Secure The Border Act Of 2023
Mr. Speaker, I rise in strong opposition to H.R. 2-- this harmful, partisan, Republican legislation--for many reasons, but especially because it will endanger people seeking asylum. This bill takes us backwards after years of acknowledging…
Mr. Speaker, I rise in strong opposition to H.R. 2-- this harmful, partisan, Republican legislation--for many reasons, but especially because it will endanger people seeking asylum.
This bill takes us backwards after years of acknowledging the need for comprehensive immigration reform. The expansion of family detention in this bill will hurt children and families. It is costly, and it does not work as the majority claims.
Mental health and medical experts agree that jailing immigrant families exposes children to high levels of trauma and distress. We should be expanding effective programs like Family Case Management, but this bill guts the program and will undermine its proven record of close to 90 percent compliance.
We live in a country of immigrants, and our Nation is stronger because of its diversity.
I urge all of my colleagues to oppose building walls and detention centers and support comprehensive, humane immigration reform that will strengthen our economy, enhance our security, and reflect our core values as Americans.
Mr. Speaker, I include in the Record an article from Social Science & Medicine about the high levels of mental health distress experienced by children who are held in immigration detention.
[From Social Science & Medicine, Apr. 29, 2019]
Mental Health of Children Held at a United States Immigration Detention
Center
(By Sarah A. MacLean, Priscilla O. Agyeman, Joshua Walther, Elizabeth
K. Singer, Kim A. Baranowski, Craig L. Katz)
1. Introduction
Immigrant children who are newly arrived in the United
States demonstrate more positive developmental outcomes, such
as resiliency and positive academic attitudes, than their
U.S.-born peers (Marks et al., 2014). However, several
environmental factors could contribute to the development of
psychological distress in these children and their families
once in the U.S. In addition to exposure to acculturation
stressors (Alegria and Woo, 2009; Suarez-Orozco and Suarez-
Orovco, 2001), immigrants may also encounter deleterious
medical and mental health outcomes associated with perceived
discrimination (Pascoe and Smart Richman, 2009). Latinx
immigrants also face health disparities driven by state-level
immigration policies (Philbin et al., 2018). Furthermore,
immigration policy and fears associated with deportation may
increase the risk of emotional distress among immigrants who
enter the U.S. without inspection or who remain without a
valid visa (Cavazos-Rehg et al., 2007; Martinez et al.,
2015). The forced dislocation from family, communities, and
employment associated with deportation from the U.S. is also
related to negative mental health outcomes (Bojorquez et al.,
2015; Morris and Palazuelos, 2015).
Beginning in 2014, there have been significant increases in
the number of individuals and their families from Guatemala,
El Salvador, and Honduras seeking asylum in the U.S. (Mossaad
and Baugh, 2018). Many women and children fleeing these
nations have reported experiencing human rights violations in
their countries of origin associated with gang-related and
intimate partner violence in the context of un-responsive law
enforcement and government presence (UNHCR, 2014, 2015).
Asylum seekers may experience a range of mental health
outcomes associated with their experiences of persecution
(PHR, 2012). They may continue to be emotionally affected by
trauma experienced in their home countries, as well as the
dangers and violence they often encounter during migration
(Temores-Alcantara et al., 2015). In addition, the very
process of seeking asylum may also contribute to their
psychological distress, as survivors are required to
participate in potentially retraumatizing asylum interviews
or adversarial immigration hearings (Schock et al., 2015).
The U.S. has also increased its capacity to detain
immigrant families seeking asylum through the creation of
more detention centers specifically designated for women and
children over the past five years (Eagly et al., 2018).
Asylum seekers in expedited removal are held in U.S.
immigration detention while they await a screening interview
for credible fear, where an asylum officer evaluates whether
the asylum seeker has a credible fear of persecution or
torture upon returning to their country of origin (HRF,
2018). This step is the first to determine eligibility for
asylum. Adults and children being held in immigration
detention demonstrate high rates of deleterious mental health
outcomes such as depression and anxiety (Keller et al., 2003;
Mares and Jureidini 2004). Studies conducted outside the U.S.
have shown that detained immigrant children present with a
high prevalence of depression/anxiety (10 percent) and post-
traumatic stress disorder (PTSD, 20 percent) (Buchmuller et
al., 2018; Sen et al., 2017). Research findings also indicate
that children held in immigration detention settings may
experience social, emotional, and behavioral difficulties at
higher rates than those seen in the community (Sarkar and
Gupta. 2007; Zwi et al, 2018).
To our knowledge, there have been no large empirical
studies that have evaluated the mental health of children in
immigration detention in the U.S. Previous studies
documenting the mental health of children in U.S. immigration
detention, though compelling, have been largely qualitative
and anecdotal (Brabeck et al., 2014), or have been from the
perspective of lawyers in the field (Bailey et al., 2014).
