Wednesday, August 11, 2010

Mental Illness Among a Hidden Population

by Michael J. Fitzpatrick, Executive Director

What would you say if you heard about people living with severe mental illness being exposed to:
  • A complicated legal system
  • Charges without a lawyer
  • Detention for long periods of time and
  • Inappropriate or nonexistent psychiatric care?
These conditions are common for immigrants living with mental illness who have entered the U.S. Immigration and Customs Enforcement (ICE) detention system. Does that change your reaction? Immigration is a divisive issue these days. NAMI’s area of expertise is not whether illegal immigrants should be allowed to stay in the country. Our question is whether a system that has a poor track record of dealing with people living with mental illness should be reformed.

The Washington Post reported that 15 percent of the total immigrant population in detention lives with a mental illness—an estimated 57,000 in 2008. Detainees with no family member or friends are appointed an ICE representative to act as their court “custodian”—“a blatant conflict of interest.”

While the ICE’s own statutes require certain standards of treatment for detainees living with mental illness, the reality usually fails to live up to those standards. Two reports, Justice for Immigration’s Hidden Population by Texas Appleseed, and Deportation by Default from Human Rights Watch, detail the conditions to which these most vulnerable of detainees are often subjected.

According to U.S. Immigration and Customs Enforcement rules:
The reality: Detainees living with mental illness are often kept in detention for extended periods of time pending a decision. Long stays tend to exacerbate psychiatric symptoms such as depression, anxiety and PTSD.
The reality: Many people do not receive this evaluation because the pattern of frequent transfers means they do not stay in one place for 14 days. Sometimes these screenings do not catch even cases of profound mental illness. Some of these problems may be due to the scarcity of mental health screening materials in languages other than English. (Appleseed, 25)
The reality: Many people are not given the appropriate medication if they are offered treatment at all. As of September 2009, there were only three psychiatrists for 5000 detainees in Texas (Appleseed, 28). Insufficient and poorly trained staff members use restraint and seclusion more frequently than recommended, sometimes for long periods of time.

It costs seven times as much to incarcerate someone with mental illness,” according to Senator Russell Feingold, yet current detention practice opts for the more expensive, less humane alternative rather than keeping people living with mental illness in the community while their fates are being decided.

While there is no simple solution to the country’s immigration problem, the tens of thousands of people living with mental illness in the limbo of our country’s detention centers might have more similarities to those of us on the outside than we realize.


Holly said...

While I understand that this problem exists, we still have the problem that our country isn't taking care of the citizens, either. That should be first and foremost. I am not saying these individuals should not be treated better. So don't send me hate mail/posts. People that legally live here are struggling in the OPEN.

Holly said...

I forgot to post this from an acquaintance:

These are citizens of the USA

Kasa said...

While I support obtaining help for our legal citizens, no one with a mental illness should be made to suffer without treatment.
It took 19 years to find an antidepressant that helped me. I understand the hell that our citizens and those confined to ICE's detention cells. When the first wave of Castro's release of citizens hit the US, we found serious mental illness that had never been treated in our state mental hospitals. All kinds of self destructive behaviors surfaced-one patient tried to detach his scrotum from his body, repeatedly. Only one example of what untreated mental illnesses can lead to-along with suicide, self mutilation, sexual assaults, and more.
All mentally ill people should be allowed access to trained professional help.

Anonymous said...

Excellent post. My personal feelings are that some people are U.S. citizens & some people are not U.S. citizens, but they are ALL human beings & they ALL deserve the best & most humane treatment available.

cleveland psychiatrist said...

"no one with a mental illness should be made to suffer without treatment" this staement from Kasa is very true, I believe each person has the right to receive the appropriate medical treatment. The ratio 3:500 is very disturbing also plus poorly trained stafs, I hope the government will value it's citizens by improving these figures.