Despite the changing social, legal, and political context in influencing the definition of mental disability, medical scholarship has maintained its position as the primary reference to interpret mental disability in the immigration system. This preliminary study examines the role of medical scholarship in attributing to the exclusion of undesired immigrants through its definition of mental disability. This paper focuses upon immigration cases to determine the patterns that emerge when immigration intersects with mental disability. The data consists of four immigration court cases in 1951-1985, 1986-2005, 2006-2015, which mark the shift of immigration policy in the United States of America (US). The court documents are collected from websites that provide online access to these documents. The examination of the cases focuses on three important criterions: a summary of cases, mental disability circumstances, and judges’ considerations. This paper uses the analysis of political deviance in courtroom settings to get an understanding of the shift in the definition of mental disability in the immigration court by tracing economic, political, and social environments that are intertwined and relevant in creating a ‘mental disabilitiy’ definition. This study suggests that medical scholarship has historically become powerful in shaping mental disability as a form of social control. From historical and case analysis, there have been changes in policies and processes toward immigrants appear to take place in the aftermath of major events—World War II, AIDS epidemic, 9/11 terrorist attack, and now Covid-19 pandemic. Preliminary examination of documented cases suggests future analysis could look at how these major events shape immigration processes and policies that more heavily rely on definitions of mental illness and use competency to stand trial proceedings to indefinitely detain people.