How Separating A Child From Their Parents Affects Their Health

On Wednesday 20th June the American Medical Association released an official statement about President Trump's "zero tolerance" separation policy. "On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to strongly urge the federal government to withdraw its 'zero tolerance' policy that requires the separation of migrating children from their parents or caregivers," wrote James L Madara, MD, the CEO of the AMA. "Instead, we urge the Administration to give priority to supporting families and protecting the health and well-being of the children within those families."

The AMA — which is the largest organisation of MDs, DOs, and medical students in the country — is one of the last major medical groups to denounce Trump's plan. So far, the American Public Health Association (APHA), the American Psychological Association (APA), the American Academy of Pediatrics (AAP), the American College of Emergency Physicians (ACEP), the American College of Physicians (ACP), and the American Psychiatric Association (APA) have all released statements highlighting the serious health implications of separating children from their parents.

What's clear from these statements is that the mental and physical effects of this separation policy are severe and lasting. As one doctor wrote in an op-ed for Slate, "Childhood is planet-size foundation upon which the sapling of adult life is created. And from a medical perspective, those few childhood years exert an outsize influence on both physical and mental health." The extent of damage that this policy will cause remains to be seen. But here's how these policies will affect children's health, according to the statements from seven national medical groups.

According to the APA, separating parents and children at the border can contribute to post traumatic stress disorder or other mental health disorders down the line. The level of stress that occurs when a child is separated from their parents is reaches traumatic levels, according to the ACP. And the longer that parents and children are separated, the worse the symptoms of anxiety and depression are for kids. Not to mention, immigrants who are in the US may suffer from feelings of stigmatisation, social exclusion, anger, and hopelessness as a result of these policies.

The AAP has strongly opposed the detention of immigrant children for years, citing studies that have shown detention can lead to anxiety, depression, and PTSD. "Conditions in US detention facilities, which include forcing children to sleep on cement floors, open toilets, constant light exposure, insufficient food and water, no bathing facilities, and extremely cold temperatures, are traumatising for children," the AAP wrote. "These are not appropriate places for children." Furthermore, the ACEP president said that children without criminal records whose parents seeking haven in the US are particularly vulnerable, and should "never be placed in detention facilities."

When a young child is exposed to serious stressful conditions (like recurrent abuse, chronic neglect, caregiver mental illness or substance abuse, violence, or repeated conflict) for a prolonged period of time, it's known as "toxic stress,"wrote Colleen Kraft, MD, MBA, FAAP, president of the AAP. Studies have shown that toxic stress essentially "derails development," and the most effective way to prevent it is to reduce the child's exposure to the conditions.

Public health research has shown that family structure, stability, and environment determine a child's health. According to the APHA, separating parents and children "sets the stage for a public health crisis," both now and into the future. Beyond the mental and physical effects, separating a child from their parent means they'll lose "critical health information that only parents would know about their children’s health status," the APHA wrote. For infants and parents who are breastfeeding, this can undo maternal bonding that's crucial for development.