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The looming health crisis for migrant children

The traumas experienced at Border Patrol centers could have life-long psychological effects

Activists protest outside the U.S. Customs and Border Protection's Border Patrol station in Clint, Tex., on Thursday. (Jose Luis Gonzalez/Reuters)

The scenes lawyers have reported witnessing in a Border Patrol facility in Clint, Tex., are shocking: children covered in mucus, a 14-year-old girl haplessly trying to care for a 2-year-old who lacked diapers, children sleeping on cold floors. Like many, we are horrified by these stories of child maltreatment. But as developmental psychologists, we also know that, after the immediate crisis ends, these experiences will reverberate for years in the minds of the victims.

Indeed, research suggests the mistreatment of children at the border could create an epidemic of health problems — from mental illness to physical disorders leading to early death.

Psychologists have closely studied children who have been exposed to chronic or intensely stressful life events that overwhelm their ability to cope, including physical and emotional abuse, neglect and separation from caregivers. All of these experiences have been linked to higher rates of depression, anxiety and behavior problems later in life. One study that followed some 2,200 people from birth to age 18 in Britain, for example, found those who experienced a traumatic event as children were twice as likely to develop a mental disorder as those who had not. (When the participants were children, their parents completed questionnaires about their mental health, and, at age 18, the participants themselves took part in structured interviews asking about past traumas and present well-being.) Twenty-nine percent of the study subjects who had been exposed to intensely adverse events developed depression, for example, compared with 16 percent who had not been exposed to similar events.

The likelihood of mental health problems grows with the number of adverse experiences. In a nationally representative survey of more than 6,000 U.S. teenagers conducted at Harvard University, teenagers were asked whether they’d experienced physical, sexual or emotional abuse, separation from caregivers or other stresses. As in the British study, adolescents who experienced one type of intense adversity were about twice as likely to develop a mental disorder as those who had not. Those who had experienced four or more types of adversity were nearly four times as likely to develop a mental disorder.

What’s going on at the border is surely equivalent to the traumas explored in those studies. Recall that these events also come on top of the staggering degree of adversity these children have already experienced. Many children are fleeing violence and chronic poverty and have risked death during their journey to the U.S. They have already been through brutalizing episodes that put their health at risk, and now it’s being compounded.

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Many studies have found links between childhood hardship and such leading causes of mortality as cardiovascular disease, cancer and diabetes. A recently published study began by asking, in 1995, more than 6,000 adults aged 25-74 years whether they had experienced emotional or physical abuse in childhood. They then tracked those people for two decades. Those who experienced abuse as children were more likely to die during that period. Scientists don’t fully understand the factors that contribute to this premature mortality, but one theory is they literally grow old more rapidly: Childhood adversity, several studies suggest, accelerates the pace of cellular aging. Scientists can measure cellular aging by examining the length of telomeres, caps on the end of chromosomes that protect the DNA. Telomeres get shorter each time cells replicate, so shorter telomeres imply more advanced cellular age. One study of 4-year-old children who had spent time in orphanages in Romania found the longer they were institutionalized, the greater their cellular age.

Stress and adversity can affect mental health at any point, but they are particularly harmful when they happen during significant periods of brain development — notably, in the first few years of life (say, zero to 3 years old) and in adolescence. When the brain is rapidly developing, it’s especially attuned to environmental experiences, positive and negative. So when unaccompanied teenagers are caring for babies, you’re traumatizing two highly vulnerable groups at once.

Young children lack the skills older people have to cope with adverse events, but they typically have a not-so-secret weapon for weathering stress: their parents. Parents are so powerful that when 4- to 10-year-old children see a mere photograph of them, that’s enough to dampen activity in brain regions related to threat detection. Separating migrant children from their parents in detention centers is, therefore, a double blow, inflicting a wound and removing the most effective balm.

Adolescents, who are going through their own intense period of brain “plasticity,” are more skilled at regulating their emotions than children, but mental illness is also most likely to first emerge during the teen years. Adolescents show greater increases in blood pressure, stress hormones and negative emotions in response to stress than younger children — and stress is linked to the onset of depression in this population.

Supporters of harsh immigration policies point to the short-term nature of detention as a partial defense, but the scientific evidence suggests exposure to a single brief stressful life event in childhood can produce lasting consequences. Children living in New York City had elevated rates of mental illness for at least six months after the 9/11 attacks, relative to levels before Sept. 11, 2001. Even less severe single life events — like breaking up with a boyfriend or girlfriend — predict the onset of depression in teenagers. If one breakup can impact mental health, what kind of harm might detention for days, weeks or months do to a vulnerable teen?

We can’t undo what has happened to the children separated from their parents at the border, but we can make resilience more likely by reconnecting them with their primary means of coping — their parents — and, if that’s impossible, with high-quality surrogate caregivers. They must have access to support services that can meet their social, educational and health needs.

These children are at grave risk. After we stop the abuse, we must begin the hard work of minimizing the long-term harm we’ve surely caused.