Horrific conditions at a Clint, Texas, Border Patrol facility came to light last week when attorneys visiting the site described unaccompanied children babysitting each other, premature infants without adequate care, and other horrendous circumstances, which Representative Alexandria Ocasio-Cortez sharply described as “concentration camps.”

While numerous human rights and civil liberties groups — including RAICES, the ACLU, the Civil Rights Education and Enforcement Center, and the Young Center for Immigrant Children’s Rights — are working at the border to document and fight conditions in these facilities, one type of group that’s been involved may be a surprise to some: Disability rights organizations.

Some of these organizations have a secret weapon in the form of a legal mandate that allows them to demand access to facilities that others, such as members of Congress, may struggle to get into. It’s the harsh conditions of detention centers at the border that allow many disability advocacy groups to qualify for access and join the fight for changes that can benefit both disabled and non-disabled immigrants.

“The intersection of disability and immigration is just one of the intersections that’s really important to look at, especially right now,” said Richard Diaz, who works with Disability Rights California, the state’s protection and advocacy organization. P&As are found across every state and US territory, with a mandate to defend the personal and civil rights of the disability community. When it came to the decision to get active in immigration detention facilities, “we had the responsibility to help people in these centers, just as we have the responsibility to help people with disabilities anywhere in California.”

Disability rights groups have accelerated their involvement in immigration detention in recent years. In its role as a P&A, Disability Rights California is entitled to demand access to state and private facilities if it has concerns about the wellbeing of disabled people housed there. So does Disability Rights Texas, which inspected shelters in 2018 to determine if disabled children were being housed there and whether they were receiving adequate care. Similarly, Disability Rights Florida evaluated and reported on the Homestead temporary shelter, a tent camp housing 1,350 children.

While P&A representatives cannot demand entry to federally owned and operated facilities, their scope is quite broad — and urgent. ACLU attorney Claudia Center noted that the physical and emotional trauma people are fleeing and enduring on their way to the US and in detention makes huge numbers of immigration detainees members of the disability community, at least temporarily. Mental health issues associated with stress and trauma like anxiety, depression, and post-traumatic stress disorder are common in immigration detention facilities, and can be covered under disability law if the condition includes disabling symptoms.

“People who are in detention, who are seeking asylum or refugee status or have experienced border crossings, are fleeing violence and threat. Almost by definition, these are people with disabilities … because of everything they have gone through,” Center said.

And any disabled people in immigration detention, whether they have PTSD or use a wheelchair for mobility — and whether in facilities operated by ICE, Border Patrol, or a local jail under contract — are covered by the Rehabilitation Act of 1973, meaning they’re entitled to accommodations. This includes physically accessible facilities, interpreters for deaf detainees, and materials accessible to blind and low-vision people, said Center. It also includes rights like being accompanied to immigration hearings and interviews, receiving legal representation when they cannot represent themselves, or taking breaks during testimony. Many of these accommodations are not provided, making them clear violations of the Rehabilitation Act.

Diaz explained that this also means the right to a least-restrictive environment, something every disabled person in the United States is entitled to; people should live in their communities, and if there is a compelling reason this is not an option, in settings that are as open and free as possible. Yet, he says, that’s not what Disability Rights California has seen in the detention facilities it reviewed, like the Adelanto Detention Facility in San Bernardino, California. Instead, disabled detainees are sometimes moved to administrative or disciplinary segregation, both of which involve being confined to cells for hours a day: 23 hours or more in disciplinary and 20-plus hours in administrative segregation.

When people with poorly managed mental health states are put in these conditions, the result can be rapid decline. The organization observed evidence of and took reports about self-harm and suicide attempts among people trapped in segregation, finding that GEO Group, the private administrator of the prison, does not track such incidents adequately.

This legal responsibility can become a framework for disability advocacy groups to fight harmful conditions in detention facilities. And these actions will benefit not just disabled detainees, but everyone.

Groups focusing on disability issues aren’t the only ones looking out for disabled people in detention. Holly Cooper, co-director of the Immigration Law Clinic at University of California Davis, frequently encounters disability issues among the young people she works with, and they have become a large part of her work.

In addition to being one of the attorneys involved in the recent groundbreaking report, she’s part of a class action lawsuit, Lucas R. v. Azar, which among other things is challenging the inappropriate use of psychiatric medication in immigrant children who are being given psychotropic drugs without the consent or involvement of their parents. The children involved in the suit were given such medications in response to mental distress caused by being in detention, such as anxiety or depression, even with family members eager to provide them with loving homes where they could begin to recover from their ordeals.

These medications can have severe effects, some of which are permanent; for example, some antipsychotics cause tardive dyskinesia, repetitive involuntary movements like lip smacking, twitching, and grunting, some of which are irreversible in some patients. Other drugs can cause damage to the liver or kidneys and other severe reactions, especially in children, as no testing has determined safe and effective doses. Forcible medication for people with mental health conditions has been a long fight for the disability community. So has the use of psychoactive medications for behavioral control, not therapeutic, purposes, as in the case of foster children receiving high doses of psychiatric medications.

The administration of medication without consent reflects a larger issue: very limited access to health care and very little autonomy and privacy for those who need it. Cooper said medications are routinely confiscated at the border, noting that this can be extremely dangerous. For example, a teenage mother with a premature infant who swam through the Rio Grande after her C-section had her antibiotics seized. For people with chronic illnesses that need medication, including diabetes, seizures, HIV/AIDS, and some mental health conditions, interruptions can be disruptive or even fatal.

Once in facilities, people can struggle to access all but the crudest of care, said Diaz. “I saw a child with a bullet still lodged in his arm, he was in 10/10 pain and it hadn’t been treated,” says Cooper. While Cooper gets calls from parents frantic about disabled children lost in the system, her work also includes unaccompanied minors, the children with no parents ensnared in a system that effectively criminalizes immigration.

The leveraging of disability law, P&As, and related resources as tools to support immigration detainees has largely flown under the radar, but that’s starting to shift. The disability community is coming to understand the importance of immigration work, while nondisabled people are learning more about the increased incidence of disability in immigration detention. Then there are people deep in immigration work, notes Cooper, who can also start to experience physical and mental health consequences themselves, bringing their work full circle.

The recognition of the role of trauma in immigration puts the experiences of the thousands of people crossing the border in context, and roots disability advocacy organizations in a large and complicated fight.

Writer s.e. smith is a Northern California-based journalist who has appeared in publications like the Guardian, Bitch Magazine, Esquire, Rolling Stone, and Rewire.News, in addition to anthologies including The Feminist Utopia Project and (Don’t) Call Me Crazy.

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