While the mental health effects on these detainees might not always be immediately observable, it is without question that the negative ramifications of changes to government policy have impacted and will continue to impact refugees, asylum seekers, and displaced persons and families.
Zero-Tolerance Policy
Between October 2019 and September 2020, the U.S. Border Patrol apprehended a total of 317,864 single adults, 52,230 family units, and 30,557 unaccompanied children. This amounted to a total of 400,651 total apprehensions over a one-year period. On May 7, 2018, a “zero-tolerance” policy was implemented by the U.S. Department of Justice (DOJ). This policy meant that all migrants crossing the border would be subject to prosecution and imprisoned. Any children under the age of 18 became the responsibility of the U.S. Department of Health & Human Services (HHS) and were separated from their parents as a result of this zero-tolerance policy. Prior to the Trump administration, this was considered a civil matter, and families were usually placed on parole in the community or detained together. Children would be allowed to live with relatives in the country or sponsors while waiting for the outcome of legal proceedings. However, with the introduction of the zero-tolerance policy and stricter restrictions on sponsors, more families and children were detained, and the strain on the system became inevitable. Because of this policy, the number of undocumented migrants being detained also increased. As a result, concerns about conditions within the detention centers where migrants (adults and children) were being held arose. Many were left wondering how these detention centers possibly keep up with such an influx.
Detention Center Conditions
Given the rising numbers of undocumented migrants, detention centers became overcrowded with inadequate access to time outdoors, food and water, and poor sanitation practices. Furthermore, detention centers were described as similar to prisons in appearance with cages, fences, and harsh overhead lighting that was left running for 24 hours a day. Effects of these conditions have included outbreaks of the flu, deaths in custody, older children caring for younger children, mistreatment, abuse, and neglect on the part of the guards overseeing detainees. Overall, there were traumatizing effects on all those housed within these prison-like conditions.
Mental Health Studies
Given these unprecedented circumstances, it is important to consider the resulting mental health effects of confinement inside of detention centers on undocumented migrants including children, adolescents, and adults. Researchers have sought to understand the potential mental health effects of spending time within detention centers for a number of years, and studies have spanned the globe including those conducted in the U.K. and Australia (on Christmas Island). In general, it is clear that a number of mental health effects result from confinement inside of detention centers. Below are the different effects that have been identified in children, adolescents, and adults as a result of detainment in specific studies.
Anxiety, Depression, and Post-Traumatic Stress
A 2018 systematic review study of 26 studies including 2,099 participants, indicated that adults, adolescents, and children experienced high levels of mental health problems. Anxiety, depression, post-traumatic stress disorder (PTSD) were most commonly reported during and after the period of being detained. A 2016 secondary analysis of previously unreported data from the 2014 Australian Human Rights Commission Inquiry into Children in Immigration Detention examined the impacts among 129 children aged 17 and under who had been detained for an average of 7 months.
Emotional and Peer Problems
A cross-sectional study of 425 mothers and their eldest child held at a U.S. immigration detention center for two months in the middle of 2018 found that the children showed emotional problems and peer problems. The younger children (aged 4 to 8) showed more conduct problems and hyperactivity problems compared to the older children.
Depression, Anxiety, and Suicidal Ideation
In a 2015 article sharing stories from unaccompanied children held at Christmas Island off of the coast of Australia, 40 boys aged 14 to 17, several girls aged 17 on arrival, and several 18-year-olds who had been 17 years old on arrival were interviewed. Most had been in detention for a period of 6 to 8 months and shared stories of leaving their homes in search of protection, employment, and education and to help their families. They were escaping war, murder, villages being burnt down, persecution, violence, sexual abuse, forced marriage, forced labor, etc. The children generally came from Afghanistan, Somalia, Iran, Burma, and Sri Lanka. Their families had either sent them or they had become orphaned or been threatened. They traveled for weeks to months through India, Malaysia, or Thailand and then eventually boarded boats in Indonesia. These children reported symptoms consistent with major depression, post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Some had psychotic symptoms. Most were afraid of being transferred to the adult living quarters and felt sad about losing friends who had been transferred to these quarters. In addition, some reported suicidal ideation.
