports published online by ICE. Causes of deaths were recorded, and death rates per 100,000 admissions were calculated using population statistics reported by ICE. Reports of individuals released from ICE custody just prior to death were also identified and described. There were 12 deaths reported from FY2021-2023, compared to 38 deaths from FY2018-2020. The death rate per 100,000 admissions in ICE detention was 3.251 in FY2021, 0.939 in FY2022, and 1.457 in FY2023, compared with a pandemic-era high of 10.833 in FY2020. Suicide caused 1 of 12 (8.3%) deaths in FY2021-2023 compared with 9 of 38 (23.7%) deaths in FY2018-2020. COVID-19 was contributory in 3 of 11 (25%) medical deaths in FY2021-2023, compared with 8 of 11 (72.7%) in the COVID-era months of FY2020 (p = 0.030). Overall, 4 of 11 (36.3%) medical deaths in FY2021-2023 resulted from cardiac arrest in detention facilities, compared with 6 of 29 (20.3%) in FY2018-2020. Three deaths of hospitalized individuals released from ICE custody with grave prognoses were identified. The death rate among individuals in ICE custody decreased in FY2021-2023, which may be explained in part by the release of vulnerable individuals following recent federal legal determinations (e.g., Fraihat v. ICE). Identification of medically complex individuals released from ICE custody just prior to death and not reported by ICE indicates that reported deaths underestimate total deaths associated with ICE detention. Attentive monitoring of mortality outcomes following release from ICE custody is warranted.

BackgroundMany civil liberties organizations have raised concerns that substandard medical care in United States Immigration and Customs Enforcement (ICE) detention facilities have led to preventable deaths. The 2018 Department of Homeland Security Appropriations Bill required ICE to make public all reports regarding in-custody deaths within 90 days beginning in Fiscal Year (FY) 2018. Accordingly, ICE has released death reports following each in-custody death since April of 2018. This study describes characteristics of deaths among individuals in ICE detention following the FY2018 mandate.MethodsData was extracted from death reports published by ICE following the FY2018 mandate. Causes of death were categorized as suicide or medical, and medical deaths as COVID-19-related or not. Characteristics were compared between medical and suicide deaths, and among medical deaths between COVID-19-related and non-COVID-19-related deaths. Additionally, death rates per person-year and per 100,000 admissions were calculated for FY2018, 2019, and 2020 using methods from prior work evaluating deaths among detained immigrants in the United States.ResultsSince April 2018, 35 individuals have died in ICE detention. The death rate per 100,000 admissions in ICE detention was 2.303 in FY2018, 1.499 in FY2019, and 10.833 in FY2020. Suicide by hanging was identified as the cause of death in 9 (25.7%), and medical causes in the remaining 26 (74.3%). Among 26 deaths attributable to medical causes, 8 (30.8%) were attributed to COVID-19, representing 72.7% of 11 deaths occurring since April 2020.ConclusionsThe death rate among individuals in ICE detention is increasing amidst the COVID-19 pandemic. Potentially preventable causes of death including COVID-19 and suicide contribute to at least half of recent deaths. Findings suggest that individuals detained by ICE may benefit from improved psychiatric care and prevention measures to combat suicide, as well as increased infection control efforts to reduce mortality associated with COVID-19.

For the past two decades, the Department of Homeland Security has housed both the Federal Emergency Management Agency (FEMA) and U.S. Immigration and Customs Enforcement (ICE). This article discusses two ways that DHS’s structure has impaired FEMA’s ability to equitably provide disaster aid: the historical refusal to guarantee undocumented people that FEMA would not share their information within DHS for removal purposes, and DHS’s reprogramming of appropriated funds from FEMA to ICE. This article frames these issues in the context of climate change, arguing for legislative solutions to ensure that ICE’s immigration enforcement functions do not overwhelm FEMA’s disaster relief mission.

