Concertina wire tops a fence at a detention facility. (Getty Images)
If not for systemic failures in medical and mental health care, almost all of the people who died in immigration detention in the U.S. between 2017 and 2021 could still be alive today, according to a report.
U.S. Immigration and Customs Enforcement (ICE) has reported 53 people died in its custody between January 1, 2017 and December 31, 2021.
Medical experts examined all but one of those deaths, and concluded that 49 of them, or 95%, were preventable or possibly preventable if appropriate medical care had been provided, according to an early version of the report by the ACLU National Prison Project, Physicians for Human Rights and nonprofit watchdog group American Oversight.
In most of the deaths reviewed, ICE detention medical staff made incorrect, inappropriate, or incomplete diagnoses; or provided inadequate or unreasonably delayed treatment.
The experts found only three examples where it’s clear someone’s life could not have been saved or the outcome could not have been different, regardless of their medical treatment. In one case from 2018, ICE did not make enough documentation available to allow a comprehensive review of what happened.
Eunice Cho is a lead author on the report, and a Senior Staff Attorney at the ACLU National Prison Project, which has been tracking deaths in ICE custody for over 20 years.
“Our constitution requires that if the government puts somebody in their custody, they have to provide adequate health care,” Cho said in an interview. “You can’t lock somebody up behind bars and not give them medical care when they’re sick, because they’re not able to go to their doctor in the outside world. If the government has chosen to take these people into their custody, they need to be providing them with constitutionally adequate care.”
ICE’s oversight and accountability mechanisms are critically flawed, and do little to prevent future deaths, the report states. Systemic failures in providing medical and mental health care in detention have caused or played a role in many deaths that would likely otherwise have been prevented, the experts found.
The report is based on a review of over 14,500 pages of documents obtained from the Department of Homeland Security (DHS) and ICE through federal and state level public records requests and civil litigation. Authors and medical experts reviewed emails the ICE investigators were sending each other, some of the documents they relied on, and some of the court documents that turned up in litigation over these cases.
“What all that information also showed was that ICE’s investigations of the deaths of people in detention are woefully inadequate, and often let the agency off the hook,” Cho said. “These are all examples of how you can’t let the fox guard the henhouse.”
“Even based on the documents that ICE’s own investigations produced, it became clear that, in the vast majority of these cases, if people had received adequate and appropriate medical care or mental health care in immigration detention, many of these people could still be alive today,” she said.
The report shows DHS’ internal oversight mechanisms have failed to conduct rigorous investigations, impose meaningful consequences, or improve conditions that cause immigrants to die in ICE detention.
“ICE has done a very good job of trying to hide these facts, to keep the public from knowing,” Cho said.
The review shows ICE’s investigations into these deaths “have failed to preserve evidence, omitted key facts, and have failed to follow obvious leads for causes of wrongful death.” Instead, ICE has omitted critical facts that could lay the blame for the deaths squarely on itself and the private prison companies it hires.
Among many other recommendations, the report calls on state and local governments to ban intergovernmental services agreements between state or local agencies and the federal government for civil immigration detention.
The report also suggests a ban on agreements that allow local law enforcement to arrest and hold migrants before they’re turned over to ICE detention, ban the physical expansion of detention facilities to hold more people, allow lawsuits against for-profit detention centers that break their contracts, and enable greater local oversight and accountability of state and local facilities.
Although Congress passed laws prohibiting ICE from spending money on detention centers that have failed two consecutive agency inspections, “no facility has lost a detention contract or failed an ICE inspection in the period covered by this report, even where ICE’s death reviews have found multiple violations of detention standards,” the report states.
Cho said she hopes ICE takes a very serious look at the report’s findings, and adopt the recommendations in it.
ICE has yet to respond to the report. We will update if and when they speak about the findings.
“These are human beings that they’re holding in custody, that are dying as a result of their policies,” Cho said. “We would like ICE and the corporations they contract to really take seriously, to take stock of the consequences of their actions.”
This story was updated to accurately reflect a statement made in the final report.
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