No amount of detention is safe for a child. Here are better solutions for migrant kids.
As a Spanish-speaking hospital pediatrician in San Antonio, I have cared for migrant and asylum-seeking youth during many stages of their journeys. I can appreciate the challenge of serving unaccompanied kids in an institutional setting, because — in the hospital — I have a similar role.
In hospitals, strange adults walk in and out of kids’ bedrooms at all hours. This would be unnerving for anyone, but for a child without a parent at the bedside it is also dangerous, putting kids at risk for heightened anxiety, panic and — at worst — physical and sexual assault.
The situation is even worse in detention centers. In fact, the Office of Refugee Resettlement has documented thousands of complaints of children being abused and assaulted in detention centers.
Because kids at Carrizo Springs will officially be in the custody of ORR, rather than immigration or Border Patrol agencies, the facility is technically a shelter. But shelters have problems, too, and must be understood as an extension of child detention: BCFS, the nonprofit that will run the Carrizo Springs facility in cooperation with ORR, has been named in some of the allegations of assault on children, and has also faced criticism for inhumane conditions at a BCFS-run “tent city” — which was also technically a shelter — for migrant children in Tornillo, Tex.
Many migrant children have witnessed murders, experienced torture, lost family members to violence, and suffered physical and sexual assault during their journeys, so in the hospital I do my best to provide trauma-informed care. Despite my efforts, kids recognize me as a stranger who won’t be in their lives for long, and they rarely trust me enough to begin a process of psychological healing.
Even if the authorities at Carrizo Springs adopt trauma-informed practices, they will encounter the same barriers I do: The structure of detention itself is traumatic. Experts have found that even brief periods of detention lead to long-term psychological harm to children. (Hospitals do the same, with long hospitalizations often leaving both kids and parents with symptoms of post-traumatic stress disorder.)
Advocates for prison reform have long pointed out that building new or “nicer” prisons does not address the fundamental problems that imprisonment creates. New prison beds get filled, and tend to stay filled. The same is true for migrant detention centers (though it is important to note that seeking asylum is internationally recognized as a human right, not a crime).
With the appointment of Alejandro Mayorkas as homeland security secretary and this week’s news that Texas’ family detention centers may be transitioned to rapid-processing facilities, we have reason to believe that the Biden administration genuinely aspires to a more humane approach to asylum-seeking families. When it comes to unaccompanied children, however, the reactivation of Carrizo Springs suggests that we are continuing the fundamentally unsafe practice of large-scale child detention.
There is an alternative to the detention of migrant children — community-based management, which is recommended by the AAP. In this model, we would immediately help those children who have family members living in this country complete their journeys. We would initiate high-contact case management and provision of medical and social services to ensure children’s ongoing safety, because our biggest fear is unwittingly delivering kids into the hands of human traffickers. This would be expensive, but likely no more so than our current system: The new Carrizo Springs facility costs an estimated $775 per child per day.
A minority of migrant children arrive without a family sponsor already living in the United States. Placing these kids in stable homes will take time. But while they wait, community-based shelters run by experienced child advocates in partnership with the Office of Refugee Resettlement should be the model for their housing.
During my residency training in pediatrics, I helped care for unaccompanied minors at one such model shelter, YouthCare’s Casa de los Amigos in Seattle. As much as those children wanted to move along to families, they nevertheless felt safe and cared for there. Because Casa is in a major population center (rather than a tiny desert town like Carrizo Springs), children had ample access to services and advocates, and there was community oversight of their well-being.
Supporters of the current plan appreciate that pediatricians have been brought in to advise the Biden administration, and hope that the facility at Carrizo Springs is, in fact, a “temporary influx center.” I hope they are correct, but there is good reason to fear that this facility will not be temporary. We cannot accept minor revisions to the inhumane policies of the preceding administration; we must devise community-based solutions to safely welcome and care for unaccompanied migrant children.
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