The Society for Adolescent Health and Medicine (SAHM), a multidisciplinary, international organization committed to improving the physical and psychosocial health and well-being of all adolescents and young adults strongly condemns the separation of children and adolescents from their parents as a deterrent to migrants, refugees and asylum seekers searching for safety by crossing our border with Mexico.
 
It is deeply and profoundly damaging to the emotional development and health of any child or adolescent to be involuntarily separated from their mother or father and this separation can affect their emotional and physical health and development for their entire lives. This inhumane approach conflicts with our society’s, our families’ and our profession’s most fundamental responsibility to protect children and adolescents. The Office of the United Nations High Commissioner for Human Rights condemned this practice on June 5, 2018 as it “amounts to arbitrary and unlawful interference in family life, and is a serious violation of the rights of the child”. Additionally, research demonstrates that these policies negatively impact not only those groups of migrants directly targeted by the policies, but other immigrant groups as well.
 
The United States has historically been a safe sanctuary for citizens of many countries who have survived great hardship. Threat to safety, exposure to violence, and the deep desire to protect children and adolescents commonly underlie the difficult decision to leave home. SAHM calls on the Administration to immediately discontinue the separation of children and adolescents from their mothers and fathers at the border and to immediately discontinue the policy of punishing undocumented people attempting to migrate to the United States by involuntarily removing their children and adolescents from their care. 
 
At this time, there is no provision for legal representation of children and adolescents of immigrants apprehended during border crossings. As a result, children as young as two years of age are put in the incongruous position of representing themselves in court. This reflects a disregard for justice and fairness. Adolescents experiencing parental separation, who commonly don’t speak English, are developmentally and emotionally incapable of providing an accurate history or arguing for their own legal rights. No system of justice can address the needs of migrant children without the presence of their parents. 
 
Cold and stark warehouses with pens to separate infants, children and adolescents from siblings (by gender) and mothers from children currently house hundreds of affected individuals. Reporters and government officials have been barred from entering the facilities to investigate the conditions under which they are held. Further, the Department of Health and Human Services manages the placements of children and adolescents of immigrants to institutional sites scattered throughout the United States, often hundreds of miles from their parents who are undergoing mass trials without legal representation or consideration of individual circumstance.
 
Children and adolescents can be extremely resilient, but the capacity for resilience has limits. The principal protection that children and adolescents have from traumatic experiences is their attachment to their parents. The involuntary forced separation they undergo through these experiences subjects them to an Adverse Childhood Experience that will result in predictable neurological damage, childhood post-traumatic stress disorder, depression and other avoidable disorders. 
              
SAHM has joined the American Academy of Pediatrics (AAP) and several other organizations throughout the country in an appeal to halt the separation of children and adolescents from their families and will continue to seek opportunities to speak out against this and other policies around the globe that threaten the lives of persons fleeing persecution. We urge in the strongest possible terms that immigration policy not leverage the health and well-being of children and adolescents as bargaining chips; nor can abusive practices be used as a legal weapon.
 
This statement is the result of a collaborative effort from SAHM members Curren Warf, MD, MSEd, Maria Veronica Svetaz, MD, MPH, Evelyn Eisenstein, MD, DrSc, Manuel Angel Oscos-Sanchez, MD, Diana Birch, MBBS, MD, and the SAHM Executive and Advocacy Committees

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