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Report examines treatment of mentally ill in immigration court and detention system

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An undocumented immigrant waits to be processed at a U.S. Immigration and Customs Enforcement detention facility Arizona.

A report issued over the weekend that deals with the treatment of mentally disabled immigrant detainees caught my attention, in part because it made me recall a particularly troubling case in San Diego last year. Human Rights Watch's Deportation by Default examines the hand-wringingly complicated issue of handling the immigration cases of the mentally ill and disabled, and argues that the immigration courts and detention system are inadequately capacitated to do the job.

The nonprofit NGO co-authored the report with the American Civil Liberties Union. From the report: "The shortcomings include no right to appointed counsel; inflexible detention policies; lack of substantive or operative guidance for attorneys and judges as to how courts should achieve fair hearings for people with mental disabilities; and inadequately coordinated care and social services to aid detainees while in custody and upon release."

The report cites the cases of Pedro Guzman and Mark Lyttle, two mentally disabled U.S. citizens mistaken deported in 2007 and 2008, respectively, and not returned home for months; Guzman, from Lancaster, survived by scavenging as his family searched for him. The report points out that some mentally disabled individuals' understanding of what is occurring to them is so limited, they have asked to be deported to "New York" or "Louisiana."

Dealing with the mentally disabled has long proven a challenge for immigration officials. A report issued last fall by U.S. Immigration and Customs Enforcement - following the announcement of planned reforms to its detention system by the Obama administration - offered the following assessment: "The current mental health intake assessment is quite brief and does not lend itself to early identification and intervention. This is limited primarily to an overview of the detainee handbook. Routine assessments should be made of aliens who remain detained or who exhibit symptoms of distress. Staffing varies at DIHS facilities and is frequently quite limited at IGSA locations. The number of aliens identified as having DSM diagnoses and prescription practices differ appreciably."

The report continues: "Few beds are available for in-house psychiatric care for the mentally ill. Aliens with mental illness are often assigned to segregation, as are aliens on suicide watch."

The lack of in-house psychiatric care has forced the agency to contract out the housing of mentally ill detainees, and this hasn't always gone well. Last year in the San Diego area, a private psychiatric hospital stopped taking non-emergency ICE detainees after news reports surfaced that mentally ill detainees were being shackled to their beds, among other things. An investigation contracted by the county found that the hospital violated state law when it allowed federal officials to shackle and deny other patient rights to the detainees.

Since last year, ICE officials have been conducting reviews of the detention system, including in the much-criticized area of medical care, as the agency goes about implementing reforms, among them plans to improve medical screening upon intake. Another recent accomplishment was an online detainee locator tool, introduced last week. But with more than 30,000 detainees in the system on any given day - and a heavy reliance on private contractors - it remains a complicated system to manage.