Nelson Kargbo was eleven years old when rebel soldiers attacked his village, Kamalo, in northern Sierra Leone. He was playing soccer on a dirt field at the edge of the village. When he saw houses on fire, he and his best friend, Foday, ran toward the jungle, following Foday’s mother and dozens of other people. They walked until late at night, when they came across a cluster of abandoned mud houses. Foday’s mother, who used to cook for the boys after their soccer games, told them to sleep under a grove of mango trees. “Tomorrow, we’ll keep walking,” she said. “We’ll make it to the city.”

The country’s civil war, which had begun five years earlier, in 1991, had seemed remote to Kargbo. He’d considered it only when he overheard his adoptive father, Lennard, a pastor who had assumed custody of him when his parents died, talking about it with members of his congregation. Kargbo was the youngest child in the family—he had seven brothers and sisters, who were all the biological children of the pastor—and he was accustomed to being ignored. He was reserved and nearly invisible, except when he played soccer. He hoped to play for the national team.

At 3 A.M., he and the others were woken by soldiers from the Revolutionary United Front, an army that was fighting to overthrow the government. They carried trussed goats and bundles of food looted from Kargbo’s village. The R.U.F. commander, a man in his early twenties called General Mosquito, told the boys and men to line up. Their mothers, wives, and daughters waited in another line. Mosquito asked the boy at the front of the line, who was Kargbo’s classmate, if he wanted to join the rebels or return to his mother, and the boy said that he wanted to go home. Without saying a word, a soldier put a gun to the boy’s head and killed him. When it was Kargbo’s turn, he said that he wanted to join the rebels. Foday said the same thing.

The soldiers then addressed the women, asking all but the elderly if they were ready to join. The first three women consented to be soldiers or “bush wives,” cooking, cleaning, and having sex with the rebels. A young soldier approached Foday’s mother, groped her breasts, and asked if she was a rebel now, too, but she pushed the man off her. The soldier shot her in the head, and said that he was setting an example. Foday fell to the ground crying. “Man up!” a soldier said, pulling him to his feet. “Stop whining like a little girl.”

Kargbo, Foday, and the other recruits walked for two days, until they reached the rebels’ base, an encampment of huts with pickup trucks parked nearby. The boys were given food, beer, cigarettes, and “brown brown,” a mixture of cocaine and gunpowder that was injected into their forearms. Kargbo’s adoptive father was a follower of the Methodist minister John Wesley, who viewed alcohol as poison. Kargbo felt that he had sinned by permitting alcohol and drugs into his body, but they made him aggressive and fearless, especially when the deputy commander, called Rambo, taught him how to operate an AK-47. He and the other boys practiced shooting at targets, as tapes featuring Tupac, Biggie Smalls, and Lucky Dube played from a boom box.

The commanders renamed Kargbo Fula Boy, because he was skinny and short, like children of the Fula tribe. (He is actually Temne, the country’s largest ethnic group.) After a month of training, Kargbo began helping to loot villages. He and the other soldiers approached towns at night, wearing bulky coats that hid the weapons slung on their backs. The boys entered first, to draw gunfire, so that older soldiers would know where to shoot. Kargbo was often so high that he would shoot an entire magazine of bullets, oblivious of whom he might be killing. The rebels had trained him to feel that he was superior to civilians. He told me, “They were just like chickens to me.”

Kargbo never understood the reasons for the war. The rebel leaders didn’t discuss politics, except to refer to their enemies as “bastards.” Kargbo saw the attacks as merely a way to procure what the soldiers called “rations”: stolen goods that they handed over to Mosquito. Kargbo came to respect Mosquito, who rarely spoke, which was Kargbo’s natural tendency, too. Before battles, Mosquito motivated the soldiers by playing the Tupac song “Me Against the World.” Kargbo, who slept with his AK-47, found solace in the lyrics: “witnessing killings / leaving dead bodies in abandoned buildings / can’t reach the children cause they’re illing / addicted to killing and the appeal from the cap peeling / without feeling.” Kargbo knew the story of Tupac’s life—he was murdered the same year that Kargbo was abducted—and viewed him as an idol who understood the inevitability of everyday violence, and the trauma of being both victim and perpetrator. Kargbo and Foday stole Tupac T-shirts from villages that they looted and wore them when they went into battle. “We were hyped from the brown brown, pumped up, ready to go,” he told me. “At the time, I was into it—I was so into it.”

When Kargbo and Foday were alone on night duty, guarding the camp, they spoke about their home, but stuck to quotidian details. Kargbo was afraid to mention Foday’s mother. He had seen what happened to boys who showed their feelings. “I used to be an emotional person,” he told me. “I used to cry.” At night, he was given marijuana and whiskey, which helped him fall asleep. He never tried to escape, because those who did had their arms chopped off with machetes. He figured that he would stop being a soldier when he died, a possibility about which he felt ambivalent.

