16 AAP News •
www.aapnews.org • September 2015
by Melissa Jenco • News Content Editor
A federal judge has ruled that immigrant children
and their parents should be released from detention
centers, an important step forward for families fleeing violence and for advocates for children like the
The July 24 ruling coincidentally came down just
hours after the Academy wrote to federal officials
expressing concerns about the physical and mental
health risks of detainment on children ( http://bit.ly/1h
Steven G. Federico, M.D., FAAP, chair of an AAP
working group on unaccompanied immigrant chil-
dren, called the ruling “a step toward
minimizing additional trauma to
children who have sustained signifi-
cant trauma already.”
He applauded the Academy’s per-
sistence on the issue, which topped
the list of priorities at last spring’s
Annual Leadership Forum.
“I think one of the reasons we are
making some progress is because of the voice of not
only the Academy but front-line pediatricians in the
border states to provide professional expertise as to why
this is not an acceptable method of detainment,” Dr.
The federal government began detaining mothers
and children in unlicensed facilities last summer as
thousands of immigrants fled to the U.S. from Central
America. The move came despite a previous settlement
agreement laying out limited circumstances in which
children could be detained.
In a July 24 letter to Jeh Johnson, secretary of the
U.S. Department of Homeland Security, AAP President Sandra G. Hassink, M.D., FAAP, questioned
whether detention facilities could care for children
properly and urged federal officials to be compassionate toward families fleeing violence.
“Children and mothers from Central America who
have crossed the border to enter the United States have
high rates of exposure to trauma in the form of threat
of death, physical and sexual abuse, and exploitation
that leave serious physical and psychological scars,” Dr.
Hassink wrote. “The act of detention or incarceration
itself is associated with poorer health outcomes, higher
rates of psychological distress, and suicidality making
the situation for already vulnerable women and chil-
dren even worse.”
In the court ruling released the same day, U.S. Dis-
trict Judge Dolly M. Gee also criticized the “egregious
conditions” in the detention facilities and pointed to
reports that they are unsafe, unsanitary, overcrowded
and lacking adequate nutrition. She ruled the federal
government had violated the earlier settlement agree-
ment by detaining families and ordered that they be
released as long as they don’t pose a significant threat
or flight risk.
Federal officials have asked the judge to reconsider
the ruling, which goes into effect 90 days after it was
Pediatricians around the country could continue to
see patients who have fled their home countries and are
suffering regardless of whether they were held in detention centers. Marsha R. Griffin, M.D., FAAP, a Texas
pediatrician who treats children from Mexico who have
passed through processing centers at the border, called
her patients the “walking wounded.”
“What I’m seeing from just children here in our community that
have made this arduous journey
often fraught with violence and humiliation and abuse by our own U.S.
… Border Patrol and immigration
officers, they have many times internalized this humiliation and it will
later be seen as acting out,” she said.
Dr. Griffin said pediatricians around the country
need to ask immigrant children about the journey they
have undertaken in order to understand their needs.
She also feels physicians need more training on how
to provide assistance.
Dr. Federico’s working group aims to provide that
training by developing toolkits that will help address
not only health, but education and legal needs.
In addition, the Academy is working with the U.S.
Department of Health and Human Services to ensure
unaccompanied minors receive health services like immunizations and preventive screenings.
Dr. Federico said next steps also must include more
advocacy for reunification of families and services to
meet their basic needs.
“I think it’s to continue to make sure that children
in all of our communities are treated with dignity and
respect in a safe and age-appropriate manner,” he said.
• AAP federal advocacy page on immigrant children,
• Immigrant Health Special Interest Group, http://bit.
• Newly updated AAP Immigrant Child Health Toolkit,
• Education resources from the National Association for
the Education of Homeless Children and Youth, http://
• State-by-State Review Regarding Ability of Minors to
Consent to Routine Medical Care, http://bit.ly/1dHFLlc
• Legal resources from Kids in Need of Defense, https://
• AAP News article “Humanitarian crisis: Pediatricians
help children at border, nationwide,” http://aapnews.
• AAP News article “Caring for immigrant children; one
year after the surge,” http://aapnews.aappublications.
AAP heartened by ruling to release immigrant children from detention centers