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Detained migrant children suffer ‘trauma after trauma,’ say pediatric experts

The numbers of immigrant children being detained by U.S. authorities at the U.S.-Mexico border have dropped in recent months. Still, medical professionals continue to articulate concerns about the harmful effects that any detention can have on both the short- and long-term health of these kids. Amna Nawaz reports and talks to Alan Shapiro of the Albert Einstein College of Medicine.

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  • Judy Woodruff:

    The numbers of immigrant children being detained by U.S. authorities at the U.S.-Mexico border have dropped in recent months.

    But, as Amna Nawaz reports, medical professionals continue to raise concerns about the harmful effects any detention can have on both the short-and long-term health of these young people.

  • Amna Nawaz:

    That's right, Judy.

    Medical doctors and child psychologists agree that the stress children endure during even short periods of detention poses very real risks, physically and emotionally.

    Dr. Alan Shapiro is a clinical professor in pediatrics at the Albert Einstein College of Medicine and co-founder of Terra Firma. That's a group that promotes access to health care and other services for immigrant children. He's also part of a group of physicians meeting with lawmakers on the subject.

    Dr. Shapiro, welcome to the "NewsHour."

  • Alan Shapiro:

    Thank you for inviting me.

  • Amna Nawaz:

    Let's start with where migrant children would first be taken into custody, along some of these Border Patrol detention and processing centers.

    You're a child welfare expert. From your perspective, can children safely be held there?

  • Alan Shapiro:

    Well, the short answer to that is no.

    And, you know, what's so important for everyone to think about is that children arrive at our border who are traumatized from violence that they have experienced in their home community, an arduous journey thousands of miles that they took to get to the U.S. border.

    So they're — they're traumatized and they're stressed. And when you think about, where would you want to put a child like that, you don't want to put a child in a freezing cold cell, or in a warehouse that's filled with cages, and that doesn't have the right mix of staff to actually take care of them.

    Really, these processing stations are the worst and the last place you would ever want to put a child.

  • Amna Nawaz:

    I should say, I have spent time in some of those facilities, and Border Patrol officers will be the first to tell you, we are not equipped to handle children.

  • Alan Shapiro:


  • Amna Nawaz:

    These are cramped, windowless, cell-like areas.

    But explain to us, because we talk about this a lot, what exactly is it that's harmful to children? What's happening in a child — in a child's mind, to their emotional, physical well-being when they're held in these kind of facilities even for short periods of time?

  • Alan Shapiro:


    So, the facility I went to was Ursula in McAllen, Texas. There were a thousand people in cages in that facility. There were no parents that were there for children. There was no one to help mitigate that stress.

    Plus, the conditions themselves in detention are harmful to children, which, unfortunately, is why that has contributed to the death of some children in the past year. They do not have medical facilities for children. They do not have proper food.

    The temperatures are freezing cold, and they're sleeping oftentimes on the floor. That is not a safe, sanitary place for a child to be kept.

  • Amna Nawaz:

    That stress that you mentioned, though, what kind of effect can that have on a child's well-being, both short-term or long-term? How does that manifest itself?

  • Alan Shapiro:


    So stress has both short-term and long-term effects on children. In the short-term, what we see is children with regressive behavior. We might see a child that had mastered bed-wetting and now all of a sudden is wetting themselves, children who become withdrawn, children who stop speaking.

    All of the things that you see in a child with acute stress, we can see, we do see in these detention facilities. So what happens is, when a child is under stress, they're levels of hormones and stress hormones rise. So, cortisol, it's one of those stress hormones that rise, right?

    That rise of stress hormones is there to protect them. That's that fight-or-flight experience that you have. Then we want those hormones to go down and for children to relax and then to go back to their baseline, and allows them to go on once they feel safe.

    If a child is constantly feeling at danger, those stress hormones never go down. And that's what leads to long-term chronic medical problems, learning problems, developmental problems and growth.

  • Amna Nawaz:

    I mean, all of these detention centers are not exactly equal.

    And I wanted to ask you about one type of facility in particular. They're called family residential centers.

  • Alan Shapiro:


  • Amna Nawaz:

    Because, obviously, many of these children are actually detained with the parent or legal guardian with whom they arrived.

    I actually asked Homeland Security Acting Secretary Kevin McAleenan about some of those centers, about the care of children in those centers when he was here.

    Here's what he had to say.

  • Kevin McAleenan:

    These centers were built, purpose-built, to house families during their immigration proceedings. Again, they have educational facilities, recreational, dining, medical.

    And they're appropriate settings for people to spend a period of time in while they go through the immigration proceedings.

  • Amna Nawaz:

    Dr. Shapiro, administration officials say these are appropriate settings, they're campus-like facilities.

    What's your opinion? Are they appropriate for children?

  • Alan Shapiro:

    So, I have been to every existing family residential center.

    And I will say — I hate to put it this way, but he's dead wrong, and he's wrong from a child welfare perspective. These facilities are prison-like. Families are treated like prisoners. Parents are not allowed to freely parent their children in the way that they want to.

    The facilities are — at the Berks Family Residential Center, where I have been, children and women have flashlights shone in their face every 15 minutes to make sure they're sleeping in their bed. Disrupts their sleep, and it scares them.

    I mean, that is not a facility that we would want our families to live in. You wouldn't want to live there. I wouldn't want to live there. We wouldn't want our families to live there. And, most egregiously, they do not have adequate medical, the mental health services that families need.

    We have to remember, detention itself is traumatizing. And that is why, when I was in those facilities, I saw very regressive behavior in children. I saw teenagers that told me that they were suicidal. I saw parents that told me they were depressed and suicidal.

  • Amna Nawaz:

    Well, let me ask you this, because the administration will say, we have an immigration enforcement job to do. Some kind of detention, for a matter of days, if not weeks, is necessary as we process who these families are, do background checks, et cetera.

    They also say these children already suffered multiple traumas before they have even gotten here. This is a much better environment than the one they came from.

    What do you say to that?

  • Alan Shapiro:

    First of all, trauma is that these children are facing are — is compounded, so it's trauma after trauma.

    Just because you have been badly traumatized in the past doesn't mean that that trauma doesn't continue. And the more trauma you have, the worse your outcome is going to be, worse your mental health, worse your physical health.

    And, remember, we're talking about children who are developing, who are learning. Every one of those traumas interferes with their growth, development and learning.

  • Amna Nawaz:

    So if you could suggest one step the administration could take today that would be in the best interests of these children, what would that be?

  • Alan Shapiro:

    My recommendation would be to free those children, let them into the community and those families into the community as soon as possible.

    And what's very worrisome is that now the administration is recommending that children and these families are kept in long-term detention. I have seen firsthand with my own eyes what can happen to children.

  • Amna Nawaz:

    Dr. Alan Shapiro, thank you very much for being here.

  • Alan Shapiro:

    Thank you so much for inviting me.

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