In 1998, after Kargbo had been with the rebels for nearly three years, he contracted malaria. On the way to a village on the border of Sierra Leone and Guinea, where the older soldiers said that there would be cows to steal, Kargbo was too sick to aim his gun from the back of the pickup truck. When the rebels passed close to Kamalo, Kargbo’s village, Mosquito stopped the truck and told Kargbo to get out. Kargbo wasn’t sure if Mosquito was being cruel to him, since he’d become useless as a fighter, or merciful. He was left at a roundabout without weapons or food.

Later that day, a member of his father’s congregation recognized him and took him back to Kamalo. His family, like many residents, had fled the afternoon that he was abducted, and were now living in a refugee camp in Conakry, Guinea. When they learned that Kargbo was alive, they sent money for the trip to the camp. On his way, Kargbo travelled first to Freetown, the capital of Sierra Leone, where he saw graffiti of Tupac lyrics and imagery, much of it scrawled by an R.U.F. splinter faction, the West Side Boys, whose name referred to Tupac’s allegiance to rappers on the West Coast.

In Guinea, Lennard Kargbo was dismayed by his adoptive son’s newfound irreverence. “He had been such a good boy,” Lennard told me. “I didn’t know what had happened to him. He became a bad example.” Kargbo went through withdrawal from the drugs and became unhinged, yelling and swearing at people. Rather than playing soccer with the other kids in his compound, he stayed inside, watching Guinean music videos on a small television.

Kargbo spoke of his experiences only in generalities. “It was too painful for him,” his oldest brother, Eli, said. “When I’d ask him about his abduction, he would say, ‘Well, brother, you know there’s not so much that I can explain.’ ” Eli thought that Kargbo’s silence was a “survival skill, but he kept surviving that way. I think he still thought that if he talked about how he felt something bad would happen to him.”

The family had applied for refugee status in the United States, and a year after they arrived at the camp the application was accepted. They left for Minnesota, where there are roughly a hundred thousand refugees, many attracted by the state’s social services and high rate of immigrant employment. Kargbo had imagined that all the young men in America would exude Tupac’s style and confidence. He told me that the other kids in the refugee camp assured him that “now it will be a good, easy life—you’ll become whatever you want to become.”

The first political refugees to settle in Minnesota came from Southeast Asia. In the late seventies and the eighties, they fled from conflicts in Vietnam and Cambodia and Laos, many having witnessed the murder of relatives and the destruction of their communities. Doctors observed that many Southeast Asians complained of stomach aches, dizziness, fatigue, shortness of breath, and pains in their joints that didn’t correspond to physical injuries. Jerome Kroll, the chief psychiatrist of the Refugee Mental Health Program at the Community-University Health Care Center, in Minneapolis, said that the refugees often expressed their emotional distress in somatic terms, locating their suffering in their bodies, not in their minds. They were taking extraordinary amounts of Tylenol and Advil. The concept of post-traumatic stress disorder struck them as irrelevant, a Western invention. When Kroll asked them what was wrong, they touched their chests, their abdomens, their knees, their shoulders.

Kroll said that the African refugees were often brought to the clinic by family members, because the patients didn’t think that there was anything wrong with their minds. But they had begun to run into the street in the middle of the night, or pace naked around their houses. Many of these patients acknowledged that they’d experienced violence in their native countries but denied that there were emotional repercussions. When Kroll asked what had happened when militias invaded their neighborhoods, they would often respond, “Nothing much.” Upon further questioning, they would reveal that family members had been shot in front of them. To complain was to suggest that they expected life to be anything but hard. Taking psychiatric medications meant announcing to their communities that they were crazy and damaged, a stigma that would contaminate their families. Kroll began minimizing his use of medical terms. He told patients that their symptoms were a “normal response to an abnormal situation.”

When Kargbo arrived in Minnesota, he was fifteen years old, and he dealt with trauma the same way that he had with the rebels: he avoided reminders of what he had lost. He was stoic and taciturn. All he wanted to do was play soccer. His high school, in St. Paul, seemed to him almost fanciful—there was free food and books, and the teachers never whipped students who were late or failed tests—yet he was unable to sit still in the classroom. In Kamalo, where the students spent the afternoons helping the teachers grow cassava leaves, to support the school, he had reached only the fifth grade. The first novel he had ever read was assigned to him by his ninth-grade English teacher. The sentences were too complex and he was uninterested in the characters, many of whom were preoccupied with choosing which rich man to marry. It was the first time that Kargbo had ever been surrounded by white people, and he thought that they had “a bad vibe about black people.” Students made fun of his accent, and he would sometimes respond by grabbing or pushing them. His first American friend smoked pot all the time. “That right there got me,” he told me.

