The lasting association between interrupted medical care during US immigration detention and mental health outcomes.

Detained immigrants with chronic health conditions face heightened exposure to health-harming conditions, including interrupted medical care for chronic conditions, with potentially long-lasting health consequences, including for mental health. Drawing on a unique longitudinal referral sample of 192 individuals with chronic conditions released from US immigration detention between 2020 and 2021 and followed through 2023, we find that 42% experienced interrupted medical care during detention. We then use longitudinal multivariable random-effects regression to examine the relationship between interrupted medical care while in detention and long-term psychological distress. We find that psychological distress decreases over time after release among those with and without medical care interruptions, but remains elevated when benchmarked against the US general population, even three years following release. We also find that those who experienced interrupted medical care during detention had higher and more persistent distress, even after adjusting for socio-demographic characteristics, prior health status, and post-detention conditions. Building on scholarship on the stress process within carceral settings and on organizations as sites of stratification, we conceptualize immigration detention as a stratifying institution that may shape health trajectories in durable ways. Our findings suggest that interrupted medical care in detention is not just a temporary hardship, but an organizational feature that contributes to enduring mental health inequities that can extend well beyond the period of confinement.