In an effort to deter immigrants from attempting to enter the United States, the Department of Homeland Security (DHS) and the Department of Health and Human Services (HHS) have proposed new regulations that would replace the standard of care for non-citizen children in the United States.

“We believe that this proposal presents a grave and urgent risk to the health and well-being of non-citizen children and their families and would have important negative consequences for the United States,” wrote Ryan Matlow, PhD, and Daryn Reicherter, MD, of the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine in Palo Alto, California, in a perspective piece published in the New England Journal of Medicine.

Drs Matlow and Reicherter lay out alternatives to the proposed regulations and call on health professionals to take action.

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The proposed regulations are likely to result in a litany of traumatizing experiences for young children that may well lead to long-term psychological harm. For example, facing constant stress and trauma in childhood can lead to psychological dysfunction. Research has shown that the DHS facilities are not adequate and do not meet the basic standards of care for children.

Drs Matlow and Reicherter advise both DHS and HHS to address the issue of a large number of immigrants coming into the United States in a way that will not have a negative impact on people for the rest of their lives. To do this, they recommend upholding the current standards from the 1997 Flores Settlement Agreement and following additional guidelines set by the Substance Abuse and Mental Health Services Administration.

This public health issue is something that healthcare professionals can help solve.

“Health professionals have an immediate opportunity to relay concerns about the harms associated with recent and proposed changes to U.S. immigration policy by means of policy advocacy and engagement with legislative representatives,” the investigators concluded.

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Matlow R, Reicherter D. Reducing protections for noncitizen children — exacerbating harm and trauma. N Engl J Med. 2019;380:5-7.