The Mental Health Impact of Family Separation

In the summer of 2018, national attention became focused on migrant children who were separated from their families at the U.S. border. The policy of mandatory family separation was short-lived, but as of January 2019 there were an estimated 10,500 unaccompanied minors in detention centers in the U.S. Many of these children will not be reunited with family, and some are likely to go into foster care.

Professor Sonya Leathers, drawing on her experience with attachment and trauma among children in the child welfare system, observes that there are always mental health impacts for children who are separated from their primary caregivers. She notes that trauma will vary with the age of the child, their particular developmental needs, current or past stresses, and by how the separation is handled. “But, in the situation at the border there has been a lack of attention to the needs of the children and how very vulnerable they are,” she says. “Their parents and siblings have really been their lifeline, not just at the moment of separation but also because they’ve been through enormous challenges up to that point. And then to have that lifeline abruptly separated…I fear there will be an enormous mental health impact.”

Assistant Professor Jennifer Geiger agrees, observing that even if a migrant family is fleeing violence or extreme poverty, the children have still felt safety and security in being with a parent or caregiver. She compares this to what she’s seen with children in the child welfare system. “Children fundamentally wish to stay with their parents and their family, even though home life may be abusive or neglectful. It might have been the worst situation you can imagine, but the child will almost always say they want to be back with their family,” she says. “So, working with and supporting the family and keeping the family intact is the desired outcome for the child’s mental health and well-being.”

For cases in which removal of the child is recommended, Dr. Leathers says that child welfare practitioners have been working toward a system of care that attends to the attachment needs of the child. Ideally, the trauma of separation is lessened by making sure the child understands the circumstances and understands that they will continue to have a connection to their parent. “We know from child welfare studies and practice that children fare much better when the separation is more gradual,” she says. “It’s helpful if they are able to go with the parent to their new home, and to know that the parent is involved in that decision.”

Dr. Geiger explains that for children entering the child welfare system, the trauma of separation from family can stem from many variables, such as the allegations against the parent, who is present when the separation occurs, the age of the child, the relationship between the child and caregivers, how the adults in the situation are responding, or whether it happens at home or elsewhere. “There is always some degree of trauma as a result of the separation,” she says. “In some cases, children may develop traumatic responses to professionals who are present at the time of removal.”

Geiger worries that with the separations at the U.S. border, neither parents nor children had time to prepare. “Plus, there’s the involvement of military or law enforcement, and the presence of weapons. All of this increases the trauma,” she says. “In separating these children from their families and placing them in institutional care, it really seems as if policymakers are not considering the long-term impacts to the children.”

Dr. Leathers observes that in child welfare, children and teens are placed in an institutional setting only after an in-depth review process, to ensure it is required to meet the child’s treatment needs. “Placement in group care usually occurs only when the child has intense physical or mental health needs that cannot be met by being placed in foster care,” she says. “And when they are placed in a group setting, we hope to make the stay as short as possible.”

Dr. Geiger adds that with children who are placed in an institutional setting such as congregate care, the trauma may become further complicated. “Research shows that this is not the best environment for kids, especially if they have higher needs. In this setting there’s more instability and staff turnover,” she says, “so it’s harder for the children to form relationships with their adult caregivers.”

Geiger notes that the child welfare system is moving away from placing children in institutional care. “With the passage of the Family First Act, there will not be as much funding for those types of placements, and this will be a real shift in how we practice child welfare,” she says, “but the goal has always been to balance the safety and well-being of the child with minimizing trauma and the resulting mental health issues.”

For the migrant children who were placed in detention centers or shelters, Leathers says that it’s hard to know what sort of care the children are receiving. “Care providers working in the shelters are probably well-meaning and want to provide the best care they can, but they are probably overwhelmed by the numbers of children,” she says. “And we don’t know how many of the children are receiving trauma-informed care.”

Even when children are reunited with their families, the process of reunification may be difficult. “We know that severing the attachment between parent and child is traumatizing, and trying to mend that is extremely difficult. Reattachment doesn’t happen automatically,” Geiger says. “We see this in the child welfare system, and social workers need to play a role in the process, helping to mend the relationship and the psychological and emotional trauma.”

“For the mental health of the children, the surest remedy is prevention, making sure that families are not separated to begin with,” adds Dr. Leathers. She says that among families entering the child welfare system, there is typically a significant level of need, making it difficult for case workers to address the various needs of the parents and the children. “I would love to see a system that puts as much effort and investment into strengthening those families and making sure that parents are well-equipped from the time they have a child,” she says.

Assistant Professor Christina DeNard, whose research focuses on improving services for families in the child welfare system, is in complete agreement. “From the literature, we know that families encountering the child welfare system already have risk factors. Once they’re in the system, the interventions are individual, it becomes an individual issue, and the onus is on the individual or the family,” she says. “We need to support families before they enter the system. If we invest in our communities, we can see a lot of difference in terms of families flourishing.”