What is the impact of separating youth from family members?

Dr Song presented on the mental health effects of separating youth and families crossing the U.S. border to the American Academy of Child/Adolescent Psychiatrists on 24 Oct, 2018 in Seattle, WA. There continue to be nearly 500 children still in U.S. government custody, since the "zero tolerance policy" of May 2018 and the subsequent policy halting the forced separation of youth from family in June 2018. Youth arriving to the border are mainly from the Northern Triangle region (El Salvador, Guatemala, Honduras), with the highest homicide rates in the world. The daily lives of many of these youth and families included influence of organizational crime (drug smuggling, arms trade, and guns) that include violence, life threats, and physical and sexual assaults. Even when they arrive at the designated points of entry to seek asylum, the U.S. separates families and places criminal charges, instead of international laws that mandate the protection and care of those fleeing persecution.

Youth enter Customs and Border Protection (CBP) custody, where the settings of "cages", aluminum blankets, overcrowding, lack of activities, bullying, verbal and physical assault are reportedly common. They they enter Department of Health and Human Services (DHSS) Office of Refugee Resettlement (ORR) custody to be placed in either shelters, secure shelters, or safe-secure holdings (of increasing restriction). Those deemed to be at risk to themselves (suicidal) or others (which they define as history of gang involvement, for example), are placed in the highest level of security and need to show a certain period of "good behavior", in order to step down to the lower level of care to then have a trial.

There are reports of using emergency restraint chairs with 4 point physical restraints, spit masks, and forced injections of psychiatric medications. ORR therapists are provided, but the information can be used against youth in court. After an appropriate sponsor is located (either a family member or caregiver), youth are released to a sponsor with no formal follow up. The sponsor is given a call 30 days later to ensure the youth comes to their court hearing, but many do not and are lost to follow up. In 2014, 8 Guatemalan youth were released to human traffickers. As a response, the government was supposed to develop a clear definition of roles and responsibilities, but there is still no formal plan. Kids, regardless of immigration status, deserve not to be trafficked and exploited. We are living in a time where some youth are deemed more deserving of basic human rights.