Mental Health Decline in ICE Detention Centers

By Rosa Morales-Simmons

The Suffolk County Sheriff’s Department in Boston began their contract with ICE in 2003, but was terminated in 2019. Termination reasons have been debated.

Amid the heightened immigration enforcement of 2025, flames of candles lit an altar for Brayan Garzon-Rayo, 27, who committed suicide at an ICE detention center in St. Louis in April 2025. 

Garzon-Rayo is part of the rising number of reported ICE detainee suicides that are sharpening the gaze on mental health care in detention centers. The deaths of 32 people in 2025 surpassed the U.S. Immigration and Customs Enforcement (ICE) detention center’s previous numbers in the last two decades, according to a report by The Guardian. The death total included the 2025 ICE reported suicides of Leo Cruz-Silva, Chaofeng Ge, Jesus Molina-Veya and Brayan Garzon-Rayo. 

ICE detention centers throughout the U.S. have accumulated corruption allegations as detainee numbers grew over the last year. The conditions of their holding centers have been scrutinized by critics, like immigrant rights and resource groups in response to accusations by detainees and their families that illustrate contentious living, nutritional and medical standards. Based on advocate reports, basic care and services are even further strained.

Massachusetts' contracted facilities have seen the end of their contracts amid ongoing protests against the alleged civil rights violations. Suffolk County Sheriff’s Department ended their contract with ICE in 2019, along with sheriff offices in Bristol and Franklin County following in 2021. Suffolk County being the first of these to have their contract discontinued for reasons critics linked to abuse. Personnel from the department challenged migrant advocates with the reason being the jail needed to make room for more female inmates. 

Photo taken across from the Suffolk County Sheriff’s Department in Boston on March 8, 2026.

In 2021, Bristol County’s longtime abuse allegations toward detainees also incurred scrutiny that led the Biden Administration to terminate their contract, while a spokesperson for the Franklin county facility cited a low detainee population as the reason they were transferred to Plymouth County Correctional Facility.

Massachusetts’ Plymouth County Correctional Facility (PCCF) is currently Massachusetts’ primary long-term ICE detention center for noncitizens. According to the “Chronicling 25 Years of Violations” 2024 report, it has expanded its holding capacity to 402 individuals despite its critic’s protests for decarceration.

The report was developed by The Prisoner's Legal Services of Massachusetts (PLS) and Boston University School of Law’s Immigrants’ Rights and Human Trafficking Program (IRHTP) and included personal accounts of more than 60 male ICE detainees who reported substandard conditions recorded over two decades.

Immigration Attorney at PLS, Leah Hastings, said that PCCF follows the 2025 National Detention Standards, which requires mental health screenings within 12 hours of arriving, and complete mental health assessment within 14 days. 

“But the more discretionary, vague, and broad requirements are minimally enforceable, and the quality of mental health care tends to be poor and inconsistent, even within a given detention center,” said Hastings. 

Hastings continued to say the direct communication between PLS and behavioral health care providers are limited since the agency isn’t updated on the detainees after medical requests are made. 

“In most cases, we have no way of knowing whether the concerns we raise are communicated to the providers, and must infer this based on our clients' medical records and their direct communication of their experiences to us,” said Hastings. 

Detention centers only provide mental health care to limit the facility’s liability if detained persons harm themselves or others, she continued to say. Detainees fear making mental health care requests, or exhibit acute distress, which “will result in them being placed in conditions akin to, or worse than, solitary confinement.”

She said detainees at PCCF lean on their legal service providers for mental health support to avoid the harsh interventions that result from urgent mental health requests. Though legal representatives aren’t capable or trained to provide mental health care, detainees are compelled to trust these providers for this assistance.

“Mental health services don’t exist. They just want to make sure they are not on the news and that we don’t hurt ourselves,” PCCF ICE detainee Santiago said in the report.

“They use suicide watch for people who answer ‘yes’ to questions like ‘do you hear things?’ But they also use it as punishment,” PCCF ICE detainee Carlos said in the report. “Sometimes I can’t sleep because I have so much running through my head. I want to ask for medicine to help me sleep, but I’m afraid they will punish me by sending me to the hole.” 

Immigrant advocates condemned the isolation methods of the Q5 protocol which is utilized for detainees on suicide watch. 

“Inmates are locked in ‘Q5’ alone, naked or nearly naked, and without a mattress. As an additional indignity, there is no toilet in ‘Q5.’ Instead, inmates must defecate in a hole in the floor,” PCCF ICE detainee Marty was quoted in the report in 2017. “Human beings endure these deplorable conditions for days, never receiving therapy, before they are asked if they still need help. Anyone who answers that they do, is held there longer.”

In Pennsylvania, Yangfeng Ge, the brother of the 32-year-old suicide victim Chaofeng Ge pursued a Freedom of Information Act lawsuit with the federal government in 2025 due to the discrepancies in the manner of his death in an autopsy report released by ICE. Yangfeng Ge shared similar grievances with the family members of suicide victim, Leo Cruz-Silva of Missouri.

Detainee Leo Cruz-Silva, 34, was held in the Ste. Genevieve Detention Center for 24 hours before he was discovered unresponsive. ICE later reported his passing as an apparent suicide.

Sara Drost is the president of the immigrant resource organization Abide in Love that coordinates resources, legal services, and a pen pal program between ICE detainees and the Ste. Genevieve community. In Cruz-Silva’s case, Drost’s organization was unable to make contact with him due to his rapid decline at the detention center. 

“In our experience, the jail usually notices the mental health emergencies before we do and will put detainees on ‘medical watch’ or ‘medical lockdown,’” Drost said in an interview. “However, when this happens, we cannot communicate with the detainee and that makes some of our efforts impossible – plus, we worry when we don't hear from someone for an extended time.”

Chief Deputy Sheriff, Major Jason Schott of the ICE contracted Ste. Genevieve County Jail in Mo. responded to an interview question on the standards of care his facility utilizes, with the U.S. Marshals Service Federal Performance-Based Detention Standards. Major Schott said that medical staff are notified to initiate an evaluation and assess care, and work alongside detention staff for follow up care. 

“Our medical staff are county employees who work alongside detention staff. This structure allows for direct, timely, and effective communication between healthcare providers and law enforcement personnel,” said Major Schott.

The facility informed Abide in Love organization that detainees are given a physical, mental and dental health assessment upon arrival, “...But, clearly this is not very thorough,” Drost said.

Migrant advocates from different regions across the United States are seeking a ban on prisons and jails being used as holding centers, like the 2025-2026 "Dignity Not Detention" act in New York state. Similar requests were made by sympathizers quoted in the PLS and IRHTP Massachusetts’ report, and are seeking an overall end to the contract between ICE and Plymouth. While the contract is currently active, adjustments in care were outlined in an executive summary that prioritizes complete medical care requests within 24 hours; allowing contact visitation, not limited to 30 minutes, and free phone or video calls with loved ones.

“A lot of men have issues. People start walking around, talking to themselves – they don’t

know who to talk to,” PCCF ICE detainee Samuel said in the report in 2022. “There's dudes in here who won’t eat. It’s not like they are on hunger strike, but they’re so stressed out it’s hard for them to eat. It’s complicated up in here, know what I’m saying? You don’t know who to talk to.”