On March 23, Hassiba Belbechir, a 27-year-old woman from Algeria, was found strangled to death in her cell at McHenry county jail. According to the Chicago Tribune, Belbechir lived in the Chicago area from November until March, when she left her husband and flew to the UK en route to Spain, where she hoped to seek asylum. British authorities intercepted her traveling with a stolen visa and returned her to U.S. custody. She was flown to O'Hare Airport and taken directly to detention in McHenry County jail, where she awaited hearings for traveling with a stolen passport, overstaying her original U.S. visa, and simultaneously applying for asylum in the U.S. All charges against Belbechir were administrative rather than criminal.

Belbechir, a French-speaker, was reportedly prescribed medication for depression within her first week in detention. She is also reported to have told the jail psychologist about an abusive relationship with her husband, a Chicago area resident. She was under supervision by the medical unit because of the new depression medication, according to McHenry County Jail chief Tom Svboda. She was not placed on suicide watch.

Just a week after arriving at the county jail, Belbechir was found dead in her cell with a pair of jail-issue socks knotted around her neck. She left a note written in French.

The circumstances of her death are the subject of current investigation by both the Immigration and Customs Enforcement (ICE)--the bureau of the Department of Homeland Security that was responsible for her detention--and McHenry County officials. The Council of Islamic Organizations of Greater Chicago (CIOGC) reports that Ms. Belbechir's family remains skeptical about the initial coroner's report of suicide.

CIOGC officials did tell the Chicago Tribune, however, that Belbechir should have been placed on suicide watch.

Immigrants in County Jails

County jails are notoriously weak on health care services---particularly for mental health care services. Cut off from the state and federal funding that supports the operation of prisons, many county jails are actually created in order to generate revenue (and jobs) for the county. Often, this scheme backfires when the number of county inmates dwindles or operation costs are too high.

In recent years, struggling jails have been turning to lucrative contracts with the Immigration and Naturalization Services (INS), now reorganized under the Department of Homeland Security. According to Charles Fasano, vice president of the John Howard Association for prison reform in Illinois, such contracts with branches of the federal government, called Intergovernmental Service Agreements (IGSA), can help to support the operation of an entire jail.

McHenry County jail was, in fact, one of two Illinois jails battling for a significantly increased IGSA contract in 2003. According to county officials cited in the Chicago Tribune, the McHenry County board sank $20,000 in a renovation plan that would nearly triple the bed space available for DHS detainees. The plan was part of a pitch for a future IGSA contract that would bring over $1.4 million annually to McHenry County.

Despite the increased revenue generated though IGSA contracts, Fasano fears that such contracts to hold immigrant detainees lead to overcrowding in jails, and the further stretching of limited resources. "Unfortunately, services may be the first area to suffer," says Fasano. "You can only stretch one nurse so far."

Fasano also fears that IGSA contracts push local inmates out of county facilities to accommodate more immigrants--a policy against which he makes his opposition clear. "I don't care--you've got to take care of your own folks first."

Immigrant detainees pose substantial challenges to county jails. They represent not only more bodies, but a complex, multi-cultural, multi-lingual population, dealing with a different set of legal issues, usually held on administrative rather than criminal charges. Detainees fall into three rough categories--criminal non-citizens in deportation proceedings, non-citizens detained on administrative charges, (such as visa overstays), and asylum seekers, who are often detained for the extent of lengthy asylum hearings.

Regular Complaints

In the Chicago area, immigrant advocates and attorneys who represent detainees regularly field complaints about substandard living conditions and inadequate health care services in county jails. Complaints range from out-of-service phones and sudden transfers between facilities (which makes attorney-client contact difficult); slow responses to health complaints and medical service requests; and inadequate or inappropriate use of pain medications.

Geoff Herrin, an immigration attorney with the Legal Assistance Foundation (LAF) in Chicago, says he regularly receives complaints about the lack of 24-hour medical services at Kenosha County Detention Center (KCDC) in Wisconsin. KCDC is one of two facilities in Kenosha County, which together regularly house over 100 DHS detainees from the Chicago district. According to Herrin, the downtown facility has 24-hour medical services, but KCDC, the larger of the two, does not. Some detainees report that officers at KCDC generally refuse to respond to night-time medical situations--offering support "only if you're dying."

The Midwest Immigrant & Human Rights Center (MIHRC), a nonprofit immigration law firm in Chicago, has a detention hotline and makes regular jail visits to conduct legal orientation (or "Know Your Rights") presentations for detainees. Through client contact, MIHRC occasionally learns of problems with detainees' ability to access both legal and health care services.

MIHRC reports that understaffing and lack of resources and training for health care staff at jails may contribute to several persistent problems. Because of short staffing, incoming detainees are often screened for health problems by the admitting officer, rather than by a nurse or doctor. Jails are also not prepared to handle the many languages spoken by detainees--so screening and other medical visits are conducted in English. In many cases, telephonic translation services are used only in the case of an emergency. Psychological services available at jails are limited, at best, and are not prepared to deal with post-traumatic stress disorder (PTSD) and other mental health complaints brought by asylum seekers.

Limited Monitoring and ICE Oversight

Underlying all these problems is the matter of appropriate oversight by the Immigration and Customs Enforcement (ICE) and consistent monitoring by independent organizations.

