Preventable Deaths Plague ICE Detainees

The 2024 Homeland Security appropriations bill significantly increased funding for U.S. Immigration and Customs Enforcement (ICE) operations. The new budget aims to support a daily detainee population of 41,500, a considerable rise from an average of 34,000 in recent years.

However, recent studies have exposed worrying inadequacies in ICE’s ability to provide medical care for detainees. These troubles include inhumane conditions, high suicide rates, and structural problems such as the use of prisons to hold detainees, delayed or interrupted medical care, and severe overcrowding. The COVID-19 pandemic has exacerbated these issues further.

A report released on June 25, 2024, by the American Civil Liberties Union, American Oversight, and Physicians for Human Rights, titled Deadly Failures, highlighted preventable deaths within ICE facilities. The report points to major flaws in investigations and systems at ICE, pinpointing lapses in diagnosis, treatment, and emergency response. It also identifies suicides that might have been avoided with proper mental health care and medication management.

Cara Buchanan, an emergency physician and fellow in health policy at the Harvard Kennedy School, reiterated these findings. Her research underscores that preventable deaths often occur due to inadequacies in medical triage, identification, and timely escalation of emergency care needs.

Various disciplines, including law, public health, and human rights, also link poor health outcomes for detainees to the structural design of detention facilities. The use of solitary confinement, for instance, is connected to increased self-harm risks. The pandemic underscored these disparities, with many facilities failing to provide adequate basic, preventive, and emergency medical care.

There is a persistent lack of transparent information about conditions in ICE facilities. This opacity has led to continued calls for greater oversight and accountability. Publicly available ICE death reports are insufficient, often leaving out critical details about the circumstances surrounding these deaths. Independent investigations have revealed systemic negligence as a recurrent issue.

Despite these issues, billions of dollars continue to flow into expanding ICE detention facilities. Private prisons contracted for immigrant detention report enormous profit margins. The Deadly Failures report by advocacy groups provides policy recommendations for the Department of Homeland Security, Department of Justice, Congress, and local and state governments.

The report suggests prompt disposition of medically vulnerable detainees, investment in community-based services, and a ban on solitary confinement. Other recommendations include limiting the expansion of detention facilities, passing legislation to ensure care standards in facility contracts, and establishing comprehensive public data reporting mechanisms. The report also calls for the dismantling of the mass immigration detention system.

One striking finding in Deadly Failures is the troubling practice of releasing detainees just before their deaths. ICE regulations mandate timely notifications and reports for detainees who die in custody but are vague about those released just before death. This technical release often allows ICE to evade mandatory public reporting.

A pattern has emerged where detainees deemed critically ill are released from custody right before death, thereby skirting mandatory reporting. For instance, a detainee contracted COVID-19 and suffered multiple complications. Despite concerns from the facility’s medical director, necessary interventions were delayed. The patient was released from custody just before death, evading the obligation to report the case publicly.

ICE states it is continually evaluating its enforcement of health standards. However, experts recommend that all deaths occurring within 30 days of release from ICE custody be mandatorily reported. Such a measure is crucial for transparency and accountability.

To prevent unnecessary deaths, detainees should be released promptly for better long-term medical care. Standardized triage protocols need to be enforced, and rigorous oversight established for clinical outcomes. ICE’s limited data collection and sharing practices leave many critical questions unanswered, furthering the need for federal and public reporting standards.

One consistent problem is the inadequate provision of language services. Federal mandates require free access to health information in a patient’s preferred language, yet this is often not met in ICE facilities. Ultimately, research consistently shows that detainees experience a diminished standard of care compared to the general population.