Family separation 2.0 compounds the trauma on children of immigrants

As pediatricians, we are watching in horror as immigration raids in Los Angeles and across the country are tearing families apart. The current administration’s deportation policy arrests people regardless of immigration status or criminal record and places them in detention. Make no mistake, this is family separation 2.0.

We are also seeing entire families, parents with their children, apprehended in our communities and being sent to newly reopened family detention centers.

These immigration policies are placing the health and well-being of children at risk.

New budgeting priorities being debated in Congress would intensify this crisis. The budget reconciliation bill that Congress is considering is seeking $45 billion for adult and family detention — an 800% increase compared with fiscal year 2024. This would drastically expand the use of family detention and lead to indefinite detention of children.

As the authors of the American Academy of Pediatrics’ policy on the detention of immigrant children, we insist that our federal government stop these dangerous practices. Our policy emphasizes that detention is not in the best interest of the child and that family separation should never occur unless the child’s well-being is at risk. Disturbingly, this administration’s policies are resulting in both.

Evidence shows that no amount of time in detention is safe for innocent children. The academy recently joined 10 other medical organizations in calling for its end. As members of humanitarian monitoring teams, we interviewed staff members and families in these prison-like facilities in Texas and Pennsylvania from 2015 to 2019. We documented worrisome behavioral changes and developmental regressions in children, such as problems sleeping, bed-wetting, severe anxiety, depression and suicidality. We also documented inconsistent medical and mental healthcare. Parents’ concerns about their children’s health often went unheeded, resulting in delays in care and at times referrals to emergency rooms.

We heard myriad stories of the deleterious consequences of children placed in detention. In 2019, one 15-year-old Central American girl was placed in immigration detention in the South Texas Family Residential Center, a facility that can hold up to 2,400 women and children. Despite having no prior mental health concerns, she repeatedly tried to kill herself during her seven months of detention. This was not a unique finding and exemplified the desperation many children and their guardians experienced.

In March, the administration reopened the two family detention centers in Texas to detain families swept up in raids. There is extensive documentation, by external and governmental watchdog groups, of poor conditions and lack of adequate healthcare in these facilities in the past. New evidence has emerged that shows conditions have not improved and that children are still not getting the healthcare services they need. As of this publication, no external medical teams have been allowed inside to monitor the conditions, nor the provision of medical and mental care. Without independent monitoring, there is no formal means to identify and mitigate threats to children’s health and safety.

We are also concerned about prolonged lengths of stay for unaccompanied children in the custody of the Office of Refugee Resettlement. Unaccompanied children can be released from custody only to a vetted sponsor — usually a family member living in the United States. The administration’s new policy places onerous requirements on sponsors, drastically prolonging the average length of stay from one month to more than seven. Potential sponsors must now pay a steep fee, be fingerprinted, share their immigration status with law enforcement agencies, submit to background checks and agree to “home visits” by Immigration and Customs Enforcement agents, who are untrained in child welfare standards.

We support evidence-based measures to ensure that children are safely released to sponsors. However, the administration’s vetting policies are punitive against sponsors rather than protective of children — leaving children to languish for months in institutional settings and leading to further psychological harm.

Regardless of political ideology, no one wants children to suffer. The public must demand that our government protect the lives of children by stopping indiscriminate deportation raids that lead to family separation and immeasurable hardships for children; rejecting expanded funding for family detention and ending the practice in favor of community-based alternatives; ensuring adequate healthcare by pediatric trained professionals for children in custody; allowing unfettered access for expert monitoring teams in all detention facilities where children are held; protecting and enhancing the minimum protections afforded to children and opposing the government’s attempts to terminate them; and creating an effective vetting of sponsors for unaccompanied migrant children that maximizes their protection and minimizes detention.

The ethics of our profession require that we intervene to prevent any harm to any child. Thus, we oppose family separation, family detention and efforts to needlessly prevent the reunification of families. We ask Americans and Congress to stand with us in protecting the health, well-being and safety of children.

Marsha Griffin, Alan Shapiro and Julie M. Linton are pediatricians and founding members of the American Academy of Pediatrics’ Council on Immigrant Child and Family Health.