Physicians group releases report on psychological effects of family separation

Fernando Arredondo embraces his daughter, Alison, at Los Angeles International Airport on Jan. 22. Arredondo was one of 11 parents who were deported without their children during the "zero-tolerance" policy.
(Jason Armond / Los Angeles Times)

Nearly two years have passed since the separation of thousands of migrant children and their parents under the Trump administration’s “zero-tolerance” policy. Months after some reunions, experts found that severe psychological trauma remained.

On Tuesday, Physicians for Human Rights published a report based on in-depth psychological evaluations of 26 asylum seekers — nine children and 17 adults — who were separated under the policy.

Medical experts documented psychological trauma, including post-traumatic stress disorder, depression and anxiety. In nearly every case, the group’s medical evaluators “noted that the trauma suffered by the parents and the children warranted further intervention and ongoing therapeutic support.”


The report concluded that the forced separation in those cases constituted torture and enforced disappearance, in that there was a period where parents did not know where their children were and were not able to contact them.

“The purpose of linking events with these kinds of human rights violations is because it calls attention to the obligation of the state,” said Kathryn Hampton, a PHR Asylum Network senior program officer and coauthor of the report. “We are calling for accountability and for the U.S. government to take responsibility.”

The total number of children separated from a parent or guardian under Trump remains unknown. At least 471 parents were deported without their children, and some have yet to be reunited.

Family separations exacerbated any existing premigration trauma, according to the report, and, following reunifications, families were not provided with psychosocial services to recover.

A Honduran father recounted that following reunification and release from detention, a psychologist tried to work with his son on four different occasions. The boy would throw things at the therapist, according to a medical affidavit.

“It appears his son was afraid of strangers, afraid they will take him from his father,” a medical expert stated.


When nervous, the boy would pace and suck his thumb, according to the report.

Children showed symptoms of regression, such as bed wetting, being excessively fearful and not willing to leave their parent’s side.

“The reunification was not at all the solution or the treatment,” said Dr. Ranit Mishori, PHR’s senior medical advisor and coauthor of the report. “The trauma remains.”

Dr. Stuart Lustig, a San Francisco-based board-certified child psychiatrist and member of the PHR Asylum Network, evaluated a 7-year-old girl separated from her parent for a month. At the time of the evaluation, it had been 10 months since the separation and “she was still quite symptomatic.”

Symptoms of the girl’s severe anxiety included difficulty at school, which Lustig corroborated by speaking with her principal. She also struggled to sleep alone.

“Most 7-year-olds can do that,” he said. “That was a new struggle compared to the sleeping arrangements back in her home country.”

Lustig said the girl — who likes to draw — was inhibited in a drawing game “that most kids do quite well at.”

“We tend to think of kids as being very resilient and parents having a great deal of wisdom and understanding to process what’s going on,” Lustig said. “Those assumptions may or may not be true, but the fact is that we know from the psychiatric literature that these kinds of trauma typically haunt people for years to come.”

Lustig called it “vital” that these families receive treatment.

“Virtually all of the people that we studied ... did have pretty significant symptoms of trauma,” Lustig said. “The effects of the separation are pervasive and obviously long-lasting and I would predict, as a psychiatrist, that certainly without treatment these people are going to be symptomatic for years to come.”

That treatment could soon happen. In November, U.S. District Judge John Kronstadt, of Los Angeles, ordered the government to begin providing mental health screenings and treatment to families who were separated under the family separation policy.

The government had appealed the ruling to the U.S. Court of Appeals for the 9th Circuit. Last week, that appeal was withdrawn.

“We’ve been operating under this cloud of uncertainty,” said Amy Lally of the Sidley Austin law firm, which brought the case along with the nonprofit Public Counsel. “It’s really a huge relief.”

The government did not respond to requests for comment.

“Those bonds that hold a parent and child together are really damaged by this type of family separation,” Lally said. “What we’re hopeful for is that families will be able to heal and that they’ll be able to be made whole.”