Suicides Point to Gaps in Treatment

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None of these problems appeared overnight. When immigration became a national security issue after the terrorist attacks of Sept. 11, 2001, the administration decided to increase raids on workplaces for undocumented workers and to round up convicted felons who had served time but were now deportable, no matter how long they had lived in the United States. This, along with a new requirement that political asylum-seekers must wait out their cases behind bars, created a deluge that the system was unprepared to handle.

A system set up for quick stays turned into a de facto long-term care center for the most troublesome patients, those whose countries of origin often refused to take them, Slate noted in a confidential e-mail.

It was in this context that the basics of sound mental health care, such as proper supervision of suicidal detainees, were often overlooked.

On the evening of March 21, 2005, Gene Migliaccio, then director of the immigration health services agency, sent a brief BlackBerry message to colleagues: "DIHS is concerned that detainee committed suicide, in medical pod, after being assessed a suicide risk."

Hassiba Belbachir, a 27-year-old woman from Algeria, had strangled herself with orange jail-issue socks, which she knotted together and wrapped twice around her neck.

Five days before her suicide, Belbachir had a panic attack in her cell in an Illinois jail and was moved to a medical ward. The next day, internal records show, she told a social worker she was hearing "parasites and radio waves" and that she wanted to die. "Death is dripping, drop by drop," she said. But she was not placed on suicide watch.

Immigration officials declined to comment, citing ongoing litigation in the case.

Belbachir had arrived eight days earlier at Chicago's O'Hare International Airport. The youngest of seven children, she loved books on religion and dancing the merengue. With a degree in Spanish, she thought of becoming a translator. "She wanted to visit the world," said an older sister, Houaria Belbachir, who lives in France.

Belbachir had gotten married, and her husband had brought her to Chicago to live. After a month, she learned he had another wife. She fled to Spain, but without a visa, she was turned away at the airport. She flew back to O'Hare, asked for political asylum and, by federal policy, was taken into custody while authorities considered her claim.

Belbachir was sent to McHenry County Jail in the far suburbs of Chicago. The jail already had problems with its medical services: Detainees did not receive the required mental health screening, nor the standard screening for suicide risk, a recent review had found. Untrained staff members often did what screenings there were.

During Belbachir's intake screening, jail records show, she said she had tried to commit suicide once by drinking soap. The social worker who interviewed her noted that she had a "major depressive disorder" and needed to see a psychiatrist for medication. Belbachir was given an appointment for 6 p.m. on March 18.