Realizing the health effects of immigrant kids being taken from parents

Immigrant families seeking asylum at the U.S. border go through so much. Parents and kids face heat exposure, dehydration and malnutrition. They survive long journeys from Central America only to be greeted with the harsh conditions of a detention facility. The resilience that brought them this far is strained to the breaking point.

Teens, small children and even infants have been separated from their parents at the border as part of the Trump administration's "zero tolerance" immigration policy. As they're removed from their mothers and fathers, they lose the nurturing and buffering effects of a parent's presence. Their physical and emotional health is in jeopardy.

Negative effects of detention and parental separation are documented in decades of global research. Toxic stress these kids suffer can stunt their development and ultimately lead to chronic disease.

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In a June 20 statement, the Society for Research in Child Development summarized findings on parent-child separation dating back to World War II. Children faced increased risk for a host of physical and emotional health problems, according to evidence the authors called conclusive.

"The physiological and psychological toll of early life stress, including parental separation, changes how the body responds to stress in the long term," the SRCD statement noted. That impact contributes to higher risk for anxiety, depression, PTSD and lower IQ. Immune system functioning and physical growth are impaired. Highly stressed kids face increased risk for heart disease, lung disease, cancer and stroke later in adulthood, multiple studies show. In contrast, children with parents in close contact are better protected from these ill effects.

In Need of Respite

They arrive after being released from the immigration processing center in McAllen, Texas, usually with just the clothes on their back. By the time refugee families reach the Humanitarian Respite Center at the Sacred Heart Catholic Church, located in McAllen as well, they're exhausted, says Sister Norma Pimentel, executive director of Catholic Charities of the Rio Grande Valley.

Families need safe haven and sustenance after their difficult travels. "They may go for days without eating," Pimentel says. "It depends whether they're able to find someone that will provide them with something to eat." However, strangers could be good Samaritans or human traffickers. "They don't know," she says. "They're on their own."

"Children arrive at the detention facility for their [processing] and they're separated from their parents," Pimentel says. Immigrants are monitored, controlled and pretty much treated like prisoners, she says: "It's traumatic for them – everything."

Up to 200 people daily, sometimes more, come through the respite center's door. "When kids arrive, they're somewhat withdrawn and they're scared," Pimentel says. "But still, they see at least the space they're in is safe."

At the respite center, people in crisis receive plentiful water, decent meals and clean clothes. Parents can shower and kids can play. Volunteer doctorsoffer medical services. If needed, local doctors will take immigrants for treatment at a nearby clinic. Some eventually go to the hospital.

The staff follows up with as many immigrants as possible. "We're establishing a network so that when they go, people can take them forward, welcome them into the community and make sure they show up in court," Pimentel says.

If kids receive proper guidance, Pimentel says, that can make all the difference. "If someone can help them through this, they'll be fine," she says. "They will definitely need help."

A study published May 2015 in the American Journal of Orthopsychiatry looked at experiences of asylum-seeking children detained in Canada. Even for brief periods "detention appears to be a frightening experience of deprivation that leaves children feeling criminalized and helpless," researchers found. When families were separated, that further "shattered" the children's sense of well-being.

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When Dr. Raul Gutierrez, a community pediatrician practicing in California, sees immigrant kids from families who've made their way to San Francisco or Oakland, he feels a certain affinity.

"I was born and raised in Brownsville, Texas," Gutierrez says. "This culture of having border patrol around, and the fact that there are detention centers in those areas, was not new to me." The immigrant kids he sees in the Bay Area come in with headaches, stomachaches and behavioral problems. Teens show signs of depression and anxiety.

About a year ago, Gutierrez began to hear of kids being removed from their parents. Two adolescent boys came to his clinic with their father. They had traveled to the U.S with their mother, planning to reconnect with their dad. However, they were blocked at the point of entry where they came to claim asylum. The boys and their mother were separated and sent to different facilities. She was deported.

"Luckily, they have the support of their father," Gutierrez says. "But they miss their mother. They both worry about her a lot and are just hoping she's going to be OK, and that at some point in the future they can be reunited."

Stress accumulates. "The vast majority of my patients and families are fleeing some type of poverty, gang-related and other violence," he says. "So they already have their fight-or-flight system on. The stress hormones bathing their brain and body are already high. [They] reach the United States, where they're trying to feel safe – and then to be separated from the one person who is buffering that stress exponentially increases toxic stress going on in the body."

A study in the September 2009 issue of the journal Child Abuse & Neglect looked at 24 children, ranging in age from 3 months to 17 years, who were held in a British immigration detention center. Depression, anxiety, sleep problems, physical complaints, poor appetite, weight loss, emotional symptoms and behavioral issues were common.

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Recent reports of breastfeeding babies separated from their mothers at the border struck a deep chord of dismay among many Americans. "There's nothing more enriching in terms of bonding and nutrition, and just support for a child, than the act of breastfeeding," Gutierrez says. "To deny a mother the ability to breastfeed her child is just one of the worst things that you can really do for a developing infant."

Younger kids can regress as a result of the migration experience, even when not separated from their parents. Gutierrez describes a once-chatty toddler who no longer talks as much. "I've seen older kids around 7 to 10 years old who started wetting the bed," he says. "I've heard parents explain that their kids used to be joyful and outgoing and have lots of friends, only now to describe them as anxious and isolated."

Kids from infants to 5 years old are at the highest risk of having stress affect their brain, Gutierrez says, because that's when so much learning occurs and so many neural connections are being made.

Nightmares, perseverating or repeated thoughts of what might happen to them and memories of traumatizing experiences in their home country or at the border often affect teens. "They can't sleep well and then they can't concentrate in school," Gutierrez says. Some kids try to cope by experimenting with alcohol, drugs or other risky behaviors that they hadn't turned to before.

The mental health of 16 adults and 20 children in an Australian detention camp was evaluated in a September 2007 study in the Australian and New Zealand Journal of Public Health. Children, ranging in age from 6 to 17, met criteria for PTSD and had major depression with suicidal thoughts, researchers found. Some had symptoms of anxiety disorder and some attempted self-harm.

Reunited?

The fate of kids among those separated, sometimes forcibly, from their families during El Salvador's civil war, which ended in 1992, was the focus of a study in the November 2013 issue of Human Rights Quarterly. Many kids were placed in orphanages or put up for adoption. As adolescents. some were eventually reunited with their biological parents. Reunification, while challenging, was ultimately beneficial for these kids, researchers concluded. However, time doesn't fully heal psychological wounds for some children, the SRCD experts warn.

The current U.S. situation is concerning from a public health standpoint, says Kanaka Sathasivan, director of communications with the Texas Nurses Association. "Here we have a community of potentially thousands of children that are all affected," she says. "And we don't know yet whether the children will be deported; whether they'll stay here in our foster care system. Whatever the case may be, they're going to need a lot of medical and psychological care once they're out of this."

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