Government video released Monday showed migrant children held in cages. Audio published that same day by ProPublica captured the wails of kids crying out for their parents as they're mocked by Border Patrol agents. And photographs taken recently at the U.S.-Mexico border recently expose minors lost, confused and scared.
Over the last few weeks, more than 2,300 migrant children had been taken from their parents as a result of President Donald Trump's "zero tolerance" immigration policy. On Wednesday, amid public outcry, Trump signed an executive order reversing, in part, the very directive his agency implemented.
But the damage is already done, experts say. Being separated from your parents is a traumatic experience for children. And that trauma, research by the World Psychiatric Association shows, will have long-lasting effects on their physical and mental health.
"There's this very real thing about trauma living in your body," says Sera Bonds, CEO and founder of Circle of Health International, an Austin-based non-profit working in the Rio Grande Valley with immigrant mothers and children. "When kids live their whole lives under stress, they come into adulthood less healthy than other people."
Immigrant children taken from their parents are enduring what experts call "toxic stress." The toxic stress response is triggered when a child experiences severe, chronic or prolonged trauma – in this case, family separation. Their heart beat increases and their body releases higher-than-normal levels of cortisol and adrenaline, the hormones that deal with stress.
Toxic stress causes those hormone levels to stay elevated for longer than usual. And that sustained response can have a detrimental impact on a child's development, especially within the first three years of life, experts say. Harvard Medical School research reveals that when cortisol levels remain high for prolonged periods, they can disrupt developing brain circuits and begin to damage the hippocampus, the area of the brain responsible for learning, memory, and ability to regulate certain stress responses. The body's stress responses are also permanently set on high alert, so hormone levels become elevated even at the slightest hint of a threat.
"The stress hormones released when a kid is exposed to protracted or even acute trauma can affect their autoimmune development, their neurological development, and certainly their psychosocial development," Bonds says. "Because that patterning is set when you're young and it's a very hard thing to change as you get older."
"To be brown every day, to be an immigrant every day, to live in fear every day of your family being taken away, of you being taken away, that's going to take a toll on your psyche," she adds.
Extensive studies show that toxic stress in early childhood can lead to lifelong problems. Minors coping with trauma, such as family separation, are at a higher risk of depression, anxiety, substance abuse, and suicide-related behaviors as they grow older, according to the Center for Youth Wellness.
Children who've undergone a traumatic event may have difficulty acquiring language or hitting milestones, have more emotional outbursts, become physically aggressive, have trouble forming secure relationships, and develop trust and anger issues, experts say. For older kids, they may be more likely to experiment with drugs and other substances, drop out of school, have anxiety disorders or eating disorders, and engage in other high risk-taking behaviors.
"That kind of enforced separation is very traumatic because what it does is lets you know as a child how vulnerable you to circumstance that are not only beyond your control, but way beyond the control of your parents," says psychiatrist James Gordon, founder and executive director of The Center for Mind-Body Medicine, who has worked extensively with refugees and displaced populations. "That level of vulnerability then becomes a part of that child's life."
"Having been deprived of people who love you and take care of you, that's something that's there and it doesn't really go away," Gordon adds. "The longer it goes on, the harsher the conditions, the deeper the trauma is likely to be."
Traumatic child-parent separation also has long-term neurological and physiological costs. Harvard Medical School researchers who studied the MRI scans of children placed in state-run orphanages in Romania found that, as those kids grew old, they had much less white matter, the part of the brain that transmits information. The results, published in JAMA Pediatrics in 2015, also showed these kids, taken from their parents before 2 years old, had significantly lower I.Q. scores later in life, and didn't exhibit the typical physiological responses to stress, such as an increased pulse and higher blood pressure.
Other research has documented the physical toll that severe trauma can exact. A 2017 Psychiatric Annals study found that children exposed to adverse events are at a greater risk for stress-related diseases – heart problems, cancer, stroke, diabetes, liver disease and skeletal fractures – well into their adult years. Another study, published in Endocrine Reviews in 2000, discovered that chronic stress can cause suppressed immunity, impaired memory, bone mineral loss and muscle atrophy.
"This type of separation is especially dangerous for infants because in the first three years of life, the brain is going to rapid neurological development," says Sandy Santana, executive director of Children's Rights, a non-profit advocating for kids in the foster-care system. "Even very short separations can lead to cognitive impairment, and it can manifest itself physically, too. The child could literally deteriorate physically."
But these children aren't victims of an isolated traumatic event, experts say. Instead, family separation is just one in a series of chronic and prolonged traumas they're enduring, making these adverse health effects even more likely.
There's the experience of migration itself: Families, many of whom are fleeing violence in their home country, embark on a long, onerous journey that's typically dangerous and uncertain. Then, there's what happens after separation, within the detention shelter's walls: For example, a federal lawsuit filed in April alleges that staff at one East Texas detention center routinely force immigrant minors to take medications that make them lethargic, dizzy and, in some cases, incapacitated. (The company did not respond to the Center for Investigative Reporting's request for comment.)
"One traumatic event doesn't always cause symptoms," psychiatrist Dr. Kimberly Gordon, vice-chair of the American Psychiatric Association's Council on Children, Adolescents and their Families, tells Rolling Stone, "but multiple traumatic events can lead to a cascade of psychological and physical health consequences."
Add to that, the dearth of human touch. Some shelters have reportedly instituted a no-hugging policy, meaning workers are prohibited from physically comforting distraught kids. In some cases, so are their siblings. (The company that operates many of the facilities at the center of the controversy has denied implementing such a policy.)
Research shows that comforting touch – a soothing hug, a close snuggle – can reduce stress and anxiety in children, and boost healthy brain development. But a lack of positive touch, studies have found, changes the growth of the amygdala and hippocampus – the brain regions that regulate attachment and fear – and can lead to depression, loneliness and generally poorer healthinto adulthood.
"The basic need for any person in a time of grief or reaction is to have a simple hug. That's just a basic need," Dr. Gordon tells Rolling Stone. "It's actually a right."
Many of these migrant children, at some point, will be reunited with their parents (although the government's process for making that possible isn't exactly clear, nor is there any evidence that the Department of Homeland Security and the Department of Health and Human Services are making any significant effort to do so). But reunification won't mitigate the effects of a traumatic separation – more so if left untreated, says psychiatrist James Gordon.
Minors may develop separation anxiety. They may cling to their parents tightly. As they grow older, they may become more vulnerable to separations and future stress, Gordon tells Rolling Stone.
That's why, he says, the focus now needs to shift to a solution: to develop meaningful, adequate interventions and treatments, and training workers in trauma-informed care, so that these migrant families can heal.
"The answer is not a shrink on call. That doesn't work. It's about understanding that this is a problem for the whole community, for all of these kids and all of their families. And you need to work with that whole community," says Gordon. "They're our responsibility now."