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Impact of punitive immigration policies, parent-child separation and child detention on the mental health and development of children.

ABSTRACT: In April 2018, the US government introduced a 'zero tolerance' illegal immigration control strategy at the US-Mexico border resulting in the detention of all adults awaiting federal prosecution for illegal entry and the subsequent removal of their children to separate child shelters across the USA. By June 2018, over 2300 immigrant children, including infants, had been separated from their parents for immigration purposes. Media reports and scenes of distraught families ignited global condemnation of US immigration policy and fresh criticism of immigration detention practices. Detention of children for immigration purposes is known to be practised in over 100 countries worldwide, despite a significant body of research demonstrating the extensive harm of such policies. This review explores and contextualises the key potential impacts of family separation and detention of children for immigration purposes including damaged attachment relationships, traumatisation, toxic stress and wider detrimental impacts on immigrant communities. As such, it is critical for host nation governments to cease the practice of family separation and child detention for immigration control and promote postmigration policies that protect children from further harm, promote resilience and enable recovery.

SUBMITTER: Wood LCN

PROVIDER: S-EPMC6173255 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Impact of punitive immigration policies, parent-child separation and child detention on the mental health and development of children.

Wood Laura C N LCN

BMJ paediatrics open 20180926 1

In April 2018, the US government introduced a 'zero tolerance' illegal immigration control strategy at the US-Mexico border resulting in the detention of all adults awaiting federal prosecution for illegal entry and the subsequent removal of their children to separate child shelters across the USA. By June 2018, over 2300 immigrant children, including infants, had been separated from their parents for immigration purposes. Media reports and scenes of distraught families ignited global condemnati ...[more]

PMID: 30306145

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Project description:BackgroundThe number of asylum seekers, refugees and internally displaced people worldwide has increased dramatically over the past 5 years. Many countries are continuing to resort to detaining asylum seekers and other migrants, despite concerns that this may be harmful. In light of the considerable body of recent research, this review aims to update and expand on a 2009 systematic review on the mental health consequences of detention on adult, adolescent and child immigration detainees, which found (on the basis on 9 studies) that there was consistent evidence that immigration detention had adverse effects on mental health.MethodsThree databases were searched using key terms relating to immigration detention and mental health. Electronic searches were supplemented by reference screening. Studies were included if they were quantitative, included individuals detained for immigration purposes, reported on mental health problems and were published in peer-reviewed journals. Two reviewers independently screened papers for eligibility, and a further two reviewers completed quality appraisals for included studies.ResultsTwenty- six studies (21 of which were not included in the 2009 review) reporting on a total of 2099 participants were included in the review. Overall, these studies indicated that adults, adolescents and children experienced high levels of mental health problems. Anxiety, depression and post-traumatic stress disorder were most commonly reported both during and following detention. Higher symptom scores were found in detained compared to non-detained refugees. In addition (and more clearly than was evident in 2009), detention duration was positively associated with severity of mental symptoms. Greater trauma exposure prior to detention was also associated with symptom severity.ConclusionsThe literature base reviewed in this paper consistently demonstrated severe mental health consequences amongst detainees across a wide range of settings and jurisdictions. There is a pressing need for the proper consideration of mental health and consequent risk of detention-related harm in decisions surrounding detention as well as for improved care for individuals within detention facilities. Recommendations based on these findings are presented, including increased focus on the identification of vulnerability and on minimising the duration of detention.

Project description:Introduction:Immigration detention has a profound and negative impact on the physical health, mental health, development and social-emotional well-being of children, adolescents and their families. Australian clinicians will report results from detailed health and well-being assessments of asylum seeking children and adolescents who have experienced prolonged immigration detention. Methods and analysis:This is a national, multicentre study with a longitudinal cohort design that will document health and well-being outcomes of the children and adolescents who have been detained in offshore detention on the remote island of Nauru. Outcome measures will be reported from the time arrival in Australia and repeated over a 5-year follow-up period. Measures include demographics, residency history and refugee status, physical health and well-being outcomes (including mental health, development and social-emotional well-being), clinical service utilisation and psychosocial risk and protective factors for health and well-being (eg, adverse childhood experiences). Longitudinal follow-up will capture outcomes over a 5-year period after arrival in Australia. Analysis will be undertaken to explore baseline risk and protective factors, with regression analyses to assess their impact on health and well-being outcomes. To understand how children's outcomes change over time, multilevel regression analysis will be utilised. Structural equation modelling will be conducted to explore the correlation between baseline factors, mediational factors and outcomes to assess trajectories over time. Ethics and dissemination:This research project was approved by the Sydney Children's Hospitals Network Human Research Ethics Committee. Subsequent site-specific approvals have been approved in 5 of the 11 governing bodies where the clinical consultations took place. In order to ensure this research is relevant and sensitive to the needs of the cohort, our research team includes an asylum seeker who has spent time in Australian immigration detention. Results will be presented at conferences and published in peer-reviewed Medline-indexed journals.

