OIG Report: Child Separation Resulted in Serious Mental Health Consequences for Detained Children
This week, the Department of Health and Human Services (HHS) Office of Inspector General (OIG), released a report regarding the mental health consequences of the Trump administration’s “zero tolerance” policy which resulted in thousands of children being separated from their parents at the U.S.-Mexico border.
The 48-page report (available below) was based on interviews with approximately one hundred mental health providers who interacted with children in federal custody.
According to the Report, “the number of young children, age 12 and younger, in ORR’s care increased sharply in May 2018 when DHS formally adopted the zero-tolerance policy of criminally prosecuting all adults for illegal entry into the United States. This policy led to children, some of them quite young, being separated from their parents. The proportion of young children in ORR care rose from 14 percent of referrals to ORR in April 2018 to 24 percent of referrals in May 2018.”
The following are select excerpts:
“As a consequence of heightened immigration enforcement beginning in 2017, DHS separated many more migrant families at the border, with the adults being held in Federal criminal detention facilities and their minor children — now ‘unaccompanied’— transferred to ORR’s care. This policy, deemed ‘zero-tolerance’ and formally adopted in May 2018, was curtailed in June 2018 by Executive Order … By that time, thousands of families had been separated.” (pg. 4)
“Facilities reported that addressing the unique mental health needs of separated children was particularly challenging…. separated children exhibited more fear, feelings of abandonment, and post-traumatic stress than did children who were not separated. Separated children experienced heightened feelings of anxiety and loss as a result of their unexpected separation from their parents after their arrival in the United States. For example, some separated children expressed acute grief that caused them to cry inconsolably” (pg. 10)
“[Officials] reported that children who believed their parents had abandoned them were angry and confused. Other children expressed feelings of fear or guilt and became concerned for their parents’ welfare. The difficulties that some facilities had in locating parents in detention and scheduling phone calls also contributed to children’s anxiety and fear for their parents’ well-being.” (pg. 10)
“‘A 7- or 8-year-old boy was separated from his father, without any explanation as to why the separation occurred. The child was under the delusion that his father had been killed and believed that he would also be killed. This child ultimately required emergency psychiatric care to address his mental health distress.’ –Program director” (pg. 11)
“‘Physical symptoms felt by separated children are manifestations of their psychological pain. You get a lot of “my chest hurts,” even though everything is fine [medically]. Children describe symptoms, “Every heartbeat hurts,” “I can’t feel my heart,” of emotional pain.’ –Medical director” (pg. 11)
“[O]ne program director noted that separated children could not distinguish facility staff from the immigration agents who separated them from their parents: ‘Every single separated kid has been terrified. We’re [seen as] the enemy.’ … some separated children isolated themselves and took longer to adjust to the facility and its routines, for example, refusing to eat or participate in activities.” (pg. 11)
“Some children who did not initially exhibit mental health or behavioral issues began reacting negatively as their stays grew longer. For example, one mental health clinician explained that even children who were outgoing and personable started getting more frustrated and concerned about their cases around the 70th day in care. According to facility staff, longer stays resulted in higher levels of defiance, hopelessness, and frustration among children, along with more instances of self-harm and suicidal ideation.” (pg. 12)
“‘The little ones don’t know how to express what they are feeling, what has happened. Communication is limited and difficult. They need more attention.’ –Program director” (pg. 12)
“[Officials] reported safety concerns when children whom staff assessed as needing a higher level of mental health care were not transferred to RTCs [residential treatment centers]. As a result, they reported that some children with more significant mental health needs — such as oppositional defiant disorder, dissociative symptoms, and suicidal ideation — remained in settings not well equipped to address their needs…. one program director described caring for children who were psychotic, self-harming, or actively attempting suicide. Another described a child whose self-harm and aggressive behavior continued while awaiting transfer to an RTC.” (pg. 16)
