A Qualitative Review of Office of Inspector General Complaints Submitted by Individuals Held in ICE Detention.

Growing evidence highlights medical mismanagement and gross negligence at United States (U.S.) Immigration and Customs Enforcement (ICE) detention facilities. Accountability at these facilities is predominately limited to annual inspections to determine compliance with specific detention standards and responses to formal grievances and/or complaints. The grievance process is particularly important as it provides an opportunity for individuals directly impacted to document and formalize negative experiences. To gain a better understanding of the conditions and violations faced by individuals detained, we performed a thematic analysis of formal complaints submitted by or on behalf of individuals detained at Stewart Detention Center (SDC) to the Office of Inspector General within the Department of Homeland Security between 2019 - 2021. Major themes included concerns about substandard medical care, human rights violations, and operational failures. Concerns about medical care were related to inappropriate management of acute and chronic medical conditions, lack of durable medical accommodations, and inadequate medication management. This study supports growing evidence of medical mismanagement at U.S. ICE detention facilities, specifically at SDC, and is one of the first contributions to the medical literature evaluating complaints submitted directly by affected individuals. Our findings provide ongoing evidence that SDC is unable to meet quality medical care standards, which supports ongoing advocacy efforts for improved transparency and accountability at U.S. ICE detention facilities.