Project description:BackgroundMany civil liberties organizations have raised concerns that substandard medical care in United States Immigration and Customs Enforcement (ICE) detention facilities have led to preventable deaths. The 2018 Department of Homeland Security Appropriations Bill required ICE to make public all reports regarding in-custody deaths within 90 days beginning in Fiscal Year (FY) 2018. Accordingly, ICE has released death reports following each in-custody death since April of 2018. This study describes characteristics of deaths among individuals in ICE detention following the FY2018 mandate.MethodsData was extracted from death reports published by ICE following the FY2018 mandate. Causes of death were categorized as suicide or medical, and medical deaths as COVID-19-related or not. Characteristics were compared between medical and suicide deaths, and among medical deaths between COVID-19-related and non-COVID-19-related deaths. Additionally, death rates per person-year and per 100,000 admissions were calculated for FY2018, 2019, and 2020 using methods from prior work evaluating deaths among detained immigrants in the United States.ResultsSince April 2018, 35 individuals have died in ICE detention. The death rate per 100,000 admissions in ICE detention was 2.303 in FY2018, 1.499 in FY2019, and 10.833 in FY2020. Suicide by hanging was identified as the cause of death in 9 (25.7%), and medical causes in the remaining 26 (74.3%). Among 26 deaths attributable to medical causes, 8 (30.8%) were attributed to COVID-19, representing 72.7% of 11 deaths occurring since April 2020.ConclusionsThe death rate among individuals in ICE detention is increasing amidst the COVID-19 pandemic. Potentially preventable causes of death including COVID-19 and suicide contribute to at least half of recent deaths. Findings suggest that individuals detained by ICE may benefit from improved psychiatric care and prevention measures to combat suicide, as well as increased infection control efforts to reduce mortality associated with COVID-19.

Project description:BackgroundParent-child separation is a considerable adversity for left-behind children (LBC), but there is little evidence on the association between detailed characteristics of parent-child separation and social-emotional development among LBC. This study examined the characteristics of parent-child separation and its impacts on developmental delay among under-3 LBC in poor rural China.MethodsWe used data from 811 LBC surveyed in five poor counties in rural China in 2018. Detailed characteristics of their parental migration were recalled by their primary caregivers in face-to-face interviews. The children's social-emotional development was measured by using the Ages and Stages Questionnaire: Social-Emotional. Logistic regression was employed to examine the association of detailed characteristics of parent-child separation with early social-emotional problems after adjusting for the children's and primary caregivers' sociodemographic characteristics.Results287 (35.4%) children were left behind by fathers and cared for by mothers (FM-MC), while 524 (64.6%) were left behind by both parents and cared for by grandparents (PM-GC). The rate of social-emotional problems among LBC was 36.8% (PM-GC vs FM-MC: 40.6% vs 29.5%; aOR 1.51, 95% CI: 1.06 to 2.16). For paternal migration, the medians of the child's age at the first migration and average duration per migration were 3 months (IQR: 1 to 9 months) and 4.48 months (IQR: 2.38 to 7.54 months), respectively. For maternal migration, the corresponding values were 9 months (IQR: 6 to 13 months) and 4.65 months (IQR: 2.71 to 7.62 months), respectively. On average, LBC had been separated from fathers for 72% of their life due to paternal migration and from mothers for 52% of their life due to maternal migration. No significant association was found between the detailed characteristics of paternal migration and social-emotional development among LBC, while social-emotional problems among LBC were significantly associated with the proportion of cumulative duration of maternal migration in the child's lifetime (aOR 2.83; 95% CI: 1.13 to 7.10).ConclusionsLBC under 3 years had a high risk of social-emotional problems in poor rural China. Cumulative exposure to maternal migration may be detrimental to LBC's early social-emotional development. Programs are necessary to support these children as well as their families.

Project description:BACKGROUND:Detained asylum seekers are at increased risk of self-harm, and the type of detention in which they are held may further exacerbate this risk. In Australia, there are four types of closed (or held) immigration detention for people seeking asylum, with varying levels of security and supports: Immigration Detention Centres [IDCs], Immigration Transit Accommodation [ITAs], Immigration Residential Housing [IRH], and Alternative Places of Detention [APODs]. The objective of this study was to examine the variation in the incidence and method(s) of self-harm among asylum seekers in Australian onshore immigration detention, according to the type of detention in which they are held. METHODS:We obtained data on all self-harm incidents reported among asylum seekers in Australian onshore immigration detention according to held detention type, as well as individual facility, between 1 August 2014 and 31 July 2015, by Freedom of Information. We calculated self-harm episode rates per 1000 asylum seekers using the average population figures for held detention type, as well as for each individual facility comprising the main types of held detention. Method(s) used to self-harm was also extracted for the main sub-populations. RESULTS:The study included 560 episodes of self-harm. Individual facility rates of self-harm ranged from 91 per 1000 asylum seekers (95% CI 72-110) in Yongah Hill IDC to 533 per 1000 asylum seekers (95% CI 487-578) in Perth IDC. On average, calculated self-harm episode rates were highest among asylum seekers in: Immigration Transit Accommodation facilities, 452/1000 (95% CI 410-493); Alternative Places of Detention, 265/1000 (95% CI 233-296); and Immigration Detention Centres, 225/1000 (95% CI 195-254). The most frequently reported methods of self-harm across the main types of held detention were: cutting (35.2%), self-battery (34.8%), and attempted hanging (11.1%). CONCLUSIONS:Self-harm rates for asylum seekers in all types of closed immigration detention were many times higher than rates found in the general population. Average rates were not lower in facilities with lower security features.

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Impact of punitive immigration policies, parent-child separation and child detention on the mental health and development of children.

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Impact of punitive immigration policies, parent-child separation and child detention on the mental health and development of children.

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