Mental Health Libraries Manage Stress for Detainees in ICE Custody

Article excerpt

The experience of being a non-U.S. citizen detained by the Department of Homeland Security (DHS) Immigration and Customs Enforcement (ICE) is inherently stressful due to multiple factors. Deportation often means leaving one's home, parents, siblings, spouse, children, job and accumulated retirement behind. The Mental Health Library (MHL) established at the DHS ICE Port Isabel Detention Center (PIDC) was created to help reduce detainee stress in an effort to increase individual physical and mental health as well as overall site safety.

The Division of Immigration Health Services (DIHS) serves as the medical authority for ICE, providing physical and mental health care services to detained non-U.S. citizens in ICE custody throughout the U.S. and Puerto Rico. Detainees, referred to as "patients" within the DIHS system, present with the full spectrum ot mental health disorders normally found in any given population sample. Many preexisting disorders are exacerbated by the stress of being detained. Frequently, disorders precipitated by the difficulty of adjusting to the detention environment are seen to emerge. ICE recognizes the importance of stress management within detention. Preventive care in the form of a two-page "Dealing with Stress" handout, translated into various languages, is a mandatory component of the inprocessing packet provided to every detainee upon arrival at an inprocessing site. This official patient education handout explains how stress can manifest in physical, emotional and behavioral ways. Dealing with Stress makes a number of suggestions for managing stress during one's detention stay. Among these suggestions is to "read books," There was no functioning library at PIDC prior to the creation of MHL, and the process for detainees to receive books from outside sources was cumbersome. It seemed natural to consider establishing a detainee lending library to increase the availability of materials aimed at stress management. Prior to the creation of the MHL, patients would frequently say to DIHS staff, "I wish I had something to read."

The Mental Health Library

The MHL began with a few volumes and grew to 723 by early 2010. The first book was checked out on Nov. 20, 2007, and more than 900 books had been borrowed as of Jan. 30, 2010. The library includes books in English, Russian, Chinese, French and Spanish. There is a section containing large print books for detainees with impaired vision. The majority of the books were purchased in small numbers using personal funds from local library resale stores and thrift shops. All genres are included: fiction, non-fiction, religious, poetry, history, self-improvement, humor, health, psychology and even children's books for those who had lower levels of literacy. Only paperback books are included in the MHL for safety reasons. One book can be checked out at a time and for a maximum of 30 days. A tracking system and a master book list was created to catalog new volumes being added to the library, as well as to keep track of volumes that were discarded due to wear and tear and that had never been returned. As the library grew, a few medical staff, outside agency staff and even detainees themselves made contributions. Many patients had strong spiritual/religious beliefs. Because of the prevalence of faith-oriented coping, community Christian organizations were queried for donations of booklets on prayer, family, hope and one's relationship with God. These volumes were added to the MHL.

The MHL is available to all detainees, though most individuals who use the library are patients receiving mental health services. On average, a detainee borrowed two or three books during his or her detention stay, though some individuals borrowed up to 15 prior to being transferred to another facility between 2007 and 2010. Lengths of stay vary depending on whether the detainee is fighting his case or has signed to be deported. All medical staff were briefed on how to use the library. …