Furthermore, experts assert that the controversial policy of
forcibly separating children from their parents at the U.S.-
Mexico border is detrimental to children's health and
wellbeing (MacKenzie et al., 2017), therefore prospective
research on the effects of this policy is needed. Given the
significant environmental factors that may contribute to the
development of psychological difficulties in these children,
we sought to understand the current state of mental health in
this population.
2. method
We conducted a cross-sectional evaluation study of children
held at an immigration detention center over two months in
mid-2018. This center detains women who are accompanied by at
least one child under the age of 18 in U.S. Immigration and
Customs Enforcement (ICE) custody. We interviewed a
convenience sample of 425 mothers who presented to the
visitation center of the detention center. Mothers were
eligible to participate if they spoke English or Spanish and
if one of their children detained with them was between 4 and
17 years of age. The purpose of the study was stated
explicitly to mothers, and they were informed that their
participation and responses would not impact their legal
proceedings. Mothers who volunteered to participate provided
informed written consent and were interviewed in private
rooms or other areas of the visitation center that ensured
confidentiality. Nine mothers refused to participate. During
the time period of this study, 17 percent of the children
included in the sample had been previously separated from
their mothers. At the time of interviews, a subset of these
families had been recently reunited. All consenting mothers
completed a demographic survey that included items related to
country of origin, age of children, and date of arrival at
the detention center. Mothers were then asked questions about
their eldest child with them at the detention center.
Each mother completed the English or Spanish parent-report
version of the Strengths and Difficulties Questionnaire
(SDQ), a 25-question screening instrument widely used
internationally in children age 4-17 years (Goodman, 2001)
and among refugee children (Zwi et al., 2017). The survey
includes items that assess the child's behavior and possible
responses are recorded as ``not true'' (0), ``somewhat true''
(1), and ``certainly true'' (2). Based on these responses,
each participant received a score indicating total
difficulties and a score for the subscales of emotional
problems (e.g., feeling unhappy or having excessive fears),
conduct problems (e.g., being disobedient), hyperactivity
(e.g., being restless or easily distracted), and peer
problems (e.g., preferring to play alone). Participants also
received a prosocial score, which assesses behaviors such as
sharing with other children and volunteering to help others.
Consistent with the scoring of the SDQ, the resulting scores
were assigned to the ``normal,'' ``borderline,'' or
``abnormal'' category for total difficulties and each
subscale. Cutoff scores were originally designed such that
roughly 80 percent
of children's scores fall within the ``normal'' range, 10
percent within the ``borderline'' range, and 10 percent
within the ``abnormal'' range (Goodman, 1997).
A subset of 150 children age 9-17 years also assented to
participate in the study following the informed written
consent for their participation by their mothers. These
children were part of a convenience sample of children who
were in the visitation center at the time of their mothers'
interviews. The children completed the UCLA Post-Traumatic
Stress Disorder Reaction Index (PTSD-RI) Symptom Scale, a 27-
question screening tool used widely to assess symptoms of
PTSD in children (Steinberg and Beyerlein, 2013), including
refugee children (Ellis et al., 2006). Children were asked
how frequently they experienced core symptoms of PTSD in the
past month, with possible responses of ``non'' (0),
``little'' (1), ``some'' (2), ``much'' (3), and ``most'' (4).
A symptom was considered ``present'' with a rating of 3 or 4.
Participants met the criterion for Category B
(reexperiencing) if ; 1 symptom was present and for Category
C (avoidance) if ; 1 symptom alterations in cognition and
mood) if ; 2 symptoms were present and for Category E
(increased arousal) if ; 2 symptoms were present. A probable
clinical diagnosis of PTSD was determined by meeting the
criteria for all 4 categories (Steinberg & B Beyerlein,
2013). Because a clinical assessment to establish a formal
diagnosis of PTDS was not included in this study, the term
``probable PTSD'' will be used when referring to prevalence.
We describe sociodemographic characteristics with
frequencies and percentages. We examined the prevalence of
outcomes for the SDQ and PTSD-RI subscales. Cronbach's alpha
for the SDQ and PTSD-RI were 0.768 and 0.908, respectively.
Covariates included age, gender, country of origin, and
previous separation from the child's mother. We considered
results to be significant if p < 0.05. All analyses were
performed using IBM SPSS (version 224).
The research protocol, survey, and consent forms were
reviewed and approved by the Institutional Review Board at
the Icahn School of Medicine at Mount Sinai. All participants
provided written, informed consent.
3. results
Most mothers were from Honduras (50 percent), El Salvador
(23 percent), or Guatemala (22 percent), which is consistent
with the overall population of residents at this detention
center. The average age of the mothers and children were 33