His brother Eli worried that Kargbo was assimilating the worst part of American culture. “Nelson used to be a very sweet and quiet boy, but he had clicked with the bad guys in the war, and he was still attracted to the bad guys, the troublemakers,” he said. “He couldn’t get out of fighting mode and become a normal person again.”

Like many former child soldiers, Kargbo felt that his family saw him as irreparably damaged. His parents yelled at him when he broke his ten-o’clock curfew, sneaking in through the basement window. “I just tried to rehabilitate myself by doing what my friends were doing, smoking weed and drinking,” Kargbo said. When the war entered his mind, he smoked more and tried to fall asleep. Sometimes he tried to convince himself that he had never killed anyone—that his bullets could have missed all their targets. At other moments, he guessed that he had killed between ten and a hundred people.

Kargbo’s nightmares shook him so deeply that, after waking up from one, he would get out of bed and start his day, even if it was 3 A.M., so as not to risk a return to his unconscious. It never occurred to him to see a doctor. He had hated visiting people in the hospital near Kamalo, which smelled like infected flesh, and he associated doctors with that stench. When he had a fever, he ate pepper soup.

When Kargbo was in the eleventh grade, his parents told him that he could no longer live at home if he continued to smoke and drink. He moved out, slept on friends’ couches, and eventually dropped out of high school. He began working at a Burger King. Within a few months, he started hearing a deep, adult voice that insulted him in Krio, the language he spoke growing up. The voice told him, “You are good for nothing,” and “You are a piece of shit”—the same things that Mosquito and the other commanders used to say when Kargbo didn’t follow their orders. Once, while he was in a friend’s car, the voice commanded him to get out. He opened the door and jumped from the moving vehicle, bruising his shoulders when he tumbled onto the road.

Not long after they began dating, Hemmingson became pregnant. They named their daughter Destanee. Kargbo was excited to be a father, but Hemmingson felt that “his head was up in the clouds and he wasn’t in reality.” Tupac was his model of how to be an accomplished black man in America, and he spent hours listening to “All Eyez on Me.” Hemmingson said that her parents often belittled his prospects for success. “My family was never O.K. with me dating a black man,” she said.

Kargbo continued to smoke marijuana and drink heavily. He was arrested for a series of misdemeanors, serving no more than a few days in jail for each crime: disorderly conduct, being a public nuisance, fleeing a peace officer, shoplifting, and possession of burglary tools—he’d acted as a lookout, according to the police, while a friend tried to break into a store.

In 2006, when he was twenty-one, he was arrested for “terroristic threats,” a crime that in Minnesota encompasses behavior committed “with purpose to terrorize another or to cause evacuation of a building . . . or otherwise to cause serious public inconvenience.” The boyfriend of Hemmingson’s cousin had called Kargbo a nigger in front of Destanee. The two men began wrestling, and Kargbo, who weighed a hundred and twenty-two pounds, found himself in a choke hold, pinned to the ground. “My cousin’s boyfriend kept saying, ‘Oh, you want to be a man?’ ” Hemmingson said. As soon as Kargbo was released, he ran to his car and grabbed a crowbar and a hammer. “Back away from me,” he said, throwing the hammer on the ground. The police were called, and he was taken to jail, where he tried to hang himself with a torn blanket. He pleaded guilty (through an Alford plea, he maintained that he was innocent) and entered a work-release program for low-risk offenders. Hemmingson, who broke up with him a year later, told me, “He tried to brush off his experiences from the war and start over, but whenever there was a possible threat he was still trying to make a point that he’s not scared of people, no matter how big they are.”

When Kargbo describes his life in America, it falls into two halves: before and after the Fords. At twenty-three, he fell in love with Marquette Ford, one of the few black people who lived in his neighborhood, and eventually moved into her mother’s home in Woodbury, a suburb of St. Paul. “His group of friends were horrible, and I took him right out of that house where he was living and introduced him to a different type of family,” Marquette told me. He dropped the rapping dream and took a job at a company that manufactured banners and signs. Marquette’s mother, Renee, a customer-service representative at the Minnesota Department of Health, sensed that Kargbo was looking for a family. She found him “respectful and shy and a hard worker,” she said. Having raised her children in white, suburban neighborhoods, she related to Kargbo’s sense of alienation. “I know how it feels to have your black ass smack in the middle of all these Caucasians,” she told me. She was especially impressed by Kargbo’s devotion to her daughter, who, she explained fondly, had the “worst attitude.”

Marquette and Kargbo had three children in four years and moved into a house across the street from Renee. Most people from his village had large families, and it felt natural and comforting to do the same. He stopped socializing, unless his friends came to his house, where he was always watching the children. He worked night shifts, taking care of them during the day. “He chose to be Mr. Mom,” Renee said. “He did the cooking, because Marquette doesn’t cook, and he did the cleaning, because Marquette doesn’t like to clean.” Destanee visited on the weekends, and Kargbo took all four children to the library and taught the older ones to play soccer.