Gail Montinegro, spokesperson for the ICE branch in Chicago, explained that all ICE detention centers, including contracted jails, are meant to follow the standards laid out in the Detention Operation Manual. The Detention Operation Manual, which is available on the ICE website (ice.gov), was created in 2000 following a spate of public scandals at INS detention centers in the late 1990s. It was meant to standardize operations in a rapidly expanding detention system; over the course of the 1990s, the nationwide detention census leapt from 5,000 to over 21,000.

At the time of its creation in 2000, the INS's stated goal was to fully implement the Operations Manual by 2003. The 2002-2003 reorganization of INS operations under the new Department of Homeland Security may have diverted focus from this operational deadline. A 2003 ICE report stated that about 70 percent of its facilities were found to be compliant. The same report specified that a facility did not need full compliance in order to maintain its ICE contract. "Facilities generally are precluded from housing ICE detainees only when conditions of confinement are found to severely affect the welfare and well being of detainees and staff."

After a strongly critical NPR report was published last November, Victor Cerda, acting director of ICE Detention Operations and Removal branch, stated that any contracted facilities out of compliance with standards would have their contracts dropped.

What MIHRC would like to see is 100 percent implementation of the detention standards. MIHRC has been part of both a local and national working group on detention conditions that meets on a regular basis with ICE Officials. According to comments made in these meetings, MIHRC reports, even ICE officials admit that they have been on the slow implementation plan, but are striving for 100 percent implementation in the near future. Not only should standards be implemented, emphasizes one MIHRC representative, they need to be regularly enforced.

Montinegro reported that the Chicago ICE office conducts a yearly review of facility operations at each of the five contracted jails, which together house an average of 500 detainees. A questionnaire based on the Operations Manual is the primary tool for this annual review. Montinegro also suggested that there may be an ICE agent placed at some of the jails for more regular oversight.

A Population in Transition

The surprising thing about the death of Belbechir at McHenry, Herrin comments, is that the facility is often considered the best of the five detention facilities in the Chicago district. Although this has not been officially confirmed, several attorneys report that for this reason (or its proximity to Chicago), McHenry has been selected to expand its immigrant detention space in preparation for the future consolidation of IGSA-contracted facilities in the Chicago district.

Currently, three contracted facilities--McHenry County in Illinois, and Kenosha and Ozaukee Counties in Wisconsin--are within two hour drives of Chicago. The other two--Dodge County in Wisconsin and Tricounty Detention Center in Ullin, Illinois--are 3- and 6-hours drive respectively.

Reacting to the news of Belbechir's death, Charles Fasano emphasized the importance of comprehensive screening procedures for every inmate or detainee that enters a county jail. County jails have the most difficult job, he explained, because they deal with prisoners "right off the streets," who have not been convicted or put into a long-term facility.

For this reason, Fasano believes, jails tend to be "more concerned with security" and "light on services" than a long-term prison facility. However, he reports, jails also have a higher rate of suicide because they deal more with a population in crisis. "What jails don't understand is that [mental health and health] services are a critical part of security," says Fasano. "Jails have the responsibility to keep inmates secure from each other and from themselves."

Immigrant detainees are, in a certain way, similar to the regular inmate population of a jail--a temporary population in legal limbo and, often, in a state of crisis. Anxiety and/or depression run high among those facing deportation back to a home country they either fear or do not know.

Detention itself aggravates anxiety and depression among detainees, especially those who have suffered past trauma. One MIHRC client, whose case is currently being reviewed by the United Nations Working Group on Arbitrary Detention, has been detained for over 30 months at TriCounty Detention Center in southern Illinois. According to a recent MIHRC press release, this 25-year-old Somali man, who came to the U.S. as a refugee during the 1990s, suffers from Post-Traumatic Stress Disorder. Thirty months in a windowless jail without access to outdoor recreation or adequate psychological services has notably aggravated his depression and other PTSD symptoms.

Whether long- or short-term, and whether the process ends in deportation or not, a period in detention has very real costs. Dawit, an Eritrean man who was detained for in Dodge County detention center for three weeks last fall, describes the tremendous anxiety he felt for his three children who did not understand where he had gone or whether he would return. Although he was eventually able to return to his Chicago home, Dawit's detention cost him his job at a parking garage where he had worked for over six years. After his release, he spent months looking for work before he finally began working as a taxi driver, a job that keeps him away from his family for longer hours.

Suicide Screening and Prevention in Jails--Not Enough

According to Fasano, Illinois state law requires all jails to have comprehensive screening procedures for incoming inmates, which include an assessment of suicide risk, drug dependence, and any health or mental health needs. For potentially suicidal inmates, jails are required to have a suicide watch program, including a specially designed cell and regular watch on a 10-, 15- or 30-minute rotation.

The Detention Operations Manual prescribes very similar procedures for ICE detainees. "All new arrivals shall receive initial medical and mental health screening immediately upon their arrival by a health care provider or an officer trained to perform this function. This screening shall include observation and interview items related to the detainee's potential suicide risk and possible mental disabilities, including mental illness and mental retardation." The manual also requires the use of a translation service if language barriers prevent the health care provider or officer from sufficiently communicating with the detainee to ensure adequate screening.

The suicide prevention and intervention program in the Detention Operation Manual includes a complete evaluation by the medical unit for any detainee identified as a suicide risk during initial screening, as well the possible use of isolation, suicide watch and/or hospitalization.

McHenry County health care staff and officials in the ICE Chicago office could not comment on the specific health care services that had been prescribed for Belbelchir as long as the case is under investigation.