Children and parents separated at the border under the Trump administration experienced severe psychological trauma that some are dealing with long after being reunited, the first qualitative study of children and parents has found.
The study by Physicians for Human Rights published in the peer-reviewed scientific journal PLOS ONE concluded that the separation of 31 parents and children whose cases the group reviewed “constitutes cruel, inhumane, and degrading treatment” and that the cases “rise to the level of torture” as defined by the United Nations Convention Against Torture.
“In the cases reviewed, it is apparent that U.S. officials intentionally carried out actions causing severe pain and suffering in order to punish and intimidate mainly Central American asylum seekers to not pursue their asylum claims,” the study stated.
Then-President Donald Trump’s "zero tolerance" policy, which separated thousands of children from their parents, was fully implemented in May 2018. Under the policy, the U.S. government took children from parents, not all who had crossed illegally, at the border and prosecuted the adults. Some parents were deported without their children.
Facing heavy backlash, Trump signed an executive order reversing the policy about a month later.
Clinicians who interviewed and evaluated the families reported that most of the individuals met diagnostic criteria for at least one mental health condition such as post-traumatic stress disorder, major depressive disorder or generalized anxiety disorder.
Children exhibited behaviors described as age-appropriate regression, such as crying, not eating, having nightmares, sleeping difficulties, excessive parental attachment, clinging to caregivers, urinary incontinence and recurring feelings of fear after being reunited with parents.
Two children who had long been reunited with parents still showed severe trauma symptoms and met mental health disorder criteria, the researchers said.
One was a 6-year-old Guatemalan girl who met criteria for PTSD a year after being reunited with parents. An 8-year-old boy met criteria for PTSD and separation anxiety two years after reunification.
“Neither had exhibited these symptoms prior to the separation event,” the researchers stated.
All parents in the study arrived at the border having already suffered significant trauma because of targeted violence in their home countries.
In almost all cases, the children had also experienced harm, including being drugged, kidnapped, poisoned and threatened with death or bodily harm by gang members.
“Parents were confident that the journey to the United States would ensure protection for their children,” the study said.
But parents and children told the researchers that U.S. officials treated them punitively. They said immigration officials forcibly removed their children from their arms and transferred parents to other facilities as they slept.
Almost all told the researchers the officials would not tell them why they were being separated, where their family member was sent and whether or how they’d be reunited.
Parents said they were mocked when they asked about their children.
Three of the 19 parents exhibited suicidal thoughts.
Clinicians who interviewed parents and children found no signs that the immigrants were exaggerating their mental health trauma or were trying to deceive others, as some immigration restrictionists have asserted, the study said.
"Physicians for Human Rights has long documented the detrimental effects of forced family separation on asylum seekers, and the findings of this study provide additional medical evidence that the psychological trauma could potentially be lifelong," Kathryn Hampton, deputy director of PHR's asylum program, said in a news release.
The researchers found that in almost every case, therapy, removal from detention and prescription of psychiatric medicines was needed.
The study is based on an analysis of affidavits from clinicians’ interviews and evaluations of children and parents. The affidavits from the interviews are used for legal cases, including asylum claims and lawsuits for damages caused by family separation.
The decision to separate children from parents was agreed on by a show of hands in a meeting of Trump senior advisers led by former Trump adviser Stephen Miller, NBC News previously reported.
The White House said last month that more than 1,000 families separated at the border had not yet been reunited.
President Joe Biden has expressed support for compensating separated families, some of whom are seeking damages from the government. The Trump White House killed a deal for mental health care for separated families, NBC News reported last year.
"It is our moral imperative to not only reunite these families, but to provide them with the support and services they need to heal," said Liza Acevedo, a Department of Homeland Security spokesperson.
She said Homeland Security Secretary Alejandro Mayorkas has heard firsthand from parents about their pain and trauma "after being cruelly separated under the previous administration's zero-tolerance policy."
Hampton said the study's findings should be considered as the administration negotiates settlements. But she also said the administration should widen its focus as it determined a dollar amount.
Researchers recommended the government include mental health support for the parents and children who were separated. They also urged changes in how immigration authorities question them, including allowing children to remain with parents during asylum interviews or allowing them to take breaks to see their children.
The Biden administration's task force created a website to assist families with reunification. A lawsuit has made some reunited families eligible for behavioral health services.
HHS and the task force also offering screenings and treatment for behavioral health conditions caused by the separations, Acevedo said. The task force also is identifying funding for ongoing treatment and future services for the families, she said.