Comparing Mental Health Needs and Service Provision between ICE-Detained and Non-ICE-Detained in a Midwest, Urban County Jail

Background and Purpose: People in jails experience higher rates of serious mental illness (SMI) than the general population (Bronson & Berzofsky, 2017; Substance Abuse & Mental Health Services Administration, 2019). Similarly, people detained in immigration detention centers (IDCs) experience higher rates of psychological distress, including anxiety, depression, and post-traumatic stress disorder (Verhülsdonk et al., 2021; Von Werthern et al., 2018). While reasons people are detained in jail typically differ from those for which they are detained by Immigration and Customs Enforcement (ICE), a subpopulation of those detained by ICE are held in jail rather than IDCs. As little has been researched about this subgroup, our study addresses the question: How do the mental health needs of and service provisions to ICE-detained people compare to non-ICE-detained people held concurrently in jail?

Methods: This exploratory study utilizes administrative data from a Midwest, urban county jail and the jail’s mental health service provider to compare individuals held as ICE detainees (n=79) and non-ICE detainees (n=526), booked 7/13/20-8/24/2020. Bivariate analyses (Chi Square and t-tests) assessed differences between groups across sex, race/ethnicity, age, SMI, history of SMI, psychotropic medication use, jail-based mental health service referrals to a provider, and service provision. Mental health (MH) was assessed at booking using the Kessler-6, which has been validated in jail populations (Kubiak et al., 2010; 2012) and includes six questions utilizing a 5-category scale to measure psychological distress and detect functional impairment (Kessler et al, 2002; 2003). Scores of 9 or above were considered as indicating SMI

Results: ICE detainees were older on average (M=37.9, SD=12.399) than non-ICE detainees (M=34.7, SD=11.017; t(97.39)=-2.194, p=.031). A greater proportion of ICE detainees were male (96.2%, n=76) than non-ICE detainees (75.5%, n=397; χ²(1)=17.299, p<.001) and Hispanic/Latino (85.7%, n=66 vs 3.4%, n=17); χ²(4)=380.103, p<.001); and a smaller proportion’s Kessler-6 results indicated SMI (5.1%, n=4 vs 33.8%, n=178; χ²(1)=27.043, p<.001). A smaller proportion of ICE detainees reported receiving treatment for a psychiatric or emotional condition (2.5%, n=2 vs 27.9%, n=143; χ²(1)=23.775, p<.001); receiving MH services in the past month (2.5%, n=2 vs 12.6%, n=65; χ²(1)=6.924, p=.009); and currently taking any psychotropic medications (3.8%, n=3 vs 16.1%, n=83; χ²(1)=8.338, p=.004). Among those identified with SMI, no difference in referral rates nor in rates of service provision between ICE-detained and non-ICE-detained was determined.

Conclusions and Implications: Limited to a single cohort, this study found ICE-detained people held in jail to report a lower SMI rate than their non-ICE-detained counterpart. MH of the ICE-detained in this jail cohort does not appear to resemble that of the average ICE detainee detained in an IDC; whether that may be due to compromised ability to accurately self-report given an English-language screening, ICE selection criteria determining detainment location undisclosed to the researchers, an unwillingness to accurately self-report in the jail setting compared to IDC setting, and/or otherwise, requires further research to posit. More racially/ethnically diverse samples as well as multilingual screening materials are needed in future studies to determine the relationship of these factors with outcomes.