The zero tolerance immigration policy implemented by the Trump Administration in spring 2018 — which enforced laws stating that children and parents who illegally immigrated into the United States must be separated at the border — resulted in divisive political commentary that further delineated the line between parties. The morality of such an issue has been hotly debated; however, the health impact associated with separation and detention has been little explored.

A statement from the Henry J. Kaiser Family Foundation highlighted the psychiatric and physiologic health implications associated with both the enforced policy and the recently signed Executive Order by President Trump which allows immigrant families to be detained together for a specific length of time.

Under the zero tolerance policy, families who were apprehended crossing between border checkpoints were detained, with children separated from their parents and placed in an Office of Refugee Resettlement (ORR) facility, with US-based relatives, or in foster care. A previous court ruling (Jenny Lisette Flores v Janet Reno) established various health standards for ORR-related facilities, which include dental care, family planning services, special diets, mental health interventions, and prescribed medications. Despite this initiative, many children and their families who are separated may experience exacerbation of previously established trauma, primarily because of the violence witnessed and experienced in their homelands.

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Numerous reported behavioral changes that commonly occur in children separated from their families after immigration through improper channels, including increased fear and anxiety, frequent crying, eating and sleeping difficulties, and withdrawal or anger. Regression, and sometimes reversal, of developmental milestones were also reported.

Psychiatric distress, including depression and posttraumatic stress disorder, are also commonly reported among separated and detained parents and children who are seeking asylum. The long-term results of this stressful situation may also affect coping skills and future stress management skills, according to the authors, which can ultimately play into future heart disease and cancer risks.

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“Focus groups conducted in Fall 2017 found that these policies, along with rising anti-immigrant sentiment, are leading to resounding levels of fear and uncertainty among immigrant families including those with lawful status,” the Kaiser Foundation statement explained. “Further, this fear and uncertainty are having significant negative effects on the health and well-being of children in immigrant families already present in the US, who are largely US-born citizens.”


The Henry J. Kaiser Family Foundation. Key Health Implications of Separation of Families at the Border (as of June 27, 2018). Published June 27, 2018. Accessed July 12, 2018.