In August, 2013, when Kargbo was twenty-eight and his younger son was a year old, Marquette stayed out past the children’s bedtime without telling him where she was. When Kargbo called her cell phone, it was answered by a man he didn’t know. When she returned home, they got into a physical fight. Marquette’s friend, who dropped her off, called the police and Kargbo was arrested for misdemeanor domestic assault. He spent six days in jail, waiting for his bond to be set. He didn’t understand why it was taking so long. On August 29th, a corrections officer told him, “ICE put a hold on you.” Kargbo replied, “Who’s ICE?”

It had been seven years since Kargbo was arrested for terroristic threats, and during that time Immigration and Customs Enforcement had expanded its system for screening foreign nationals held in jail, accelerating their deportation by more than a hundred per cent. The Obama Administration has removed more than two million people from the country—more than any other President. Kargbo had escaped notice on his previous arrest, but this time his name drew a “hit.” ICE had determined that he could be deported, because his record showed convictions for shoplifting, possession of burglary tools, and terroristic threats. These offenses were classified as crimes of moral turpitude, an amorphous category that includes dozens of crimes, from perjury to prostitution. Moral turpitude has been defined by the courts as behavior that is “inherently base, vile, or depraved, and contrary to the accepted rules of morality.”

Kargbo was transferred to Carver County Jail, one of several Minnesota institutions that have a contract with ICE. He wasn’t given the opportunity to post bail. The passage of two laws in 1996, the Antiterrorism and Effective Death Penalty Act and the Illegal Immigration Reform and Immigrant Responsibility Act, allowed the government to detain non-citizens without a bond hearing and to deport them for a number of violations, including moral turpitude. The laws restricted judges’ discretion to consider the ties that immigrants, including refugees here legally, had formed in the country, and the hardship that deportation would impose on their families. The bills were drafted after the World Trade Center and Oklahoma City bombings, during a wave of fear about crime and terrorism, and President Clinton signed the first one with misgivings. He said that the law “makes a number of major, ill-advised changes in our immigration laws,” warning that its “provisions eliminate most remedial relief for long-term legal residents.” In the next ten years, the deportation of legal permanent residents left some hundred thousand American children without a parent.

Kargbo was so ashamed and confused by the idea of being deported—he didn’t realize that it was possible, since he had a green card—that he never called home to explain what had happened. Renee expected that he would be out of jail within a day or two, and that, she said, “he’d sit on my couch and we’d pick each other up and dust each other off.”

In Sierra Leone, it is often said that female child soldiers grow up to be prostitutes, having lost their sexual purity, and that male soldiers dominate the okada industry, a motorbike taxi service, one of the cheapest forms of transportation. Theresa Betancourt, a professor at the Harvard School of Public Health, said that many of the okada drivers are dismissed as crazy and dangerous. Betancourt has been following war-exposed youth in Sierra Leone and has found that child soldiers endured new forms of trauma once the violence ended. Some returned to communities that performed cleansing and atonement ceremonies, but others were blamed for their brutal deeds, and continued to do drugs. The latter group often became hostile, aggressive, and anxious; their inability to reënter their community as equals, she said, could serve as a reminder of their unresolved guilt and remorse.

In response to the Syrian-refugee crisis, the Obama Administration has promised to increase the number of refugees it resettles, from seventy thousand a year to a hundred thousand. The Department of State gives preference to the most vulnerable refugees, who have been tortured or persecuted at home. Their traumas will inevitably follow them here. Studies show that migration, especially when coupled with discrimination, elevates people’s risk of psychosis. An analysis of more than four million medical records in the Canadian Medical Association Journal found that immigrants from East Africa and Southeast Asia were nearly twice as likely to develop psychosis as the general population was.

Within the immigration system, the link among crime, mental illness, and trauma is largely ignored. Heidi Altman, the legal director of the Capital Area Immigrants’ Rights Coalition, in Washington, D.C., told me, “In recent years, we’ve seen this trend of people who survived the big civil wars of the nineties—Sudan, Liberia, Sierra Leone—come to the U.S. as refugees, and now, many years later, are struggling with the traumas they endured.” Immigration detention, she said, is even less suited for the mentally ill than are jails and prisons, which have become the default provider for Americans who need psychiatric care. “In the criminal justice system, at least there is some acknowledgment that jails are functioning as de-facto psychiatric facilities,” she said. “But that conversation isn’t even happening on the immigration side.”

Until 2011, the immigration system had no guidelines for dealing with people who were mentally impaired or incompetent, and they routinely appeared in court without lawyers. In the past few years, in response to a class-action suit, California, Arizona, and Washington, along with some cities, have begun providing government-appointed counsel for the mentally incompetent. But in most parts of the country these people must either find a lawyer on their own or, like eighty-four per cent of detained migrants, represent themselves. Immigration law is notoriously complex; to understand it, the Fifth Circuit Court of Appeals has written, “Morsels of comprehension must be pried from mollusks of jargon.”

