Released 27 May 2009  By Greg Moran, San Diego Union-Tribune
Mentally ill detainees' treatment at hospitals worries advocates
Greg Moran, San Diego Union-Tribune
May 18, 2009
Background: Federal immigration detainees with severe mental illnesses at times are placed in private psychiatric hospitals, where they are held in condi tions that legal advocates say violate state and federal law.
What's changing: Disability Rights California, an advocacy group, is pressing immigra tion officials to change their policies.
The future: U.S. Immigration and Customs Enforcement says it is reviewing its detention policies nationally, but did not comment specifically on allegations regarding Alvarado Parkway Institute or other private hospitals.
Federal immigration officials send mentally ill detainees to a private psychiatric hospital in La Mesa, where they are shackled to beds 24 hours a day, prohibited from watching television or using the telephone, and cut off from family.
Disability-rights lawyers and advocates for the mentally ill say the conditions at Alvarado Parkway Institute in La Mesa violate state and federal laws governing treatment of mentally ill people.
They also say the hospital, known as API, is one of a little-known network of private hospitals that U.S. Immigration and Customs Enforcement uses to hold severely mentally ill detainees around the country, often out of reach of lawyers and even their families.
Ann Menasche, a lawyer with the legal advocacy group Disability Rights California, said she has been to API and has spoken to detainees there. In an eight-page letter sent to immigration officials April 24, Menasche said the conditions are “excessive, unjustifiable and punitive.”
Menasche also said they violate California laws covering the rights of patients in psychiatric hospitals, as well as Immigration and Customs Enforcement's own standards and rules for detaining immigrants.
“We have toured and talked to people,” Menasche said in an interview. “They are held like this for no other reason than they are in this category of people who are immigration detainees.”
Other patients are not routinely subjected to such conditions, she said.
Patrick Ziemer, the CEO of the hospital, said the measures taken for the detainees are done for security reasons and are required by Immigration and Customs Enforcement. Ziemer said the shackles are “security shackles, not restraints” as defined under state law.
He said that detainees' movements are restricted but that it is not as bad as Menasche said.
“Patients can move about and walk around, a few steps from their bed,” Ziemer said.
One day last week, there were two mentally ill immigration detainees at the facility, Ziemer said. At other times, as many as five detainees are held at API, Menasche said. Stays range from a few days to several weeks, she said.
Immigration and Customs Enforcement declined to answer specific questions about the treatment of patients at API. In a statement, the agency said it is reviewing “visitation and telephone access practices for immigration detainees being housed in private psychiatric facilities to ensure they have appropriate access to both.”
Homeland Security Secretary Janet Napolitano also has ordered a broader review of all ICE detention conditions.
API is licensed for 66 beds for acute psychiatric care. The low-slung, two-story building is on Parkway Drive near Lake Murray Boulevard. State records show three complaints regarding care and treatment of patients were lodged in 2008, but all were found to be unsubstantiated.
Other measures in place at API for immigration detainees, according to Menasche's letter, include:
Two armed guards are assigned to each detainee when they are taken to API.
Except for daily sessions of therapy lasting between 20 and 50 minutes, immigration patients don't socialize, participate in group therapy, get to use the phone or have visitors, except a patient-rights advocate and a lawyer if they have one.
Because of the shackling, detainees get no exercise other than whatever movements they can do at their bedside.
State law gives psychiatric patients certain rights, such as permission to see daily visitors, access to a phone and so on. The law also says those rights can be denied if the person in charge of the facility deems there is “good cause” to do so, in order to protect the patient, others in the hospital or the facility itself.
Ziemer said API follows all federal and state standards, and reports annually to the state when it has had to restrict a patient's rights.
“The patients who come to us are unmanageable in their setting,” he said. “They are here because they can't be managed safely in the environment they are in.”
Menasche said she was told in a meeting with Ziemer and ICE officials that ICE detainees are being automatically denied these rights, without any individual assessment of whether such a step is needed. The policy comes from Immigration and Customs Enforcement, Menasche said.
She also said that before shackling a patient, the law requires that specific findings have to be made in the individual's case.
The detainees are taken to API from a private immigration jail in Otay Mesa run by Corrections Corporation of America, the largest private prison company in the nation. It has contracts to provide thousands of jail beds to the federal immigration agency.
The jail has a psychiatric care unit, but some detainees become too sick to be treated there and have to be moved.
Ziemer declined to say how much Immigration and Customs Enforcement pays for a patient to be housed at API. The agency did not respond to questions about the cost, which is paid through its health services division.
ICE detainees are held as civil law violators, awaiting outcome of their cases involving deportation, asylum or other issues in immigration court. Some have been caught in immigration raids, while others are being deported after they were convicted of a crime.
Because they are being held for civil violations of immigration laws, they don't get many of the rights – a government-appointed lawyer, for example – that criminal defendants do.
The number of immigration detainees nationwide has risen dramatically over the past several years as the federal government has stepped up enforcement. About 35,000 people are held in a system of public and private jails, ICE detention facilities and privately run jails across the country.
How many are mentally ill is not known, and how many end up in the little-known system of private hospitals is also unclear.
Greg Pleasants, a lawyer with Mental Health Advocacy Services in Los Angeles, said Immigration and Customs Enforcement uses several private hospitals there for mentally ill detainees. Pleasants has complaints about conditions in those facilities, which he said also violate patient-rights laws and ICE's own detention standards.
Pleasants represents a severely mentally ill detainee who is facing deportation and has been shuttled between jails and private hospitals for two years. During much of that time, the man's mother could not find out from immigration officials where her son was.
The woman did not want to be identified because she did not want to jeopardize her son's case. She said in an interview that her son was abruptly moved from a jail in Los Angeles to a hospital, but for nearly a year, she did not know exactly where he was.
“I felt desperate,” she said. Eventually, she learned her son had been in a hospital in South Carolina for several months, then returned to Los Angeles, where he contacted her.
Being cut off from family and legal counsel makes the problem worse, Pleasants said, especially for detainees whose illness limits their ability to advocate for themselves.
“The stories I've heard are terrible,” he said. “You have family members going to visit loved ones in detention facilities and being told they are not there. And when they ask where they are, they're just told, 'We can't tell you that.' ”
Menasche sent a letter to county mental health officials May 5 urging them to examine the issue. A county spokesman said Friday that the mental health agency is looking into the complaint. Menasche said API is the only facility she knows of that handles immigration patients in the county.
The conditions at API are alarming, said Sean Riordan, a lawyer with the American Civil Liberties Union of San Diego and Imperial Counties.
“An immigration detainee, particularly one that is mentally disabled, is entitled to broad protections,” Riordan said. “And that means being treated in a decent way and not being exposed to deprivations that don't bear any reasonable relation to security.”
Greg Moran: (619) 542-4586; firstname.lastname@example.org
Greg Moran: (619) 542-4586;