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Family Separation Trauma Sustained by Asylum-Seeking Children and Parents Persists After Reunification, Medical Study Finds

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Physicians for Human Rights
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New analysis from Physicians for Human Rights finds long-lasting psychological harm sustained by survivors of the “zero tolerance” policy

NEW YORK -- A new study analyzing the mental health impacts of family separation finds that children and parents seeking asylum at the U.S.-Mexico border experience severe psychological trauma even years after reunification. The Physicians for Human Rights (PHR) study provides the first-ever qualitative analysis of the mental health effects of the forced family separation policy and shows further evidence of the "zero tolerance" policy's detrimental effects on the mental health of impacted families.

The study,"The Psychological Effects of Forced Family Separation on Asylum-Seeking Children and Parents at the US-Mexico Border: A Qualitative Analysis of Medico-Legal Documents," published today in the PLOS ONE medical journal, finds that forcibly separating parents and children, especially when compounded with pre-migration traumas, produced signs and symptoms of trauma that met the diagnostic criteria for at least one mental health condition such as post-traumatic stress disorder (PTSD), major depressive disorder (MDD), or generalized anxiety disorder (GAD). The symptoms commensurate with these disorders were present at the time of the family separation as well as the time of the examination post-reunification.

Clinician experts from PHR's U.S. Asylum Program analyzed 31 medico-legal affidavits of children or parents who faced forced family separation while seeking asylum in the United States between July 26, 2018 and December 14, 2019.

"This analysis shows the trauma and agony endured by parents and children who were forcefully separated from one another, and the compounding toll that trauma takes on both mental and physical health, lingers with these individuals for weeks, months and years after they've been reunited," said Dr. Ranit Mishori, PHR's senior medical advisor and co-author of the study. "The forced family separation policy violated human rights, and resulted in severe and long-lasting psychological harm among children and parents who have already faced life-threatening risks in their home countries that have forced them to seek safety in the United States. As the Biden administration seeks to remedy this atrocious policy, these long-standing impacts must be considered."

All parents studied arrived at the U.S. border having already been exposed to significant trauma due to experiencing targeted acts of violence in their home countries. Many were victims of gang-based violence including death threats, physical assault, murder of relatives, extortion, sexual assault, and/or robbery. In each affidavit analyzed for this study, parents feared for their child's life and safety if they stayed within their home country. In almost all cases, their children also had experienced severe harm before fleeing. Gang members drugged, kidnapped, poisoned, and threatened children, including threats of death or bodily harm, if they or their parents did not comply with the gang's demands.

While anti-immigrant actors have pushed false narratives that asylum-seekers embellish claims to obtain asylum, the study also found an absence of signs of malingering in all cases. Clinicians concluded that the 31 parents and children interviewed showed "no evidence of exaggeration or deception," providing accounts that "constitutes an entirely expectable, natural and cohesive psychological story." Evaluations of separated children and parents also provided further evidence of harmful and inhumane treatment by U.S. immigration officials at the U.S.-Mexico border.

This article builds upon the landmark 2020 report by PHR, "'You Will Never See Your Child Again': The Persistent Psychological Effects of Family Separation," and provides further evidence that the practice of forced family separation not only constitutes cruel, inhuman, and degrading treatment consistent with the legal definition of torture, but that the severe psychological trauma associated with separation persists for both children and parents.

Parents reported severe residual effects of sustained trauma including physiological manifestations of anxiety and panic, experiencing "pure agony," emotional and mental despair, and suicidal thoughts. Children exhibited reactions that included behavioral regression, even after reunification.

In one instance, an 8-year-old boy who was separated from his father for three months continued to have nightmares and to meet full diagnostic criteria for both post traumatic stress disorder and separation anxiety disorder today, two years after being reunited with his father. For children and parents who were separated for even longer periods of time, in some cases for several years, the level of trauma and long-term consequences for their overall development could be even more severe.

Interviews with separated children and parents also showed that the conduct of U.S. immigration officials was punitive rather than protective. Asylum narratives detailed in the study documented multiple instances where parents were taunted and mocked by immigration authorities when asking for the whereabouts of their children following forced separation. Half of the parents interviewed by PHR clinicians reported poor living conditions at the detention facilities where they were held, and children also reported being mistreated or living in poor conditions while detained and while in foster care.

As the Biden administration and Department of Justice consider redress options, the study also includes PHR's call to the U.S. government for a multi-system, multi-sectoral support, including health and mental health services, legal services, and reparations for the documented and verifiable trauma inflicted on asylum seekers by this policy. Beyond immediate reunification of parents and children on U.S. soil, PHR calls on the Biden administration to consult affected families regarding the most appropriate means of reparation, including but not limited to a formal apology by the U.S. government, a pathway to permanent legal residence, prosecution of the officials responsible for the policy, and potential monetary settlements for impacted families.

Clinician members of PHR's Asylum Program recommend various trauma-informed adaptations to mitigate harm to children and parents seeking asylum, during the on-going legal process. They outline practices that immigration authorities should incorporate, such as providing additional time to process questions and formulate responses, repeating questions, pre-medicating with anti-anxiety medication, allowing for frequent breaks to rest and allowing children to remain with parents during the interview or allowing parents breaks to see their children.

"Physicians for Human Rights has long documented the detrimental effects of forced family separation on asylum seekers, and the findings of this study provide additional medical evidence that the psychological trauma could potentially be life-long," said Kathryn Hampton, deputy director of Physicians for Human Rights' Asylum Program. "While this fact must be considered when determining legal settlements for victims of the policy, the U.S. government's narrow focus on the determination for an exact dollar amount is a shameful deflection from the critical actions it should immediately commit to -- supporting justice and treatment for survivors of this inhumane policy and reforming the United States' punitive and abusive immigration system so that we never repeat this shameful chapter of American history."

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.