By now, you’ve probably read or heard about the terrible stories coming in the wake of the Trump administration's zero-tolerance policy, which has resulted in thousands of children being separated from their families at the U.S.-Mexico border. Aside from the obvious practical issues with separating children from the families that care for them, several prominent medical and psychological associations are pointing out the many potentially disastrous health consequences.
During a press conference on Friday, officials from the Department of Homeland Security (DHS) said that at least 2,000 children have been separated from their families between April 19 through May 31 of this year, CNN reports. As of now, the children are being held in temporary holding centers with no clear procedure on how they’ll be reunited with their families other than hotlines parents can call to try to track down their children, the DHS said on the call.
So how did we get here? Back in April, the Department of Justice announced it would start prosecuting as many adult illegal entries and illegal entry attempts at the border as possible (a misdemeanor on the first offense) under a "zero-tolerance" policy.
But, The Washington Post explains, the Department of Justice can't prosecute adults with their children (partly because there are strict limits on how long children can be held in criminal detention facilities), so family separation is a cruel byproduct of enforcing the zero-tolerance policy. After separation, parents are then prosecuted and, in some cases, deported, while their children are left in holding centers with no obvious procedures in place for reuniting them other than sending parents to hotlines to attempt to find their relatives.
According to The Washington Post, under previous administrations, families who crossed the border illegally were not generally separated because adults were not prosecuted in such an extensive way, except in cases of suspected trafficking, for instance.
Public outcry has been swift, and the United Nations Secretary-General António Guterres heavily implied on Tuesday via a press release that this policy is in violation of international law. “Children must not be traumatized by being separated from their parents,” he said. “Family unity must be preserved.”
As of today, President Trump indicated that he'd sign an executive order to end the separation of families at the border, the AP reports. However, it's not clear exactly how that would be accomplished. And unfortunately, thousands of families have already been separated at the border with no explicit plans to reunite them.
Major medical organizations are calling out the mental health repercussions of separating children and their families.
"The [American Academy of Pediatrics] urges the Department of Homeland Security and Department of Justice to immediately end the policy of family separation. Separating children from their parents contradicts everything we stand for as pediatricians—protecting and promoting children’s health,” the American Academy of Pediatrics (AAP) said in a statement. “We know that family separation causes irreparable harm to children. This type of highly stressful experience can disrupt the building of children's brain architecture.”
"Psychological research shows that immigrants experience unique stressors related to the conditions that led them to flee their home countries in the first place,” the American Psychological Association (APA) says. "The longer that children and parents are separated, the greater the reported symptoms of anxiety and depression for the children. Negative outcomes for children include psychological distress, academic difficulties and disruptions in their development."
"Separating a child from his or her parents triggers a level of stress consistent with trauma," the American College of Physicians said in a statement. "Families seeking refuge in the U.S. already endure emotional and physical stress, and separating family members from each other only serves to dramatically exacerbate that stress."
Experts say that children who are detained face both short-term and long-term mental health challenges.
The situation is traumatic for children and it's on top of the already stressful experience of seeking refuge, Ana María López, M.D., M.P.H., president of the American College of Physicians, tells SELF. “As a physician, I have seen first-hand the significant health consequences that stress and trauma can have on individuals,” she says. “Separating a child from his or her parents triggers a level of stress consistent with trauma.”
In the short term, children face immediate regressive behavior, Cristina Muñiz de la Peña, Ph.D., mental health director and co-founder of Terra Firma at Montefiore Medical Center in the Bronx who provides mental health services to unaccompanied immigrant children, tells SELF. They may have difficulty regulating their emotion, which can manifest through uncontrollable crying, anxiety, impulsivity, and even self-harming behaviors. They also can have difficulty talking like they normally would and may either cling to whoever provides them with some level of safety or shut down and withdraw completely, Muñiz de la Peña says.
Children may also develop post-traumatic stress disorder from the experience, Julie Linton, M.D., co-chair of the American Academy of Pediatrics’ Immigrant Health Special Interest Group, tells SELF. Research has found that more than 30 percent of asylum-seeking children who migrate to the U.S. experience symptoms of PTSD—and that doesn’t include children who are separated from their parents.
When a child’s fear response is chronically activated, kids may lose their ability to differentiate between safety and danger, Kalina Brabeck, Ph.D., an associate professor of psychology at Rhode Island College who specializes in discrimination, immigration, and trauma, tells SELF. “They may over-generalize danger and see everything as a threat. They may constantly monitor their environment for signs of danger,” she says.
Experiencing stress this great at a young age, particularly without the help of parents, can also place kids at a higher risk for developing depression, Dr. Linton says.
Traumatic events like being suddenly and unexpectedly separated from your parents with no idea of when you’ll be reunited with them can alter previously held beliefs, Brabeck says. For example, a child who previously thought that their caregivers would be reliably there for them and that they had some control over their environment now changes those beliefs to accommodate the new information associated with the traumatic event. “That is, they begin to believe that caregivers are unreliable [and] that the world is unpredictable and unsafe,” she says. “These beliefs can be generalized to non-threatening and non-dangerous situations in problematic ways.”
Parents also face serious mental health challenges.
“There are few things that are more stressful for parents than not knowing if their children are safe or not,” Sarah Vinson, M.D., a member of the American Psychiatric Association’s Council on Communications, tells SELF. Dr. Vinson has conducted political asylum evaluations of people and points out that it’s hard for most Americans to understand the circumstances they’re coming from.
“These oftentimes are folks who have experienced trauma and disruption where they’re from,” she says. And a history of trauma makes people more susceptible to the heightened effects of trauma in the future, she says.
In the short term, parents will likely suffer from “very severe anxiety,” including feelings of helplessness and hopelessness that can affect their ability to function, Dr. Muniz de la Peña says. Symptoms of depression, including feelings of guilt or shame about possible actions they could have taken differently, will often follow. They may even develop suicidal ideation and behavior, she says.
For instance, Marco Antonio Muñoz, a Honduran man who was separated from his wife and child after crossing the U.S.-Mexico border died by suicide in a Texas jail cell in May after he suffered a mental breakdown in custody, The Washington Post reports.
And, like their children, parents are also at risk of suffering from PTSD, Dr. Vinson says.
While reuniting these families can help, much of the damage may already have been done, Dr. López says. “This traumatic experience will create an adverse health risk that will last for the person’s entire life,” Dr. López says. Counseling and therapy could help, Muniz de la Peña says, but this is a population that likely does not have easy access to mental health services. And, again, there is no clear system in place as of now to help reunite these families.
Here's what you can do to help:
For starters, contact your state representatives to make it very clear how you feel about this policy. You can also donate to the American Civil Liberties Union, which is working to defend asylum-seeking parents who have been separated from their children.
The ACLU also has a form on their website that will quickly and easily connect you directly with a staffer at your local senators’ office, where you can voice your opinion on this policy.
“The administration could end this policy any day," Dr. Linton says. "They don’t need a law to end this.”