On June 20, 2018, the American Psychiatric Association (of which I am an Assembly Member) and 17 other mental health organizations joined forces in a letter to the Departments of Justice, of Homeland Security and of Health and Human Services, urging the administration of President Donald Trump to end its policy of separation of children from their parents at the United States border.
The letter states that “children are dependent on their parents for safety and support. Any forced separation is highly stressful for children and can cause lifelong trauma, as well as an increased risk of other mental illnesses, such as depression, anxiety, and posttraumatic stress disorder (PTSD). In addition, the longer that children and parents are separated, the greater the reported symptoms of anxiety and depression for the children.”1
The separation and detention of minors is a human rights crisis
The United Nations Convention on the Rights of the Child emphasizes the importance of considering “the best interests of the child.”2 These interests include:
- Protection against discrimination
- Safety
- Wellbeing
- Health
- Ensuring to the maximum extent possible the child’s survival and development
- Preservation of the child’s identity
- Family integrity
- Protection against the separation from parents against the child’s will
- Free expression of ideas
- Freedom
- Education
The separation of children from their families and their detention under inhumane and deplorable conditions are in direct opposition to all these interests.
The emotional impact of the separation
The negative effects, both physical and emotional, on the children separated from their parents may not be apparent for many years and some may be irreversible.
The short-term emotional effects include:
- Post-traumatic stress disorder
- Anxiety
- Depression
- Low self-esteem
- Feelings of helplessness and hopelessness
- Behavioral problems
- Irritability
- Sleeping problems
- Changes in appetite
- Loss of interest in pleasurable activities
- Poor self-care
- Feelings of guilt
- Suicidal thoughts or behaviors
The long-term emotional sequelae can be reflected in:
- Developmental delay
- Poor psychological adjustment
- Poor school performance
- Regressive behavior
- Aggression
- Increased vulnerability to physical illness
- Alcohol and drug use
Studies show that no matter how brief the detention, it may cause severe and long-term psychological trauma and increase the risk of mental disorders.3
Parents may also be affected due to the uncertainty of what may be happening to their child, which may manifest itself in:
- Increase in physical and emotional problems
- Anxiety
- Depression
- Post-traumatic stress disorder
- Difficulty in their relationships
- Suicidal thoughts or behaviors
What is Attachment?
Attachment is the bond between the child and his parents, which plays a fundamental role in the social and emotional development of the child. Adequate attachment fosters feelings of security in the child. Poor attachment can make the child grow insecure, with separation anxiety, self-esteem problems, trust issues, behavioral problems, and even extreme dependence on others.
The relationship between parents and children can continue to be affected even after being reunited, which may be manifested in:
- Attachment problems
- Reduction in parental authority
- Poor parent-child relationship
- Difficulties in child rearing
How can we prevent these negative effects?
- Putting a stop to the separation of families and to the inhumane conditions in the detention centers. The separation of a parent from a child should never occur, unless there are concerns for the safety of the child at the hands of his/her parent.
- Early detection of symptoms through mental health assessments and periodic reevaluations (especially when symptoms may arise later as the separation or detention persists).
- Coordination of services:
- o Physical health
o Mental health
o Legal
o Interpretation in the child’s primary language - Psychotherapy and counseling can help the children and their parents to deal with their feelings or negative thoughts, identify stressors, and strengthen coping skills. Therapy can assist in processing emotions and offer support and hope.
- Psychiatric medications may also control symptoms of depression, anxiety, post-traumatic stress disorder, or any other mental health condition.
- Finally, there should be no shame in seeking help, which can improve the lives of the child and his/her family.
Remember…
Be Smart. Be Safe. Be Healthy. Be Strong.
Until next time!
Dr. Felix
References:
1American Psychiatric Association. (2018, June 20). Mental health organizations urge administration to halt policy separating children and parents at U.S. border. Retrieved from https://www.psychiatry.org/newsroom/news-releases/mental-health-organizations-urge-administration-to-halt-policy-separating-children-and-parents-at-u-s-border/
2United Nations. Convention on the Rights of the Child. Retrieved from https://www.ohchr.org/en/professionalinterest/pages/crc.aspx/
3Linton, J.M., Griffin, M., Shapiro, A.J. (2017, March). Detention of immigrant children. American Academy of Pediatrics. Retrieved from http://pediatrics.aappublications.org/content/pediatrics/early/2017/03/09/peds.2017-0483.full.pdf