Study: ICE Violated Its Own Healthcare Standards

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Key Takeaways

  • A recent investigation found that U.S. Immigration and Customs Enforcement (ICE) centers violated their own internal medical standards.
  • Researchers found that ICE violated its own internal medical standards in 78% of deaths included in this study.
  • Experts call for more transparency and oversight.

A new study examining deaths at U.S. Immigration and Customs Enforcement (ICE) detention centers found that personnel significantly violated internal medical standards.

The researchers found that ICE violated its own internal medical standards in 78% of deaths included in this study. These findings raise concerns about the treatment of people with health conditions in U.S. detention centers, highlighting a lack of oversight of the process.

For the study, the team looked at deaths in ICE detention centers between 2011 and 2018. The reports of 55 people were used in this study.

Out of the 55 reported deaths, 47 were medical-related and 8 were attributed to suicide. The people who died while in ICE detention had been in these centers for an average of around 40 days, and in the U.S. for an average of 15 years.

Twenty-nine of the 47 deaths were attributed to non-noncommunicable diseases, like cancer and stroke. Out of these 29 deaths, 21 of these people were documented as having abnormal vital signs during at least two encounters with ICE personnel before death in the detention center or transfer to a hospital. There were also delays in providing cardiopulmonary resuscitation (CPR) to people by ICE personnel.

"Delays and transfer to a hospital despite demonstrating signs of critical illness, delays in initiation of CPR, and delays in addressing a concern in relation to the time at which that concern had initially been voiced, those to me are unfortunate and striking incidences of what I see as substandard care," lead study author Molly Grassini, MD, a physician in the department of emergency medicine at the Keck School of Medicine of the University of South California and the Los Angeles County+USC Medical Center, tells Verywell.

"I am concerned that some of the findings from our study demonstrate that there may be difficulties in the individuals practicing in these settings to see immigrant detainees population that they're serving as they would be if that person was their own family member," Grassini adds.

The study was published in the JAMA Network Open journal in early July.

People in ICE Detention Centers Face Mental Health Challenges

In the study, of the eight people who died by suicide, four were under supervision for suicidal ideations at some point during detention, and six were taking medication for their mental health.

"If that individual has demonstrated evidence that they may be experiencing some mental health concerns, that person should be closely attended to," Grassini says, expressing concerns that these deaths might have been preventable if people were appropriately cared for.

A 2018 systematic review examining the mental health of people in immigration detention found that 73% of people reported having unmet psychological needs. The most common mental illnesses people experienced were:

  • Affective disorders (36%)
  • Anxiety disorders (34%)
  • Posttraumatic stress disorder (23%)

"Most of the detainees in ICE centers have lost loved ones, and all are separated from their loved ones but are held in such uncertain and harsh conditions they cannot grieve and process their losses," Adrianne Aron, PhD, a Berkeley-based psychologist and the author of "Human Rights and Wrongs," tells Verywell. "Fear, depression, a sense of a foreshortened future, and the pain of an insupportable present contribute to depression and despair."

What This Means For You

Community-based organizations often provide fundamental services to detainees in ICE facilities. Reach out to local organizations to see how you can help or learn more. If you're concerned about ICE's practices in your area, you can contact your elected officials.

The Need for More Transparency and Oversight

After someone dies, Grassini explains, it is standard for a doctor to complete a report, which other physicians can review. ICE creates their own medical standards and has their own contractors' review reports about problems, instead of a third party who may be more neutral.

"There is a lack of external oversight," Grassini says. "That in combination with the kind of absence of transparency into the ongoings in these facilities, and for providers to review, is very dangerous."

Even when it came to following its own medical standards, ICE failed to meet them.

"Human Rights Watch evaluated 15 DDRs [detainee death report] and identified a number of dangerous inadequacies, including practitioners failing to interpret basic medical data and appropriately treat acute conditions, problematic use of solitary confinement (also known as segregation) for people with psychosocial disabilities, and flawed emergency responses," the researchers wrote.

This is not the first time that experts raise concerns about the oversight in ICE detention centers. A January 2021 report from the U.S. Government Accountability Office found "at least 50 of the reports [for complaints] were for multiple violations of similar issues, such as violations of agreed-upon discipline processes and staffing shortages that compromised detainee health or safety."

And back in April, the American Civil Liberties Union called for the Biden administration to close ICE detention centers due in part to the medical care in these centers.

"Last year alone, we saw reports of increased use of force, solitary confinement, patterns of sexual abuse, forced sterilization, and an utter failure to protect people from COVID-19," the ACLU wrote in a press release. "ICE’s extreme recklessness in handling the COVID-19 virus showed the blatant disregard it had for the health and well-being of detained people, as well as the extent to which it was willing to lie or obfuscate to avoid accountability."

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Grassini M, Terp S, Fischer B et al. Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention FacilitiesJAMA Network Open. 2021;4(7):e2116019. doi:10.1001/jamanetworkopen.2021.16019,

  2. von Werthern M, Robjant K, Chui Z, et al. The impact of immigration detention on mental health: a systematic reviewBMC Psychiatry. 2018;18(1):382. doi:10.1186/s12888-018-1945-y.

  3. U.S. Government Accountability Office. Immigration Detention: Actions Needed to Improve Planning, Documentation, and Oversight of Detention Facility Contracts.