This summer, I joined psychologists and lawyers from across the Midatlantic and New York to visit the Berks County Detention Center, in Pennsylvania.  Berks is one of 108 immigration detention centers around the country run by U.S. Immigrations and Customs Enforcement (ICE), and it is home to 36 families, including children of as young as two years old, who are awaiting deportation from the U.S.  The purpose of our visit, which was arranged by Human Rights First, was to review conditions in the detention center; as a doctoral student in clinical psychology, my particular interest was in understanding the mental health needs of the detainees, and the availability of qualified mental health care in the Center.

Many studies and reports have demonstrated the impact of detention on mental health, and some of these impacts were clearly visible in talking to the families at Berks.

Life in the detention center – where people can remain for over a year – lacks a lot of the freedoms that we take for granted.  Detention Officers – most of whom used to serve as prison guards – are reported to use racial slurs and threats of violence to keep detainees in line – including children; one mother reported that an officer had pulled her child hard in one direction, and he hit his head against the door.  Lights out time and outdoors time are mandated, and meals are served on a weekly rotating basis with no ability for detainees to prepare their own food.  Detainees cannot receive incoming phone calls, and during the night, detention officers carry out regular bed checks, shining their lights into the faces of the children, disturbing their sleep.  During the day, detention officers are required to put on medical gloves any time they want to touch one of the children, for example to shake their hands.

In such conditions of incarceration and isolation, depression can be expected – and indeed it was obvious in speaking to the detainees that many are extremely depressed by their conditions, up to the point of suicidality.  One mother I spoke with told the story of how her 6-year old attempted suicide in the last few months by strangling himself with the lanyard that hangs around his neck, carrying the ID badge that all detainees are mandated to wear at all times.  I was struck by how difficult it must be for children to see their parents powerless in these conditions – and for parents unable to meet their children’s needs and requests, from ice cream to play time to deeper emotional needs.

The government psychologists who are assigned to Berks note, unsurprisingly, that mood disorders are the most prevalent mental health issue, and expressed that a lot of the children are subject to temper tantrums, hitting and kicking out at others.

In such an environment, the availability of mental health care is critical.  Among the provisions that Berks does make for its detainees are a weekly interdenominational religious service, a basketball court, and a birthday cake for kids if one is requested. There is little to add to this list.  Berks does have on-site psychologists, but conducts only a minimal intake interview of incoming detainees that seems mostly focused on trauma and biopsychosocial history rather than being intended to identify or diagnose existing mental health conditions.  The government counsellors and psychologists on site are not provided with any specialized cultural competency or language training available, and may not themselves have the experience of working with immigrant or non-English-speaking communities prior to their assignment at Berks.  The counsellors conduct wellness checks in a group and individual basis – but have a high trust barrier to overcome in order for such checks to be effective.

I am not here to pass judgement on detention law and immigration policy – though I certainly have opinions as an immigrant myself.  But simply looking at the immigration detention system through the eyes of psychology, it seems clear that something is deeply wrong – and deeply disturbing – about a system that treats children like incarcerated criminals, that provides minimal mental health care for its detainees, and that seems to fall far short of UN standards that call for detainees to be treated with a basic human dignity.  I believe that we have a responsibility to be not only psychologists, but also advocates for mental health issues, and I will take the experience and knowledge I gained from my day at Berks with me in all my engagements with both governmental and non-governmental bodies who are capable of doing something to improve the conditions in immigration detention centers around this country.

Interested in getting involved in detention center mental health services or advocacy?  Here are some points of contact:

• Human Rights First
• APA Topic: Immigration
• Asista
• International Detention Coalition
• Psychologists for Social Responsibility
• US Immigration and Customs Enforcement Health Service Corps

Samira Paul is a third year doctoral student in clinical psychology at the American School of Professional Psychology at Argosy, Washington DC.  She is the Diversity Chair for the District of Columbia’s Psychological Association, and the former Advocacy Chair for the Maryland Psychological Association Graduate Students.