Criminalized and Helpless
A 2015 qualitative study of 20 detained families held for an average of 56 days in Canada showed that children were frightened, and felt criminalized and helpless. Even brief detention of a period of just 48 hours was shown to result in emotional and behavioral effects that affected their sense of well-being that lasted months after release.
Weight Loss and Sleep Problems
In a 2009 study of 24 detained children (aged 3 months to 17 years), it was shown that children were experiencing depression, anxiety, sleep problems, somatic problems, poor appetite, emotional symptoms, and behavioral problems. Weight loss, developmental problems, educational problems, and nutritional problems were also noted in the study.
Signs of Emotional Distress
Emotional distress resulting from being in a detention center has been shown to be experienced by adults, adolescents, and children. Some of the common factors that affect these groups equally include the conditions within the detention center, such that it resembles a prison-like environment rather than feeling like home. For children specifically, emotional distress can result from the loss of the parent-child bond (if they are separated from their parents), loss of education and activities, and interference with normal stages of development. Below is a summary of signs of distress or mental health problems (primarily in children and adolescents but also in adults).
Problems in Children, Adolescents, and Adults
Problems with normal brain development due to chronic stressIssues with problem solving and emotional regulationPoor educational attainment and delays in language developmentBeing easily startled or constantly on alertFeeling as though adults or persons in authority can’t be trustedA failed sense of morality and justiceFrequent crying spells and temper tantrumsConduct problems or not getting along with other peersPhysically fighting with peersFailure to eat or weight lossFeelings of confusion and hopelessnessSelf-harm and suicidal thoughtsInability to concentrate and respond to social cues
Problems Specific to Adults
Worrying about their own stress affecting their childrenBeing unable to comfort their childrenLoss of authorityInability to provide normalcy to their children (e.g., cooking a family meal)
Factors Affecting Mental Health
It’s important to understand the factors that influence detainees’ mental health prior to and during their detainment. Below are some of the factors that are involved.
Duration of Detention
Research has shown that detention duration was positively associated with the severity of mental symptoms. This means that the longer children, adolescents, and adults spend in a detention center, the more likely it is that they will experience severe mental health effects.
Trauma Prior to Detention
In that same 2018 review study, it was shown that greater trauma exposure prior to detention was also linked to the severity of symptoms. In countries such as Guatemala and Honduras, families often grow up in extreme poverty and have already been victims of violence—this is part of their reason for leaving. Many have faced trauma in their country of origin, and may also have witnessed the police or government being involved in or failing to act against criminal activity. Add on top of this trauma the long and arduous journey many of these families have made through Mexico to reach their destination, and it’s easy to see that they are already in a vulnerable position.
Prison-Like Setting
In addition to the duration of stay and past trauma, the conditions within the detention center can also play a role in the development of mental health symptoms or effects. Beyond basic aspects of survival, the prison-like environment with guards, fences, and harsh lighting create a stressful atmosphere that can make detainees feel as though they are criminals. Strict schedules that don’t allow for adequate time outdoors or recreation can also interfere with mental health and compound trauma. Furthermore, young children may end up being cared for by older children since inadequate care is available. All of these factors interact to predict the inevitability of deteriorating mental health.
Well-Being of Parents and Child-Parent Connection
Finally, one factor specific to children is the well-being of their parents. When parents are unable to provide for their children as normal parents do (e.g., cooking dinner, enjoying recreational activities together), they may feel a sense of loss and hopelessness. When a parent’s mental health is compromised, this also impacts their children rather than being an isolated effect. Similarly, when a child is separated from their parents, both of their mental health will naturally suffer. Children separated from their parents are likely to experience feelings of loss, separation anxiety, and hopelessness.
How to Improve Conditions
Based on what has been learned from the various research studies, how can conditions within detention centers be improved to reduce negative effects on the mental health of detainees? Or, said another way, what alternatives can be introduced to mitigate the mental health effects that are currently being seen among those held in detention centers? Should detention centers be eliminated altogether or is there a way to set them up properly?
