A former Obama administration official says that canceling classes hurts children's mental health and could also make it harder to catch physical health issues.

Migrant children from different Latin American wait to receive food at the Casa del Refugiado, or The House of Refugee, in El Paso, Texas, on April 24th, 2019. (Photo: Paul Ratje/AFP/Getty Images)

Last week, the Washington Post reported that the Trump administration would cut English classes, recreational activities, and legal aid for unaccompanied migrant children in government-run shelters. Medical experts and a former Obama official worry that the budget cuts could endanger children's lives, and others say that they could constitute negligence under regulations protecting the welfare of children.

In a statement to Pacific Standard, a Department of Health and Human Services spokesperson attributed the rollback in services to serious budgetary constraints brought on by an increase in the number of children in the custody of the Office of Refugee Resettlement, the HHS agency that takes charge of children who arrive on the border unaccompanied. (Some advocates attribute this increase to the fact that, during the Trump administration, Immigration and Customs Enforcement has been arresting many of the sponsors—often immediate family members—who previously came forward to care for children in the shelters.)

"We have a humanitarian crisis at the border brought on by a broken immigration system that is putting tremendous strain on the Office of Refugee Resettlement," says Evelyn Stauffer, an HHS spokesperson. "This week, ORR instructed grantees to begin scaling back or discontinuing awards for [unaccompanied migrant children] activities that are not directly necessary for the protection of life and safety, including education services, legal services, and recreation."

Stauffer says that HHS has requested over $2 billion in emergency funds from Congress to ensure that ORR can provide adequate care—and also increase its shelter capacities.

Medical experts disagreed with Stauffer's characterization that the programs cut—like education—are not "directly necessary for the protection of life and safety."

"These aren't luxuries. These are necessities for normal human development," says Dr. Joseph Shin, assistant professor of medicine at Weill Cornell Medicine.

"Many of these children are fleeing conditions where they've experienced multiple forms of trauma over a long period of time," Shin says, explaining these traumas include physical and sexual abuse, as well bearing witness to other forms of violence. Additionally, Shin says that many of the struggles children faced in their home countries are mirrored in government custody.

"They faced many of the same sort of deprivations that we’re talking about here: lack of access to education, learning, and recreational activities," Shin says. "Which are all a necessary part of normal human development."

Shin explains that structured education and recreation are not just a part of children's healthy development—they're also critical components of healing from trauma. With a team of researchers, Shin studied 180 psychological and medical evaluations performed on children seeking asylum in the United States by doctors working with the watchdog organization Physicians for Human Rights. Their findings, published by PHR this week, discovered that the children who had experienced the fullest recovery had found access to education, sports teams, and other forms of social connection and support.

In addition to the impact on child development, some worry that the program cuts could harm the children in other, more immediate ways: Robert Carey, who ran the Office of Refugee Resettlement from 2015 to 2017, worries that the budget cuts could even endanger lives.

One of Carey's immediate concerns is that, in the absence of educational or recreation activities, children experiencing medical crises could go unnoticed.

"If there's a child with problems—whether it's medical, or psychological, or social or whatever—if they're in communication with a lawyer, or a teacher, or with someone leading an exercise program, that's another safeguard," Carey says. "Those are eyes are on the child, if something medically or otherwise is about to happen."

Carey explains that, in shelters, children—many of whom might have experienced trauma at the hands of police and other government personnel in their home countries—might be more willing to confide in a figure like a teacher than with other facility staffers. And with less access to teachers and coaches, children might have fewer chances to share if they're in the midst of a crisis.

"When you lessen those standards, you not only lessen [the standard of] care, but also the oversight, security, and well-being of children," Carey says.

As the number of migrant children dying in government custody continues to rise under the Trump administration, pediatricians and other medical experts have raised concerns about government agents' ability to notice and flag when a child might be experiencing a medical emergency. As the former president of the American Academy of Pediatricians told Pacific Standard in January, children often do not display symptoms of severe illness in the same way that adults do—and, without proper training, government agents might not be able to notice when a child needs emergency treatment.

Because of the harm the cutbacks could present to children, some argue that they could be illegal under regulations that protect child welfare.

"It might be that this kind of deprivation borders on potential abuse and negligence," Shin says, arguing that budget constraints aren't a sufficient justification for potentially endangering children's well-being.

Because of the well-documented negative effects of detention on children's health, a variety of court decisions and federal statutes have established guidelines for children's care in government detention and shelter facilities—most notably the landmark Flores v. Reno decision in 1997, which established migrant children's basic rights. When it was first reported that HHS would stop offering educational, recreation, and legal services, some lawyers raised the worry that the agency could be in violation of those regulations: "We'll see them in court if they go through with [with the cuts]," Carlos Holguin, the human rights lawyer who argued successfully in Flores, told the Washington Post.

"What's next? Drinking water? Food? Where are they going to stop?” Holguin told the Post.