A few weeks after Kargbo’s arrest, at his first hearing, in a courthouse in Bloomington, Minnesota, he heard a voice telling him to give up, because he wasn’t going to win his case, no matter how hard he tried. He was so distraught that he told the judge he wanted to return to Sierra Leone. At the next hearing, the judge said, “I’m going to have to order you removed back to Sierra Leone. . . . You told me you had no fears of returning back to—”

“I was just mad, sir,” Kargbo interrupted. “That was my daughter’s birthday, and everything was emotional.” He wore an orange jumpsuit, and his wrists and ankles were shackled. “I was confused—I didn’t even know what was going on,” he told the judge later. “My mind wasn’t thinking straight.”

The judge scheduled another hearing in two weeks, to give Kargbo time to compile evidence: because the classification of his crimes made him automatically deportable, the only way he could stay in the country was to prove that he would be threatened or tortured in Sierra Leone. The government’s lawyer argued that Kargbo’s concerns about persecution were outdated. Kargbo couldn’t refute the government’s position, because he had no access to the Internet and was unable to do research from jail. He tried to obtain pro-bono representation, to no avail. When Kargbo learned that he’d have to represent himself, he began to cry.

At the next hearing, in November, a different judge told him, “O.K., sir, I’ve ordered you deported.”

“I wish to appeal this one, Your Honor,” Kargbo said. “I’m not going to Sierra Leone. You can either send me to Liberia or somewhere else.” He had never been to Liberia and knew no one there, but it was the first country that came to mind. He told the judge that he didn’t think he could survive for two months in Sierra Leone. “This is my life, Your Honor,” he said. “I’ve got kids in America.”

“He’s playing with my life right here,” Kargbo went on, referring to the government’s lawyer. “He’s playing with my kids’ lives.”

Kargbo wrote an appeal, modelling it on that of his cellmate, a young man from Sudan who was also fighting deportation. “Till this day I’m still having nightmares,” Kargbo wrote. “I was just a kid; the responder never mean to hurt nobody, but his life was on the line one way if the responder doesn’t do what the leader he was going to get kill.” Referring to himself in the third person, Kargbo explained that he had no family in Sierra Leone and was afraid of the country’s leadership. “If the Sierra Leone government get a whole of him who is going to let his family know?” he wrote.

Kargbo worried that his younger son, Ka’marion, who was learning to walk when he was arrested, would forget who his father was. On the phone, Kargbo told Ka’marion that he loved and missed him, but he wasn’t sure if his voice had triggered his son’s memory. “I just hope his older sister shows him my picture,” Kargbo said. His oldest child, Destanee, didn’t understand why he’d been gone for so long and begged him to come home. “So what are you doing?” she wrote him in a letter. “I really miss playing with you.”

Marquette, who was now responsible for her three children, lost her job, at a Goodwill store, because she couldn’t afford a babysitter. “Nelson was there for them more than I was,” she told me when I visited her at her new, subsidized house, which she hadn’t had time to furnish. “They listened to him more,” she said, sitting cross-legged on the living-room floor. “My voice wasn’t strong enough, or I just never followed through.” Marquette has an intimate way of talking about her flaws; she sits close to people, casually touching them, sharing her anxieties in a confessional tone.

When I met Kargbo for the first time, in jail, he talked about his experiences as if he hadn’t been present for them. If I confused events in his life and asked him a question that was fundamentally wrong, he let the facts stand uncorrected. He seemed to become stiffer the closer the conversation came toward the subject of himself. The idea that he had a “story” to tell appeared to strike him as unseemly, as if the details could reactivate the past—an attitude that hurt him during his legal proceedings. He answered the judges’ questions with as few words as possible, the register of his voice barely changing. The numbness with which he described traumatic experiences made him appear as if he were bored by the memories.

Even when his nightmares woke Marquette in the middle of the night, because he was thrashing around in bed, he wouldn’t recount his dreams. Marquette knew that he didn’t like to discuss the war, but she didn’t know why. “I think it’s something with a secret society?” she told me. “I don’t even get it, but in the war I think they said he’s not supposed to tell anybody what happened.”

The only person Kargbo had felt comfortable opening up to was Renee. Kargbo called her routinely from jail and assured her, “I’ll be O.K., Mom.” She didn’t believe him. “He isn’t O.K., because I know his fears,” she said.

