Guest Editorial

How U.S. Immigration Policy Damages Children's Well-being

February 02, 2018 03:51 pm Audrey Hertenstein Perez

After a recent immigration raid at a Chicago bakery, news reports focused on the financial fallout:(www.chicagotribune.com) millions of dollars in lost sales throughout North America as the facility struggled to replace 800 detained workers.

[Audrey Hertenstein Perez, MD]

Audrey Hertenstein Perez

As a medical student studying in that very city, my thoughts gravitated instead to the human toll of the raid: hundreds of families torn apart. In Chicago and throughout the United States, our health care system needs to be a space that promotes healing and resilience among families affected by these issues. The well-being of immigrant children and families is intertwined with the well-being of our society.

Despite claims by the Trump administration that immigrants being detained or deported are dangerous criminals, the 8 million undocumented people in the United States who are at risk for deportation are often working mothers and fathers with no criminal records. They are our co-workers, classmates and neighbors. Many of their children are U.S. citizens or grew up knowing no other country to call home.

These parents now face separation from their families, leaving children in our community to face unnecessary stress and hardship that may well stay with them for years to come.

During my fourth year of medical school, I participated in an advocacy course hosted by Community for Children,(www.communityforchildren.org) an organization committed to fostering a culture of compassion among physicians. I traveled to the U.S.-Mexico border in Texas and partnered with colleagues to explore and help address stress among children being held by the Office of Refugee Resettlement (ORR). The teens we worked with were among the tens of thousands of unaccompanied children fleeing violence and poverty in Central America who had been placed in federal detention centers by organizations with which the ORR contracted.

More than 59,000 children were processed through these centers in fiscal year 2016 while hoping and waiting to be reunited with family or sponsors in the United States. During this time, the children appear before a judge, often alone. Those who qualify for visas as victims of human trafficking or violence or for asylum status will enter a separate court system. Others will be deported back to the country from which they fled.

In a class another medical student and I led during our time at the border, we asked teenagers to respond to a simple question: What causes you stress?

"I get stressed when I miss my parents, but I can't talk to them," said one girl, her eyes welling with tears.

Another boy responded, "I get scared lying in bed at night because all I can think about is my family."

The period of adolescence is, by nature, filled with change and uncertainty about the future, heightened emotions, and stress. The responses from this classroom full of 15- to 17-year-olds highlight how immigration policies significantly add to this stress and take an even deeper toll on mental and emotional health.

As a future physician passionate about primary care, my No. 1 job is to keep children and their families healthy. So, I am especially distressed by the health implications for children and families who are separated and/or detained. On average, children spend 30 days in these detention centers, although some children we spoke with had been detained for more than a year. Children who have been detained often experience negative emotional disorders such as post-traumatic stress, developmental delay and poor psychological adjustment. Similar mental health effects are found in children whose parents have been threatened with or subject to deportation orders.

The harm to children's mental health and psychological functioning caused by separation from family can last into adulthood. While working at the border, I saw first-hand how detention isolates children not only from their families and support systems, but also from mental health services and counseling that are vital to promoting resilience in these young people.

My experience at the border calls me to advocate for including health care professionals in immigration policy discussions. We understand what children and families need to be healthy. It's time to raise our collective voices and oppose any policies or practices that threaten their well-being.

Audrey Hertenstein Perez is a fourth-year medical student studying at Loyola University Chicago Stritch School of Medicine.