Children and Families Should Not Be Detained
When considering the most basic principles, children should not be held in detention centers for immigration reasons because of the intense psychological burden. At the same time, families should not be separated because of the mental health effects on the children. Instead, families should be on parole in the community while awaiting their legal proceedings. This is a more economical strategy that limits exposure to facilities and maintains contact within family units. It allows families to maintain their connections especially given the strong emphasis on family as a cultural value within the Latino community, this should be seen as of paramount importance. Rather than holding immigrants waiting for proceedings as prisoners, there should be a system put in place to give them the best possible chance at overcoming the trauma they have already endured. One exception to this situation would be when a court deems a child to be in danger if remaining within the family unit. In this case, a court may choose to separate a child from a family.
Detention Length Should Be Minimized
It goes without saying that the length of detention should be minimized. The Flores Settlement Agreement enacted in 1997 limited the length of time that children could be detained when crossing the border to 20 days. However, the American Academy of Pediatrics issued a statement that no amount of time spent inside a detention facility is safe for children. Instead, transfer to other agencies such as the Department of Health and Human Services (HHS) and US Immigration and Customs Enforcement (ICE) should be swift.
Detention Centers Should Be Converted to Campuses
Instead of resembling prison facilities, detention centers should instead be converted to resemble college campuses. These campuses should allow detainees the freedom to roam without fences, cages, or guards. They should also provide adequate living conditions and basic amenities to ensure the safety of those who are being held.
Education and Services Should Be Accessible
Finally, these campuses should provide detainees with adequate access to basic services. These services should include the following. Education and Training Currently, children and adolescents held in detention do not have adequate access to education. In addition, adults do not have access to training. Both education and training should be available and accessible to detainees who wish to access these services. Healthcare Services Those being held in detention centers should have adequate access to healthcare services for themselves and their families. Given language and cultural barriers, there should be adequate support to ensure that they understand all services that they are offered. They should also have the right to refuse services or to ask for clarification if they are confused about what is being offered. Counseling Support Those in detention should have access to social services and counseling support. Many of these individuals and families have survived trauma and are vulnerable populations. Identifying those individuals most at risk for mental health issues and providing them with adequate support should be of paramount importance. These populations should also be protected from further trauma by ensuring that they are protected from further violence or abuse within the detention centers. Childcare Services Instead of older children caring for younger children, adequate childcare services should be provided for children in need of care. While the ideal scenario involves no time in detention for children, realistically childcare support should be provided given the probability of delays in transferring migrants to appropriate services. Language Interpreters As mentioned previously, language support in the form of interpreters or translators is a necessary service within detention centers. Such services would reduce the mental fatigue of detainees when navigating the various services that would be accessed during detainment. This should include Spanish-language support as well as support for those who speak other languages. Legal Services Finally, detainees should have access to legal support and services during their time spent in detention centers. Again, this would require the involvement of language interpreters.
Why Change Is Needed
It is obvious that the current climate of detention centers is detrimental to the mental health of those passing through the borders traveling from Latin American countries. Not only are these individuals already susceptible to mental health effects due to their previous trauma in their country of origin, but they are subject to feeling like criminals upon landing in the United States.
A Word From Verywell
Rather than enacting a zero-tolerance policy to strip parents of their children in the hopes of deterring migrants from entering the country, an improved system would anticipate the needs of those seeking asylum and adequately provide support. This system would make use of community-based sponsorships and parole situations, to ease the burden on immediate detention facilities. This system would also invest more in resources to support what is happening at the border, rather than attempting to deter asylum seekers. It is clear that being in a detention center in the United States is a more appealing option to those fleeing their home countries than the violence and threat that they were escaping. The job of a nation such as the United States is not to turn its back on neighbors in need, but rather to create a system that adequately supports those seeking refuge. Anything short of this can only be viewed as intentional disregard for those most vulnerable in this situation—the children.