The staff at the jail initially wrote that they found Kargbo “pleasant,” “sociable,” and “personable.” But a few days after the judge ordered him deported Kargbo heard voices in Krio that told him, “You don’t deserve to live here,” and “You’re not capable—you’re not worth it.” He covered his ears. He worried that other inmates would think he was crazy if they saw him responding to the voices, so he walked away in order to conduct his conversations in private. It occurred to him that he looked like the Craze Men, as they were called, whom he used to see in his village, gesticulating and talking to themselves. Kids threw rocks at them and beat them with sticks. Some were chained to trees by their families, so that they wouldn’t run away or cause trouble. In his cell, Kargbo told the voices, “Leave me alone, leave me alone,” and then prayed to God to help. When that didn’t work, he imagined that the best way to quiet the voices was to bust his head open. He repeatedly banged his head against the wall.

Two weeks later, guards found him lying on the concrete floor, singing loudly. When asked what he was doing, he explained that he was singing to the floor. “I can’t take this,” he told a nurse. He said that he was overwhelmed by the idea of returning to Sierra Leone and was “hearing voices telling me to hurt myself as the only out.” A nurse evaluated him and gave him a handful of diagnoses: post-traumatic stress disorder, schizophrenia, bipolar disorder, and depression. He was prescribed two antipsychotic drugs, a mood stabilizer, and pills to prevent him from having nightmares. The nurse wrote, “He says he tends to get in a fight if he is stressed out. This has been happening since he has been in high school.”

After a month in solitary confinement, Kargbo was placed in protective custody, in Sherburne County Jail, the state’s largest facility for immigrant detainees. He was dressed in a “suicide jacket,” which restricted his movement, and he wasn’t allowed to leave his cell except to shower and to exercise, for an hour each day. Kargbo said that there were four other “mental people” on the unit with him, and a man who had been arrested for murder. He and other ICE detainees were given the same treatment as criminal inmates.

In February, after Kargbo had spent half a year in detention, a nurse found him hiding under his bed. He had hallucinated that his cell was being attacked by a three-headed demon with a tail. The nurse described him as extremely withdrawn, but noted, “He has four children and the thought of them gives him hope to carry on.”

By the spring of 2014, Kargbo was contemplating telling the judge to send him to Sierra Leone. He figured that he would return to his village and live on the streets. “I’ll probably be homeless,” he told me, “but at least I can call my kids and talk to them whenever I want.” Although the Board of Immigration Appeals had granted Kargbo’s appeal, agreeing that his status as a child soldier had not been sufficiently considered, he had to wait in jail for three months before his case would be heard again. When I asked him how he would prepare for the hearings, he seemed confused. “How would I prepare?” he said. “I just wake up in the morning and see what they’re going to say.”

The immigration-court system has a backlog of nearly half a million deportation cases, even though hearings tend to be brisk. One immigration judge compared the situation to “holding death-penalty cases in traffic court.” Although it costs more than a hundred and twenty dollars a day to house a detainee, the Department of Homeland Security places little priority on alternatives to detention, an approach encouraged by the agency’s funding. To compel the Obama Administration to enforce immigration laws, Congress introduced an amendment to the 2010 budget mandating that the D.H.S. fill a quota of more than thirty-three thousand beds each day—thirteen thousand more than it had on an average day the previous year. A similar requirement has been included in each subsequent budget, making the D.H.S. the only U.S. law-enforcement agency that must detain a certain number of people. In 2013, John Morton, then the director of ICE, told the House Judiciary Committee, “We do our very best not to have empty beds,” explaining that “obviously, if Congress appropriates us money, we need to make sure that we are spending it on what it was appropriated for.”

Kargbo had been in jail for nine months when he learned that Linus Chan, a lawyer with the University of Minnesota’s Detainee Rights Clinic, was willing to take his case. One of the judges presiding over the case had expressed concern about Kargbo’s mental health and asked the government’s lawyer to check if there were any available attorneys who would work for free. When Chan met Kargbo, he found him dejected and lifeless. He had stopped hearing voices since he began taking the antipsychotics, but he had a blank gaze and spoke in a monotone; he had also gained sixty pounds. The drugs had altered the way his body metabolized glucose, which eventually led to diabetes.

Kroll wasn’t certain that Kargbo had schizophrenia; he displayed paranoia, but his suspicions seemed natural, considering that he was incarcerated with violent strangers. Kroll, who recommended that Kargbo’s medications be reduced, said that it was impossible to disentangle the schizophrenia process from his experiences in the war, his childhood drug use, and the trauma of his indefinite detention. Refugees often resist psychiatric drugs, maintaining that their distress is a social consequence of war, not a pathology. When Kroll gives presentations to staff at the United States Citizenship and Immigration Services about the mental-health needs of refugees, he shows a slide that says, “Citizenship is better than Prozac.”

At Kargbo’s next hearing, in June, 2014, he said he was afraid that he would be chained and beaten in Sierra Leone, where psychosis is commonly treated as a curse. When he described his memories of the treatment of Craze Men in his village, he began sentences without finishing them; his syntax was fractured, his tone flat. When the judge asked him what his voices said to him, he responded, “That’s why I was fighting myself. It said, you know what I mean: let me just hurt myself. I don’t deserve to live at this time.”

