Children also experience night terrors and separation anxiety, and as adults face greater risks of mental and physical challenges

Separated from his father at the US-Mexico border last year, the little boy, about seven or eight, was under the delusion that his dad had been killed. And he thought he was next.

Other children believed their parents had abandoned them. And some suffered physical symptoms because of their mental trauma, clinicians reported to investigators with a government watchdog.

“You get a lot of ‘my chest hurts’, even though everything is fine” medically, a clinician told investigators. The children would describe emotional symptoms: “Every heartbeat hurts,” or “I can’t feel my heart.”

Children separated during the Trump administration’s zero tolerance policy last year, many already distressed in their home countries or by their journey, showed more fear, feelings of abandonment and post-traumatic stress symptoms than children who were not separated, according to a report from the inspector general’s office in the Department of Health and Human Services (HHS), released on Wednesday.

The chaotic reunification process only added to their ordeal. Some cried inconsolably. Some were angry and confused. “Other children expressed feelings of fear or guilt and became concerned for their parents’ welfare,” according to the report.

Facebook Twitter Pinterest Migrant families enter to be processed at the central bus station before being taken to Catholic Charities in McAllen, Texas, 29 June 2018. Photograph: Larry W Smith/EPA

The child who believed his father was killed “ultimately required emergency psychiatric care to address his mental health distress”, a program director told investigators.



The child psychiatrist Dr Gilbert Kliman, who interviewed dozens of migrant children in shelters after zero-tolerance took effect, told PBS’s Frontline and the Associated Press that the kids can move on with their lives after reunifying with parents but may never get over it.

As children they have night terrors, separation anxiety and trouble concentrating. As they become adults, they face greater risks of mental and physical challenges, from depression to cancer.

Among the separated children, he foresees “an epidemic of physical, psychosomatic health problems that are costly to society as well as to the individual child grown up. I call it a vast, cruel experiment on the backs of children.”

The AP obtained a copy of the report in advance of the official release, the first substantial accounting by a government agency on how family separation under the Trump policy has affected the mental health of children. It was based on interviews with about 100 mental health clinicians who had regular interactions with children but did not directly address the quality of the care the children did receive.

“Facilities reported that addressing the needs of separated children was particularly challenging, because these children exhibited more fear, feelings of abandonment and post-traumatic stress than children who were not separated,” said the deputy inspector general, Ann Maxwell. “Separated children are also younger than the teenagers facilities were used to caring for.”

The report covers a period last year when facilities were overwhelmed by the policy under which at least 2,500 children were separated from their parents. They stayed behind in border custody while their parents were taken to federal court for criminal proceedings.

The watchdog said the longer children were in custody, the more their mental health deteriorated, and it recommended minimizing that time. It also suggested creating better mental health care options and hiring more trained staff.

The department assistant secretary, Lynn Johnson, said in a letter to the watchdog that the average length of stay was much shorter now and noted the report was not a clinical review of treatment.

Facebook Twitter Pinterest Andy, seven, is reunited with his mother, Arely, at Baltimore-Washington international airport 23 July 2018. They had been separated upon entering the US. Photograph: Win McNamee/Getty Images

She wrote that “significant factors” beyond the agency’s control contributed to “the issues identified in the report”. Those included a surge in children at the border, the children’s unique mental health needs and a shortage of qualified bilingual clinicians, especially in rural areas.

She said that efforts had been made to bring in more medical health professionals, but “adverse media coverage and negative public perception ... have hampered efforts to expand”.

After a federal judge ordered the children reunified with their parents, guidance on how to do it kept changing and that led to further anxiety and distress, according to the report.

In one case, a child was moved from a Florida facility to Texas to be reunited with her father. After the child made several trips to the detention center, she was returned to the Florida facility “in shambles”, without ever seeing him.

Investigators visited 45 facilities in 10 states during August and September of 2018, interviewing mental health clinicians. During the interviews, there were almost 9,000 children in shelters; nearly 85% were 13-17 in age, 13% were 6-12 and 2% were infants to age 5.

A separate report also released Wednesday by the health and human services inspector general found that migrant detention facilities were woefully substandard. Specifically, many case managers did not meet the minimum education requirements for the Office of Refugee Resettlement. In addition, the review found 28 of the 45 facilities didn’t have enough mental health workers.

Beto O’Rourke, a Democratic presidential hopeful, called the report a confirmation of the psychological toll taken on separated migrant children.

“This confirms what we already knew: the children separated from their families, locked in cages, forced to sleep on concrete floors under tinfoil blankets, will live with this trauma for the rest of their lives,” he wrote on Twitter. “We’ll have it on our consciences for the rest of ours.”