A pediatrician’s core professional responsibility is to protect the health and well-being of children. We emphasize prevention, diagnose and treat acute and chronic illnesses and react to emerging conditions. We also do everything in our power to respond to public health threats.
Government-sanctioned family separation, anti-immigrant rhetoric and expanded deportation (including parents of U.S. citizen children) are public-health threats that we could never have imagined. The administration has been carrying out the practice of separating parents and children at the border for months, and it recently formalized the policy as a way to deter families from migrating to the United States. As pediatricians who work in communities rich with immigrant families, we have witnessed first-hand the collateral damage that this practice is having on our own patients and are responding to the mental-health needs of children gripped by fear of their families being ripped apart.
We think of our patients like Jose and Byron,* who grabbed onto their mother’s legs as they sat on the floor of the pediatric clinic. Their mother Maria* shared that authorities had forcibly separated her from her children at the Texas-Mexico border. The children were placed in foster care for several months before she was reunited with them in North Carolina. Maria had fled Honduras after suffering longstanding physical and sexual abuse and direct threats to her and her children’s lives. While seeking safety and a hopeful future in the states, she and her children suffered additional trauma caused by separation.
Highly stressful experiences, like witnessing violence and the separation of children from loving parents, can disrupt children’s brain architecture and affect their short- and long-term health by causing an extreme stress response. Moreover, instead of having the parent present to mitigate the traumatic event, family separation egregiously removes that buffering support. This toxic stress can carry lifelong consequences for children, such as developmental delays, learning problems and chronic conditions such as hypertension, asthma, cancer and depression.
Leading medical and mental-health organizations including the American Academy of Pediatrics, American Medical Association and American Psychological Association have universally spoken out against the practice of family separation. As pediatricians, we echo this opposition and call on our members of Congress to reject the policy of family separation and its systematic harm to children and families, like Jose, Byron and Maria.
Jose wants to be a pediatrician, and Byron is too young to know what he wants to be when he grows up, but loves to read books with his mom. They are similar to other children their age in so many ways, but have endured experiences that no child or family should have to. Jose and Byron do not know why their mother was taken away, and it took them months to reestablish trust in that relationship and in their interactions with others. Their symptoms of anxiety have not yet abated, but we hope that time, reunion with their mother and ongoing support from medical and mental-health professionals will help them to heal.
As immigration discussions continue in our nation’s capital, let us not turn our backs on our shared values. We are a nation of immigrants. We are a nation that values families. Policies that harm children, including the separation of children from their parents, and deny them protection are counter to American values to treat people with dignity, respect and compassion. It is critical that our leaders remember this and oppose any policies that tear families apart.