Jun. 21 2018

Mailman Faculty Discuss Public Health Impacts of Family Separation

Mailman School professors and researchers say the U.S. federal government’s recent actions at the southern border to separate migrant families violates international human rights conventions and jeopardizes the health and well-being of children. Public health research, including at the Mailman School, has documented connections between childhood traumassuch as family separationand risks to healthy development.  

Since Attorney General Jeff Sessions’ April announcement of a policy mandating prosecution of all migrants, even if they are carrying small children, federal authorities have separated about 2,300 children from their families. Many of these children have been held in detention facilities under conditions that observers have characterized as cruel and inhumane.

On June 20, President Donald J. Trump signed an Executive Order to end future separation of children from their parents, while keeping in place a mandate to prosecute migrants and deny asylum requests for gang violence and domestic abuse. The order says nothing about children already separated from their parents.

Terry McGovern, JD, an authority on health and human rights, is the Harriet and Robert H. Heilbrunn Professor and Chair of Population and Family Health, a department which houses the Program on Forced Migration and Health. According to McGovern, the treatment of migrants violates international law. Under the United Nations Convention Relating to the Status of Refugees, governments must not penalize refugees for illegal entry and must treat them with dignity and respect. The U.N. Convention on the Rights of the Child guarantees civil, political, economic, social, and cultural rights to all children, irrespective of migration status or citizenship, and requires that states act in the best interests of the child.

“International conventions protect rights of all humans regardless of place of origin, reason for migration, or legal status,” says McGovern. “This includes freedom of movement and the right to health. The U.S. Constitution provides its own protections as well under the Due Process Clause of the Fifth Amendment.”

Health Consequences

Michael Wessells, PhD, a psychologist and professor in the Program on Forced Migration and Health, studies child mental health and psychosocial support in emergency settings. He says separating children from their parents and detaining them causes profound harm especially coming on the heels of a long, distressing flight from a dangerous situation.

“The separation and detention occur at a moment when the children are most in need of support, and parents are the children’s primary source of support,” says Wessells, who helped develop the first consensus guidelines on mental health and psychosocial support in humanitarian settings. “Evidence globally indicates that the provision of care by a concerned parent is one of the most important determinants of children’s well-being.”

Cassie Landers, EdD, MPH, assistant professor of Population and Family Health, has worked with UNICEF and other international agencies to promote policies and programs in support of young children and their families in more than 60 countries. She knows firsthand the dangers of isolating children, having participated in a UNICEF mission examining children institutionalized in Romania under Communist rule. 

“We saw children permanently scarred by the experience, who were rocking back and forth because they weren’t given human contact and stimulation,” says Landers. “Of all the traumas children can endure, separation—especially at the youngest ages—may be the most severe. These children need supportive environments, starting with primary caregivers. Absent that support, there is serious risk of lasting harm.”

According to news reports, children taken from their mothers were young enough that they were still being breastfed—a crucial period of nutritional and psychological nourishment, according to Landers. Another report that guards are forbidden from providing physical comfort to distressed children, and that some children are denied toys, were scolded for attempting to play in their cage, which her research in emergency settings has found are crucial areas for healthy development.

Uncharted Territory

Pediatric oncologist Manuela Orjuela-Grimm, MD, an assistant professor of Epidemiology, studies the long-term health risks of migrant youth who cross the border with Mexico. “All of the young people I speak with remember being detained by Homeland Security in what they call the ‘hielera’ or icebox,’” she says. “Years later, the experience is still vivid in their minds and remains what they remember as one of the worst parts of their journey: the chill of the air conditioning, terrible and insufficient food, guards yelling at crying children.”

“What’s happening now is unprecedented,” adds Mark Canavera, MA,  associate director of the CPC Learning Network, an entity housed at the Mailman School focused on children’s protection, care, health, and development. “This is the first time we’ve seen the separation of children from their families used as a punitive tactic to deter future asylum seekers.”

What Next?

While the President’s Executive Order ends a policy of family separation, the fate of children already separated is unclear. Many children have been taken to detention centers across the country—including to New York City. Some parents have been returned to their home countries. Already, caregivers have had difficulty learning the whereabouts of their children and have been denied the opportunity to speak with them. According to Canavara, a member of a research project on measuring child separation in humanitarian settings, this situation is unnecessary as family tracing methods have been successfully used since World War II. 

The June 30 Executive Order also calls for the indefinite detention of families past the current U.S. legal limit of 20 days. According to Landers, parents traumatized by long-term confinement in caged cells will be unable to provide adequate care for their children. Separated children must be reunited with their families and afforded psychological support and humane treatment in accord with international human rights standards, adds Wessells.

Going forward, another challenge is restoring trust, says Orjuela-Grimm, who conducts asylum evaluations through the Columbia Human Rights and Asylum Clinic. “Traditionally, many Central American families turn themselves in at the U.S. border because they believed that once they got here they’d finally be safe. Now, there’s a sense of betrayal. It’s unclear how we can rebuild their trust in the U.S. system, and for children, that betrayal will leave long-lasting scars.”

“The real threat is not from people fleeing violence in their countries to seek asylum in the United States,” says McGovern. “Instead, the real threat is the one directed at the migrants, denying their rights and endangering their health.”