“Death by Deportation”: Repatriating the mentally ill to Cambodia

katya cengel

Khe Khoeun was deported eight years ago from the United States to Cambodia. Here, she sits outside her home in rural Battambang province.

BATTAMBANG, Cambodia—One of Khe Khoeun’s few possessions is a small album of family photographs. In one picture, she is wearing a puffy, pastel wedding party dress; in another, she stands next to her four siblings. A third photograph shows her with her young son on Halloween.

She keeps the album of her life in America, the country where she was raised, in a one-room wooden lean-to in rural Cambodia. It offers some of the only clues to the decades Khoeun spent in Washington state. She is only 40, but her teeth are rotten, she tends to cry without warning, and she has trouble remembering details of her past. Repatriated in 2009 to Cambodia, which she’d fled with her family as a small child, Khoeun is one of perhaps thousands of mentally ill legal permanent residents the United States has deported in the last two decades.

After arriving on a U.S.-chartered flight to Phnom Penh, Khoeun moved in with extended family she barely knew. But when her emotional problems grew too burdensome, they brought her to the Returnee Integration Support Center (RISC), a nonprofit organization opened in 2002 to help Cambodians deported from the United States. RISC found her a therapist who prescribed anti-depressants and sleeping pills, medications she said she took in the U.S., though without Khoeun’s medical records it’s been impossible for RISC to confirm that information.

She lived at the group’s Phnom Penh office for two months, until RISC tracked down her uncle near Battambang, a provincial city in the country’s northwestern rice-belt region. He agreed to take her in. Two years ago she married an elderly man from the same village. Her uncle worries that the man drinks too much and mistreats her.

Since 2002, when Cambodia signed an agreement with the United States allowing the repatriation of Cambodian nationals who’d run afoul of American law, more than 560 people have been deported to the Southeast Asian country. Many escaped the killing fields of the Khmer Rouge in the 1970s or the preceding period of U.S. bombings and civil strife. The deportees rarely speak fluent Khmer or have strong ties to the country. Bill Herod, an American who helped establish RISC, says at least a dozen of the deportees he’s encountered suffer from severe mental illness—bipolar disorder, schizophrenia, or psychosis. He says: “These are people who required medication and constant care.”

But care is often a casualty of deportation. While immigrant detention centers have begun to offer improved mental-health services in recent years, refugees who are detained and deported often lose the support of their friends and families. Little is done to ensure they remain on antipsychotic medications or receive treatment once they arrive in their unfamiliar homelands. The consequences can be dire. One man deported to Cambodia in 2002 carried out a double murder. Two deportees committed suicide. Others have drunk themselves to death. Herod calls this “death by deportation.”

NO RIGHT TO A LAWYER

When Khoeun arrived in the United States as a child, she was among hundreds of thousands of people fleeing the wars of Indochina during the 1970s. The United States eventually granted asylum to more than 100,000 Cambodians between the 1970s and 1990s. Many were resettled in Washington state, and at the time, it seemed unthinkable that these refugees might one day be repatriated to their war-weary country.

But in 1996, amid rising fears of terrorism following the Oklahoma City bombing, Congress and President Clinton approved legislation expanding the list of “aggravated felonies” for which non-citizens, including legal refugees, could be deported, and limiting judges’ ability to consider the individual circumstances of each case. Under these rules, even those who commit minor offenses such as shoplifting are eligible for expulsion. In 2002, after the repatriation agreement was signed, the first...