Summer 2026 Issue

Ethics: When Care Is Embedded in Harm
By Mandi Eldred, MSW
Social Work Today
Vol. 26 No. 3 P. 30

Social Work Ethics and Immigration Detention

I was not looking for an ethical dilemma when I opened TikTok. Like many people, I was scrolling absentmindedly at the end of a long day when a video claimed that Immigration and Customs Enforcement (ICE) was hiring social workers. My initial reaction was immediate and familiar: “That cannot be ethical.” The comment section echoed the same sentiment, with social workers invoking our profession’s Code of Ethics and asserting that such employment would violate our core values.1 I agreed. I nodded along, liked a few comments, and moved on.

But curiosity lingered. I opened the job posting itself.

And that is where certainty gave way to discomfort.

A review of publicly available ICE Health Service Corps job announcements for behavioral health roles illustrates how these positions combine clinical care with compliance, supervision, and coordination within detention systems.2 The positions were not framed as enforcement roles. They were described as providing behavioral health services to individuals held in immigration detention—assessment, crisis intervention, case management services, and coordination of care. In other words, services directed toward detained immigrants themselves. At first glance, this appeared aligned with core social work commitments to service, dignity, and the alleviation of suffering. For many social workers, this kind of ethical whiplash is familiar: a strong initial reaction followed by the uneasy realization that the dilemma is more complicated than it first appeared.

This realization gave rise to an uncomfortable question: if people are being detained regardless of one’s moral stance on immigration enforcement, do they not still deserve access to mental health care?

Let me be clear: I do not believe people are “illegal.” I do not believe detention is a humane or ethical response to migration. But I also do not believe that the absence of care makes a harmful system less harmful. This tension, between opposing the system and recognizing the needs of those confined within it, sits at the center of the ethical dilemma social workers are now being asked to confront.

A closer reading of the job descriptions complicated the issue further. These roles extended well beyond direct clinical care. Responsibilities include monitoring individuals designated as high risk, adjudicating requests for outside mental health services, conducting utilization reviews, ensuring compliance with national detention standards, consulting with custody and legal staff, and reporting through formal supervisory chains. Some positions place social workers in supervisory authority over other clinicians, accreditation processes, suicide prevention programming, and facility-level behavioral health operations. In these roles, social workers are not only treating trauma—they are helping administer the very systems that produce it.

This dynamic reflects what ethicists describe as a dual loyalty dilemma: a situation in which a professional’s obligation to their client conflicts with obligations to an employer or governing institution.3 In immigration detention settings, this conflict is not theoretical. A social worker may recognize that confinement itself exacerbates a client’s mental health symptoms while simultaneously lacking the authority to alter the conditions causing that harm. Clinical judgment, advocacy, and care are structurally constrained by enforcement priorities, operational mandates, and institutional boundaries.

The dilemma deepens when considering that these positions are not open to civilian social workers. They are limited to commissioned officers of the US Public Health Service or candidates called to active duty. This places clinical social work squarely within a federal command structure, formally subordinating professional practice to governmental service obligations. In this context, dual loyalty is not incidental—it is designed into the role.

This raises an additional ethical concern: the risk of legitimization. The presence of licensed social workers within detention facilities may improve individual access to care while simultaneously enabling institutions to claim adequacy, compliance, or humanity without confronting the structural harms inherent in detention itself. Mental health services may mitigate suffering while also buffering the system from accountability.

At the same time, refusing to engage does not dismantle detention. It does not prevent trauma. Immigration detention facilities will continue to employ mental health professionals across disciplines, all of whom bring rigorous training and ethical obligations to their work. For social work, whose ethical framework explicitly centers social justice, structural context, and systemic harm, disengagement raises its own moral questions rather than resolving them.

What troubles me most about the initial public reactions I shared is not the moral outrage, but the certainty. Social work is a profession grounded in nuance, reflection, and ethical deliberation. When complex dilemmas are reduced to slogans or purity tests, we lose the very tools that define our professional identity.

Rather than asking whether social workers should or should not work within immigration detention, a more necessary set of questions emerges: What safeguards exist to protect professional integrity in these roles? How much advocacy is structurally possible? Can harm be meaningfully documented and challenged, or only managed? And what does it say about our profession if the people most in need of care are those we determine are ethically safest to walk away from?

There may be no ethically pure position in this dilemma. Absent rapid and fundamental structural change, immigration detention will likely persist and expand—further entrenching these ethical conflicts rather than resolving them. But refusing to name its complexity does not protect social work values—it obscures them. As immigration detention continues to expand, these ethical tensions will move from the margins to the center of social work practice. Yet, social workers are often left to navigate them individually, in the absence of clear professional guidance or collective ethical infrastructure.

Questions remain about how practitioners can document harm while providing care, how professional integrity can be preserved within systems of coercion, and how the profession itself should respond when its values are embedded in structures that contradict them. These are not questions that can be resolved by individual moral certainty alone. They require collective ethical reflection, institutional accountability, and a willingness to confront the limits of social work practice when care is structurally subordinate to control.

— Mandi Eldred, MSW, is a Kansas City–based social worker with 20 years of experience working in complex systems.

References
1. Code of Ethics. National Association of Social Workers website. https://www.socialworkers.org/About/Ethics/Code-of-Ethics. Updated 2021.

2. Behavioral health provider (O-5 billet) supervisory. USAJobs website. https://ice.usajobs.gov/job/851817200. Updated 2025.

3. Physicians for Human Rights. Dual loyalty and human rights in health professional practice. https://phr.org/wp-content/uploads/2003/03/dualloyalties-2002-report.pdf. Published 2002.