Detention of Immigrant Children

Abstract

This Policy Statement was reaffirmed November 2022. Immigrant children seeking safe haven in the United States, whether arriving unaccompanied or in family units, face a complicated evaluation and legal process from the point of arrival through permanent resettlement in communities. The conditions in which children are detained and the support services that are available to them are of great concern to pediatricians and other advocates for children. In accordance with internationally accepted rights of the child, immigrant and refugee children should be treated with dignity and respect and should not be exposed to conditions that may harm or traumatize them. The Department of Homeland Security facilities do not meet the basic standards for the care of children in residential settings. The recommendations in this statement call for limited exposure of any child to current Department of Homeland Security facilities (ie, Customs and Border Protection and Immigration and Customs Enforcement facilities) and for longitudinal evaluation of the health consequences of detention of immigrant children in the United States. From the moment children are in the custody of the United States, they deserve health care that meets guideline-based standards, treatment that mitigates harm or traumatization, and services that support their health and well-being. This policy statement also provides specific recommendations regarding postrelease services once a child is released into communities across the country, including a coordinated system that facilitates access to a medical home and consistent access to education, child care, interpretation services, and legal services.

Global Human Trafficking and Child Victimization

“…11 These children are particularly vulnerable if they lack the necessary authorization or documents required under immigration regulations and have been smuggled across an international border; traffickers may subsequently lure them into situations of severe exploitation or circumstances of debt, bondage, or other abuses and maintain control over them through violence, threats, or economic or psychological manipulation. Unaccompanied children are likely to be reluctant to report abuses to authorities because of concerns of corruption among officials (law enforcement, immigration, consular), highly stressful conditions in Customs and Border Protection processing centers, 43 and the child's fear of arrest and/or deportation. Finally, gender-based violence and discrimination, a cultural assumption that boys cannot be victims, cultural beliefs that children must support the family in crisis, the sexualization and objectification of girls, and weak recognition of children's rights are societal factors that contribute to vulnerability.…”

“…Finally, gender-based violence and discrimination, a cultural assumption that boys cannot be victims, cultural beliefs that children must support the family in crisis, the sexualization and objectification of girls, and weak recognition of children's rights are societal factors that contribute to vulnerability. 4, 36, 38 -40 Although researchers suggest that victims of sex trafficking in the United States are likely to seek medical attention at some point during their period of exploitation, 44,45 trafficked immigrant children detained at the United States border may receive insufficient care, 43 and those trafficked abroad may receive little or no care at all. 46,47 However, it is important for health care professionals all over the world to be alert to possible indicators of sex trafficking, and these are described in detail elsewhere.…”

Infectious Diseases among Refugee Children

“…Strong advocacy efforts and policy statements by the American Academy of Pediatrics provide recommendations for the care of immigrant children following release from detention facilities to address medical and legal needs, education, and interpretation services. [135,136]. Increased funding in conjunction with multi-sector collaboration between governments, nongovernmental organizations, and local community agencies are needed to address the complex social, health, and economic needs of refugee and immigrant children and youth [137,138].…”

Editorial – Introduction to the “Special Issue on Adolescent and Young Adult Refugees and Unaccompanied Minors in Residential Care”

“…Instead, media reports have repeatedly drawn attention to the vulnerability of URMs in residential care settings with reports of abuse and of URMs being placed in crowded detention facilities for undetermined times and, on occasion, with adults (e.g., Burke & Mendoza, 2018). While the extent of these problems is unknown across countries, warnings have been issued by professional groups such as the American Academy of Pediatrics that basic standards and guidelines for care are not being met in the case of URMs (Linton, Griffin, & Shapiro, 2017). It would seem that URMs are particularly vulnerable to be affected by those aspects of residential care that have long been discussed in the literature as being inherently problematic (e.g., Dozier et al, 2018).…”