U.S. Immigration and Customs Enforcement (ICE) facilities house thousands of undocumented immigrants in environments discordant with the public health recommendations to reduce the transmission of 2019 novel coronavirus (COVID-19). Using ICE detainee population data obtained from the ICE Enforcement and Removal Operations (ERO) website as of March 2, 2020, we implemented a simple stochastic susceptible-exposed-infected-recovered model to estimate the rate of COVID-19 transmission within 111 ICE detention facilities and then examined impacts on regional hospital intensive care unit (ICU) capacity. Models considered three scenarios of transmission (optimistic, moderate, pessimistic) over 30-, 60-, and 90-day time horizons across a range of facility sizes. We found that 72% of individuals are expected to be infected by day 90 under the optimistic scenario (R0 = 2.5), while nearly 100% of individuals are expected to be infected by day 90 under a more pessimistic (R0 = 7) scenario. Although asynchronous outbreaks are more likely, day 90 estimates provide an approximation of total positive cases after all ICE facility outbreaks. We determined that, in the most optimistic scenario, coronavirus outbreaks among a minimum of 65 ICE facilities (59%) would overwhelm ICU beds within a 10-mile radius and outbreaks among a minimum of 8 ICE facilities (7%) would overwhelm local ICU beds within a 50-mile radius over a 90-day period, provided every ICU bed was made available for sick detainees. As policymakers seek to rapidly implement interventions that ensure the continued availability of life-saving medical resources across the USA, they may be overlooking the pressing need to slow the spread of COVID-19 infection in ICE’s detention facilities. Preventing the rapid spread necessitates intervention measures such as granting ICE detainees widespread release from an unsafe environment by returning them to the community.Electronic supplementary materialThe online version of this article (10.1007/s11524-020-00441-x) contains supplementary material, which is available to authorized users.

Victims or Criminals? Discretion, Sorting, and Bureaucratic Culture in the US Immigration System

Concerns have been raised that substandard medical care has contributed to deaths in US Immigration and Customs Enforcement (ICE) detention facilities. After each in-custody death, ICE produces detainee death reviews, which describe the circumstances of the death and determine whether ICE Performance-Based National Detention Standards (PBNDS) were violated. To describe factors associated with deaths in ICE detention facilities. This case series used data extracted from detainee death reviews of deaths among individuals detained in ICE facilities for whom these reviews were available from January 2011 to December 2018. All individuals were in the custody of ICE at the time of death. Data including demographic information, medical histories, recorded medical data, and reported violations of PBNDS were systematically extracted and summarized. Among 71 individuals who died in an ICE detention facility during the study period, detainee death reviews were available for 55 (77.5%). Most were male (47 [85.5%]), and the mean (SD) age at death was 42.7 (11.5) years. Individuals resided in the US for a mean (SD) of 15.8 (13.2) years before detention and were in ICE custody for a median of 39 days (interquartile range, 9-76 days) before death. Most had low burdens of preexisting disease, with 18 (32.7%) having a Charlson Comorbidity Index score of 0 and 15 (27.3%) having a score of 1 or 2. A total of 47 deaths (85.5%) were attributed to medical causes and 8 (14.5%) to suicide. Markedly abnormal vital signs were documented in the death reviews before 29 of 47 deaths from medical causes (61.7%), and 21 of these 29 deaths (72.4%) were preceded by abnormal vital signs during 2 or more encounters with ICE personnel before death or terminal hospital transfer. Overall, 43 detainee death reviews (78.2%) identified PBNDS violations related to medical care, with a mean (SD) of 3.2 (3.0) deficiencies per detainee death review. In this case series, deaths in ICE detention facilities from 2011 to 2018 occurred primarily among young men with low burdens of preexisting disease. Markedly abnormal vital signs preceded death or hospital transfer for most nonsuicide deaths. The PBNDS were violated in most detainee death reviews. These results suggest that additional oversight and external evaluation of practices related to medical and psychiatric care within ICE facilities are needed.