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Parents Experience Severe Psychological Trauma Four Years After Family Separation by the U.S. Government: PHR Report

U.S. government obligated to provide reparations and rehabilitation to families due to its violations of domestic and international law

Three to four years after being separated from their children by the U.S. government, deported asylum-seeking parents continue to endure severe psychological trauma, according to a new investigation published today by Physicians for Human Rights (PHR). The report’s findings underscore the U.S. government’s unfulfilled obligation to provide remedy, rehabilitation, and redress to survivors of family separation.  

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All 13 parents who received psychological evaluations by PHR expert-clinicians met diagnostic criteria for at least one mental health condition linked with the trauma of family separation. A large majority of parents received a diagnosis of post-traumatic stress disorder (11 of 13). Other diagnoses included major depressive disorder (10 of 13), generalized anxiety disorder (5 of 13), trauma related disorder (1 of 13), and adjustment disorder with mixed anxiety and depressed mood (1 of 13). 

‘Part of my heart was torn away’: What the U.S. Government Owes the Tortured Survivors of Family Separation” is the first study to-date to document the psychological impacts of family separation on parents three to four years after being separated from their children and deported by U.S. officials during the Trump administration. The report is also the first to assess separated parents’ wishes regarding redress and accountability, shedding light on what forms of reparations separated parents seek from the U.S. government.  

“The psychological evaluations conducted by PHR clinicians show that separated families continue to endure significant distress, functional impairment, and mental health disorders,” said Michele Heisler, MD, MPA, medical director at PHR and professor of internal medicine and public health at the University of Michigan, who conducted an evaluation for the report. “This ongoing trauma is a consequence of being forcibly separated from their children by the U.S. government and later deported to face persecution in their countries of origin.” 

“These new findings make it clear that reparations and redress are not an optional policy choice. It is the bare minimum fulfilment of the U.S. government’s obligation owed to victims as a result of its violations of international and domestic law,” added Dr. Heisler. 

At least 3,951 children were separated from their families during the Trump administration, according to the White House Interagency Task Force for the Reunification of Families. At least 324 children are in the process of being reunified as of February 2022, while 1,228 children have not been reunified with their parents. After calling family separation “criminal” during the presidential campaign and vowing to restore “humanity” to the asylum system, the Biden administration abruptly walked away from settlement negotiations with separated families in December 2021. Families have been left in legal limbo, vulnerable to deportation and with no access to permanent immigration status. While previous court rulings have required the U.S. government to reunify families and provide rehabilitative services, many families remain separated, lack access to health care, and have not received the redress or reparations owed to them by the U.S. government.  

For this study, clinicians across specialties (including psychiatry, psychology, neurology, pediatrics, and others) conducted in-depth psychological evaluations of 13 parents who were separated by the Trump administration in 2017-2018 and later were deported to their countries of origin, including El Salvador, Guatemala, Honduras, and Mexico. At the time of the evaluations (March and April 2021), 11 of the 13 parents had still not been reunited with their children. Clinicians compared symptoms with criteria from the Diagnostic and Statistical Manual of Mental Disorders and/or used validated Spanish versions such as PCL-5, GAD-7, and PHQ-9, which are used to preliminarily diagnose disorders and assess severity of symptoms.  

The 13 parents may not be representative of all separated and deported parents, as they were referred to PHR by Al Otro Lado, a civil society organization based in Tijuana, Mexico that provides legal representation to refugees, asylum seekers, and other migrants. However, given that survivors of family separation are hard to reach, dispersed across countries, highly traumatized, and frequently in hiding, the study offers an important window into the lived experiences of people harmed by U.S. immigration policy and what they seek in terms of redress and reparations.  

The study sheds light on the parents’ experiences of separation, deportation, and the ongoing trauma they and their children endure. Almost universally, parents noted continued disturbances in sleep, nightmares, loss of appetite, loss of interest, fear for the future, constant worry, hopelessness, and loss of the ability to concentrate. One mother said being separated from her daughter felt like something “choking me from the inside.” Another parent stated that the separation felt like physical pain because his son was “part of my heart that was torn away from me.” One mother said, “I don’t know if I will ever be able to recover from what I have experienced.”  

PHR’s expert evaluators noted that the trauma suffered by the parents and the children warranted further intervention and ongoing therapeutic support, because the events were causing significant distress and ongoing functional impairment. The interventions most frequently recommended included trauma-focused psychotherapy, supportive therapy, and psychiatric care to consider treatment with medications. 

“Even compared to other highly traumatic experiences like assault, many parents said that family separation was the worst thing they’ve ever experienced,” said Ranit Mishori, MD, MHS, senior medical advisor at PHR, professor of family medicine at Georgetown University Medical School, and report co-author. “U.S. officials forcibly separated parents from their children, causing extreme pain and suffering, to coerce them into giving up their asylum claims. For these reasons, the cases that PHR documented meet the legal definition of torture. As a perpetrator of torture, the U.S. government is obligated to provide prompt and effective redress to survivors, including the psychological rehabilitative services that this study shows are urgently needed.” 

Clinicians also asked the 13 affected parents their perspectives on measures of reparation, including: reunification and immigration status in the United States as a form of restitution and guarantee of non-repetition, financial compensation, medical and mental health treatment as rehabilitation, and measures such as a public apology, investigation, and criminal prosecutions as measures for satisfaction and guarantees of non-repetition.  

Broadly, most parents expressed support for a formal public apology by the government, an investigation such as a truth commission, financial compensation and funding for rehabilitation expenses, legal reforms to prevent repetition, and permanent immigration status in the United States, to ensure that they would not be separated from their children again. Support for criminal prosecution of the officials who designed and implemented the family separation policy was mixed. As the report highlights, these measures of restitution are all backed by U.S. law and international treaties ratified by the United States.  

“The severe and persistent effects of family separation mean that survivors’ health, well-being, and self-sufficiency may never fully recover. But by embracing survivor-centered reparations, the U.S. government has an opportunity to atone for its violations, advance healing for the affected families, and show human rights leadership on the international stage,” said Kathryn Hampton, MSt, MA, deputy director of the PHR Asylum Program and report co-author. “The Biden administration should immediately return to the global settlement negotiations it shamefully walked away from in December. Rather than defending Trump’s family separation practices in court, the Justice Department should instead provide redress and rehabilitation, in line with U.S. treaty obligations. Families should be offered permanent immigration status and should be consulted with extensively on other crucial reparations measures, including a formal apology from the U.S. government and a truth commission.” 

A new petition launched by PHR calls on the Departments of Justice and Homeland Security to immediately reunite families that remain separated and to provide compensation to all affected families. 

“’Part of my heart was torn away’: What the U.S. Government Owes the Tortured Survivors of Family Separation” builds on several landmark studies by PHR on the impacts of family separation, including the February 2020 report “’You Will Never See Your Child Again’: The Persistent Psychological Effects of Family Separation,” and a November 2021 article published in PLOS One, “The psychological effects of forced family separation on asylum-seeking children and parents at the US-Mexico border: A qualitative analysis of medico-legal documents.” 

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.

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