Almost one year ago, the Trump administration instituted a “zero tolerance” immigration policy, which included family separation at the southern border. Nearly 3000 children were separated from their parents, according to the federal government, although a recent report from the New York Times suggests that that number is too low.1

During this time, reports indicated that many children were being given psychotropic drugs to help with trauma after the separation, without their parents’ consent. These actions led to an April 2018 lawsuit under jurisdiction of the Flores Settlement, which established welfare standards for children in detention centers.

“In the absence of further government regulations and laws on the matter, [the Flores Settlement Agreement] has acted as the binding authority on issues concerning detention of immigrant children,” wrote Scott J. Schweikart, MD, MBE, in an article published in the AMA Journal of Ethics. “[It] has become increasingly relevant during the 2018 border crisis.”2

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The 2018 Flores Settlement Suit says that the US government is in violation of the Flores Settlement for a number of reasons, including giving children psychotropic medication as a means of control instead of providing proper health care. The suit says “the potential for abuse — including using drugs as ‘chemical straight-jackets’ to control children, rather than to treat actual mental health needs — is unacceptably high.” Side effects from the medications can cause depression, dizziness, and other potential long-term harm.

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The suit also said that these medications are being administered without parental consent. Without this consent and authorization from the parent or guardian, clinicians would not have the legal authority to give children this medication.

“The US government’s administration of psychotropic drugs to children — without parental consent or proper oversight and against the best interests of the child,” said Mr Schweikart, “constitutes unethical, unlawful, and clinically inappropriate practices.”


  1. 1. Jordan M. Family Separation May Have Hit Thousands More Migrant Children Than Reported. New York Times. January 17, 2019. Accessed March 6, 2019.
  2. Schweikart SJ. April 2018 Flores Settlement Suit challenges unlawful administration of psychotropic medication to immigrant children. AMA J Ethics. 2019;21(1):E67-E72.