The judge again ordered him deported, and the Board of Immigration Appeals affirmed the decision seven months later. Whenever Kargbo heard the guards’ footsteps at unexpected times, he grew anxious. “I was just waiting for them to knock on my door and say, ‘Pack up,’ ” he said. Although Ebola was widespread in Sierra Leone, people were still being sent back.

In April, 2015, nine months after the deportation order, Kargbo was put into a van and driven to Idaho. After a few nights in jail, he was sent by bus to Nebraska, where he boarded a chartered flight along with men from Sierra Leone, Jamaica, and Mexico. Their limbs were shackled throughout the flight. The plane stopped in Louisiana, to pick up more detainees, then landed in Pennsylvania. Kargbo and several other men from Sierra Leone were confined in the York County Prison, where they all had appointments with officials from the Sierra Leonean consulate, which had to issue travel documents for them. The detainees tried to cheer each other up. Kargbo said that one man told everyone, “They’re not deporting us—we’re not going anywhere!”

On the second day of interviews, Kargbo was called into a conference room by two men in suits, who asked him if he wanted to live in Sierra Leone. He told them he was afraid of returning to the country—he hadn’t spoken to anyone there since he was fourteen—and that he couldn’t live apart from his four children. Kargbo recalled, “They were giving me some looks, like ‘You’re a bad kid.’ ”

Kargbo was returned to jail in Minnesota, where he continued to wait. A month later, a colleague of Chan’s from the University of Minnesota, Katherine Evans, filed a habeas petition, asserting that Kargbo’s detention for nearly two years without a bond hearing was a violation of due process. The government had kept Kargbo incarcerated without ever determining if he was a flight risk or a danger to his community—a predicament common to tens of thousands of detainees each year. In 2003, the Supreme Court held that legal permanent residents could be detained without a bond hearing for an unspecified “brief period.”

The Board of Immigration Appeals sent the case back to court for a review, in response to a last-ditch motion to reopen it. At a hearing in July, Kargbo’s lawyers argued that deportation would lead to conditions resembling torture—a claim that has been made in recent years by mentally ill immigrants fighting deportation to Haiti, Liberia, Somalia, Ghana, Sudan, and Jamaica, among other countries. Kargbo’s lawyers drew from a 2014 case concerning a bipolar man, Tumaini Temu, who had been arrested in Washington, D.C. He had previously been hospitalized in Tanzania after walking into traffic and trying to prevent car accidents with his hands. Hospital orderlies beat him with clubs and leather straps, bound his hands with rope for up to eight hours a day, and referred to him as mwenda wazimu, a Swahili term that means “demon-possessed.” Because psychiatric medications in Tanzania are scarce, the Fourth Circuit Court of Appeals found that bipolar Tanzanians qualified as a persecuted social group, writing that “Mr. Temu’s membership in his proposed group is not something he has the power to change.” His deportation was cancelled.

Kargbo’s lawyers argued that the Craze Men were treated like Tanzania’s mwenda wazimu. Patients who were admitted to the country’s only psychiatric hospital, known as Kissy Mental, in Freetown—a dilapidated structure that was destroyed by rebels in the civil war and only partly reconstructed—were chained to their beds. A 2013 Human Rights Commission report found that some nurses assigned to Kissy Mental refused to go to work, because of the stigma associated with the hospital.

Ayana Jordan, a psychiatry fellow at Yale who studies mental health in Sierra Leone, told the judge that if Kargbo were deported he would likely have another psychotic episode. “He’d be highly stigmatized, seen as abnormal, feared, shunned, chased out of town,” she said. Jordan said that during her visits to Sierra Leone people told her that mental illness could be “caught” when a cool breeze entered the room while someone was sleeping, through witchcraft and bad dreams, and by bathing at the wrong hour. In her visits to the Kono District, a region devastated by the war, she discovered that many former child soldiers were relegated to an area known as the Bronx, a derelict open-air ghetto, where they continued to use brown brown. People told her, “If you want to see the Craze Men, go to the Bronx.”

The country’s only psychiatrist, Edward Nahim, who recently retired, wrote a letter to Kargbo’s judge explaining, “We must use chains to restrain patients to their beds so they cannot escape.” He said that many patients at Kissy Mental went untreated, owing to shortages in medication, and when released they “roam around the streets aimlessly, though they are not welcomed there. Other people laugh at them, tease them, beat them up, and throw stones at them.”

At the end of the hearing, the judge found that the conditions for the mentally ill in Sierra Leone violated the United Nations Convention Against Torture, and deferred Kargbo’s removal. But she placed him in a kind of legal limbo, ordering him expelled from the United States. The government had to find another country that would take him. Kargbo was sent back to jail.

