After months of social distancing, many of us are feeling its effects. Experts have delineated the mental and physical health impacts of isolation caused by the pandemic, and those who have experienced home quarantine have been particularly vulnerable to loneliness and depression.
Imagine though, if quarantine meant you were confined to a single bare room and deprived of the things that could keep you happy and sane — video chats with loved ones, digital entertainment, a sense of purpose through work, and of course, occasional human contact.
Yet that has been the experience of the pandemic for many in U.S. Immigration and Customs Enforcement detention, where isolation in a single cell is being used as a substitute for medical quarantine. Attorneys and other advocates have begun reporting ICE’s inappropriate use of solitary confinement to media outlets and the court system.
Some in ICE custody have recounted their experiences in sworn court documents: Oscar Perez Aguirre, who is being detained in Aurora, Colo., became ill with Covid-19 and needed to be hospitalized. Upon his return to the detention center, he was placed into “the Hole.” Despite being too sick to stand, he remained in segregation for more than two weeks in a cell he described as “filthy and freezing.” Ruben Mencias Soto, a detained person in Adelanto, Calif., was placed in a bare cinderblock room after his hospitalization. He was locked in by himself for 23 hours a day.
ICE has a history of inappropriately using solitary confinement cells for the “medical segregation” of individuals sick with cancer, tuberculosis, mumps, HIV, and mental illness, a practice one of us (E.G.) exposed while working for the Department of Homeland Security. We have collectively reviewed hundreds of ICE documents, called segregation reports, detailing instances where individuals were placed in solitary confinement. As medical professionals, two of us (S.F. and J.W.B.) have performed hundreds of forensic psychiatric evaluations of asylum seekers, some of whom had been held in solitary confinement for months, and have seen the devastating mental and physical repercussions.
A punishment by design, solitary confinement is so deleterious to mental health that in 2011, the United Nations’ Special Rapporteur on Torture condemned its use apart from exceptional circumstances and for as short a time as possible. ICE is making no such limitations.
The mental health effects of living in such an environment are well-documented. Research going back to the 1970s has shown that just one week of isolation results in significant changes to baseline brain activity and recent animal experiments have demonstrated the impact of social isolation on parts of the brain that help regulate mood.
Stuart Grassian, a psychiatrist who has spent his career studying solitary confinement, has reported that it can cause hallucinations, panic attacks, paranoia, and obsessive-compulsive behaviors. Forced isolation for as little as five days is also correlated with increased risk of PTSD and suicide. Choung Woong Ahn, a detained person at the Mesa Verde ICE facility in California, was placed in Covid-19 medical isolation on May 15 and died by suicide two days later.
As we write this, 862 people in ICE detention centers have tested positive for Covid-19. As medical professionals have explained, solitary confinement and unit lockdowns are insufficient for preventing disease transmission, and epidemiologists have predicted that at least 72% of the more than 21,000 individuals in immigration detention will become infected. There are also legitimate concerns that sick people put in solitary confinement will receive inadequate medical care.
ICE’s use of solitary confinement and lockdowns as a substitute for quarantine amid soaring infection rates simply highlights the sheer inability of detention centers to implement CDC-recommended public health measures and keep those under its custody safe.
Health and legal professionals, including the Department of Homeland Security’s own medical experts and the former head of ICE, have already called for the large-scale release of those in detention. The public health risks are reason enough, but the cruelty of using solitary confinement in the name of protecting the well-being of immigrants — including many asylum seekers who were victims of torture before entering the U.S. — is another reason it cannot be ignored.
The Department of Homeland Security has long been aware of ICE’s inappropriate use of segregation, and legislation has been proposed to curb the practice. Congress, so far, has failed to act. But this crisis presents an opportunity for redemption. The pandemic may have forced us to pull away from each other, but we maintain hope it can also inspire us to recognize, and act upon, our shared humanity.
Samara Fox is a resident psychiatrist at Beth Israel Deaconess Medical Center in Boston who previously worked as an immigration attorney at Greater Boston Legal Services. Ellen Gallagher is an attorney and former policy adviser at the Department of Homeland Security’s Office of Civil Rights and Civil Liberties. J. Wesley Boyd is a staff psychiatrist at Cambridge Health Alliance in Cambridge, Mass., a co-director of its Human Rights/Asylum Clinic, an associate professor of psychiatry at Harvard Medical School, and a faculty member in the HMS Center for Bioethics.