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AAP calls for revamped detainment procedures for immigrant, refugee children
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The condition of detainment facilities provided by the Department of Homeland Security for children immigrating to the United States do not meet basic standards for the care of children in residential settings, according to a policy statement released by the AAP’s Council on Community Pediatrics.
The organization has urged that immigrant children have limited contact with these facilities, regardless of whether they arrive unaccompanied or in family units, and has requested an evaluation of the health outcomes of detained children who have entered the U.S.
“Pediatricians who care for previously detained immigrant children in communities throughout the United States should be aware of the traumatic events these children have invariably experienced to better understand and address their complex medical, mental health and legal needs,” Julie M. Linton, MD, FAAP, from the Department of Pediatrics at Wake Forest School of Medicine, and colleagues wrote. “Pediatricians also have an opportunity to advocate for the health and well-being of vulnerable immigrant children.”
In 2014, a previously unseen number of immigrants from Central America — specifically Guatemala, Honduras and El Salvador — prompted the use of family detention to “send a message of deterrence abroad.”
The Customs and Border Protection’s secure processing centers provide unacceptable living conditions, according to interviews with advocacy groups, detainees and the DHS Office of Inspector General. These include inadequate bedding and the need to sleep on cement floors, open toilets, no bathing facilities, constant light exposure, confiscation of belongings, insufficient food and water supplies, poorly conditioned temperatures and lack of legal counsel.
Children and their families have also been separated, kept longer than the mandated 72-hour period before they are transferred to the Office of Refugee Resettlement’s custody, denied medical care and medications, and have been physically and emotionally maltreated.
The AAP stresses that the best interests of children should be prioritized by the government. They also wrote that children who are in the custody of a parent should never be detained or separated from their parent. The exception to this matter would include a ruling made by a competent family court.
The statement provided many ways in which immigrant children should be handled while in custody. The following are a sample of suggested guidelines:
- Treat all immigrant children and families seeking safe haven who are taken into U.S. immigration custody with dignity and respect to protect their health and well-being.
- Eliminate exposure to conditions that may retraumatize children, such as those that currently exist in detention, or detention itself.
- Children, whether unaccompanied or accompanied, should receive timely, comprehensive medical care that is culturally and linguistically sensitive by medical providers trained to care for children and should be consistent across all stages of processing.
- Children and families should have access to legal counsel throughout immigration. Unaccompanied minors should have free or pro bono legal counsel with them for all appearances before an immigration judge.
- Pediatric providers should familiarize themselves with trauma-informed care and promote access to comprehensive mental health evaluation in the community.
- Pediatric providers serving previously detained immigrant children should elicit specific history of abuse, neglect, abandonment, persecution, trafficking, or violence to screen children for legal needs and refer these children to legal services.
“From the moment children are in the custody of the United States, they deserve health care that meets guideline-based standards, treatment that mitigates harm or traumatization, and services that support their health and well-being,” researchers wrote. – by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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