A few weeks later, according to Kargbo, his deportation officer asked him where his refugee papers had been processed. When he said that he’d been in a refugee camp in Guinea, the deportation officer told him that he would look into sending him there.

Kargbo’s lawyers filed another habeas petition, arguing that his ongoing detention had come to seem punitive, since it was improbable that he would be deported anywhere. On October 2nd, two months after the hearing, a magistrate judge recommended that the petition be granted, noting that there was no evidence that the D.H.S. had made any attempts to find a new country that would accept Kargbo.

A week later, a guard woke Kargbo at 6:30 A.M. He had fifteen minutes to get dressed, pack, and leave the jail. He put on the same jeans and T-shirt he’d worn when he was arrested. He’d lost some weight, after his medications had been reduced, but his clothes were still too tight. His Liberian cellmate, who was fighting his deportation without a lawyer, congratulated him and went back to sleep.

Kargbo’s lawyer, Katherine Evans, drove him to Renee’s house. He waited at the front door with a paper bag containing all the belongings he’d accumulated in the past twenty-six months: his legal papers, a Bible that he’d received in a Bible-studies class, and some songs he had written on notebook paper about his love for Marquette. Now she had a new boyfriend, and had decided that the relationship was over, but Kargbo still hoped, he said, that “we can patch things up.”

Renee screamed when she saw Kargbo at the door. “Coming, coming, coming!” she said, as she ran down the stairs from the second floor. Kargbo pushed open the door, and they held each other, jumping up and down and then rocking back and forth. She touched his dreadlocks, which had grown to his chin, and his cheeks and then rubbed his stomach. “Ah! He’s got a gut,” she said, clapping. “Oh, my God, he is so chunky!” Her forty-sixth birthday was in two days, and she told him that she expected him to cook rice and chicken, his best dish. “Best birthday present ever,” she said.

“Uncle?” Kargbo asked.

Cay’vion quickly corrected himself. For the rest of the day, whenever his brother or sister did anything that could be perceived as disturbing Kargbo, he shouted, “Leave my dad alone.”

Kargbo moved into Renee’s house, sleeping on an inflatable mattress in the living room, under a tapestry of John F. Kennedy. Renee wished she had a basement so that Kargbo could live there permanently; then the children could sleep over every night. She preferred that Kargbo live in her house. “Only because then he won’t feel alone,” Renee said. “I don’t want him to ever feel like his family’s not here.”

Within days, Renee realized that Kargbo wasn’t acting the way that she remembered. She kept asking him to cook his rice-and-chicken dish. “I don’t even think Nellie remembers the damn rice!” she told me, three weeks after he’d returned home. We were sitting on a large brown couch in the living room, Renee at one end and Kargbo at the other, his body tilted away from us. “Every time I mention the rice, he has a puzzled look on his face. It’s like his mind is blank.”

Kargbo had spent the past hour calling different pharmacies to try to refill his diabetes medication. He had only one pill left. Because he had lost his status as a refugee, he was no longer eligible for Medicaid, and he didn’t know how he would pay for his medications. He wanted to return to his job at the signage company, but he had to wait at least three months to get a work permit, since his green card had been revoked. The misdemeanor domestic-assault charge was looming, too. Marquette had asked that the charge be dropped more than a year before, but now that Kargbo was out of detention the criminal process would begin. If he is convicted of a new crime, the deportation process could start again.

Kargbo sat hunched forward, his elbow on one knee, looking at the black screen of his phone. He was waiting to hear back from a community clinic about free samples of his medication. Renee spoke about Kargbo as if he weren’t there. “He’s a lot quieter now,” she told me. “He can’t hear you when you talk. I’ll be like, ‘Son! I’ve been talking to you for the last five minutes.’ ”

Kargbo admitted that he wasn’t used to stimulation. He said that, in jail, if he wasn’t playing spades or reading the Bible, “I just had to just walk around like a crazy man.”

“Our relationship is totally different,” Renee went on. “It’s like, What happened to my Nellie? We just used to be goofballs. We used to talk to each other about everything.”

“It’s like you said,” Kargbo told her, still looking down at his phone. “I changed a little bit, and I’m trying to get back into the groove.” ♦

 

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Rachel Aviv joined The New Yorker as a staff writer in 2013. She has written about criminal justice, psychiatry, education, foster care, and homelessness, among other subjects. In 2010, she received a Rona Jaffe Foundation Writers’ Award. Her writing on mental health was awarded a Rosalynn Carter Fellowship, an Erikson Institute Prize for Excellence in Mental Health Media, and an American Psychoanalytic Association Award for Excellence in Journalism. Her writing is collected in “The Best American Nonrequired Reading 2010” and “The Best American Science Writing 2012.” She has taught courses in narrative medicine at Columbia University Medical Center, the City College of New York, and at Mount Sinai School of Medicine.

>via: http://www.newyorker.com/contributors/rachel-aviv