An unmarked police truck patrols outside a detention center in Eloy, Ariz. A new report on immigrant deaths in detention centers found that the Arizona facility lacked a suicide prevention plan, despite several recent suicides. Credit: Ricardo Arduengo/Associated Press

Poor medical care, including underqualified staff and systemic neglect, has contributed to deaths at immigrant detention facilities around the country, according to a report released today by two advocacy groups.

The report is based on doctors’ evaluations of U.S. Immigration and Customs Enforcement death reports from 2012 to 2015 and on interviews with people who are or recently were detained in facilities overseen by the agency. Those interviews suggest that dangerous medical systems remain in place today, as President Donald Trump plans to bring even more undocumented people into long-term detention.

“There is significant evidence that ICE does know about many of the deficiencies in its medical care system, but that it has failed to take swift and appropriate action,” says the report from Human Rights Watch, which investigates global human rights abuses, and Community Initiatives for Visiting Immigrants in Confinement, which opposes immigrant detention. Immigration and Customs Enforcement’s “own investigations into deaths in detention have shown that it lacks the procedures necessary to take appropriate and timely corrective action.”

The agency’s review of a suicide at the Eloy Detention Center in Arizona noted that the privately run facility lacked a suicide prevention plan, “despite (the man’s) suicide being the third at (Eloy Detention Center) since April 2013 and the fifth since 2005.”

The report is a follow-up to one released last summer, which focused on 18 death reviews posted to Immigration and Customs Enforcement’s online Freedom of Information Act library. Two doctors reviewed those reports at the nonprofits’ request and found that underqualified staff and slow responses contributed to at least seven of the deaths, with “repeated, clear-cut instances of subpar medical care.”

These include 34-year-old Manuel Cota-Domingo, who died at Eloy of untreated diabetes and pneumonia in 2012, and Lelis Rodriguez, 50, who died in the Rio Grande Valley staging facility in Texas after two weeks without receiving treatment for his high blood pressure.

A woman named Tiombe Carlos committed suicide in York County Prison after two and a half years in detention, during which she received “woefully inadequate” mental health care, according to one expert reviewer. At the Orange County jail in New York, a man identified as Luke R., who’d been diagnosed with schizophrenia, had his prescription changed from an anti-hallucinogen to the antihistamine Benadryl, then repeatedly was disciplined for misbehavior.

The new report also includes lessons from more than 90 interviews with people who are or were recently detained. They described long waits and language barriers when they needed medical help.

Private company GEO Group responded to the groups’ report last summer with a statement: “Our company takes all recommendations made by ICE very seriously, and for instances in which corrective actions are required, our company has had a long-standing, steadfast commitment to allocating the necessary resources and to working in partnership with ICE to ensure compliance.” 

CoreCivic/CCA, another private firm, had responded by noting that medical care at its facilities is provided by the Immigration and Customs Enforcement’s Health Service Corps, not the company.

“Because we are not the healthcare provider, we do not have access to medical-specific information about detainees,” the company said.

The U.S. uses more than 200 facilities to hold people awaiting their day in immigration court. Operations at the facilities vary widely – some are operated by the federal government, while others are run by private companies or local governments under a contract with Immigration and Customs Enforcement. The government maintains four different sets of safety standards depending on the facility.

“The problem of poor medical care in immigration detention cannot be separated from the enormous and unwieldy nature of the system itself,” the report says.

On a given day, more than 40,000 people are held in immigrant detention facilities. Many are seeking asylum in the U.S. But the facilities tend to resemble prisons, the groups note, including in their provisions for medical care. (In February 2016, Reveal investigated similar concerns about medical care at immigrant-only prisons.)

The report also points to California’s Senate Bill 29 as a promising idea. The bill would end county contracts with private companies to hold immigrants in detention and require county-run facilities that contract with Immigration and Customs Enforcement to adhere to the government’s most recent set of standards.

The report also recommends that federal agency stop contracting with facilities with repeat problems with medical care and detain far fewer people who are waiting on court dates.

The Trump administration so far has taken the opposite approach. An executive order Trump signed in January calls for detaining more people and building more facilities to hold them. A memo from Homeland Security Secretary John Kelly says parole should be used “sparingly.” And in April, Immigration and Customs Enforcement announced that GEO Group would be building a new 1,000-bed detention center to meet the rising demand.

Patrick Michels can be reached at Follow him on Twitter: @PatrickMichels.

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Patrick Michels is a former reporter for Reveal, covering immigration. His coverage focused on immigration courts and legal access, privatization in immigration enforcement, and the government's care for unaccompanied children. He contributed to Reveal's award-winning project on indigenous land rights disputes created by oil pipelines. Previously, he was a staff writer at the Texas Observer, where his work included an investigation into corruption at the Department of Homeland Security and how the state's broken guardianship system allowed elder abuse to go unchecked. Michels was a Livingston Award finalist for his investigation into the deadly armored car industry. He has a bachelor's degree in journalism from Northwestern University and a master's degree in photojournalism from the University of Texas at Austin, where his work focused on government contractors grappling with trauma and injuries from their time in Iraq.