Toxic effects of stress on children separated from parents


It’s been said that you can always count on Americans to do the right thing — after they have tried everything else.

We cannot think of a better example than the Trump administration’s policy to forcibly remove children from parents caught trying to enter the U.S. illegally as they are seeking asylum from violence, presumably to deter people from entering the country illegally.

{mosads}Their children, including babies and toddlers, are then labeled “unaccompanied alien children” (a phrase never intended to be applied to children who could not yet walk) and placed in the custody of the Office of Refugee Resettlement (ORR).


They are then transferred to live with people they do not know, sometimes thousands of miles away from their parent(s), with their parents not even knowing where their children are being taken. Previously, most children had been allowed to stay with their parents in shelter for families while they waited for their deportation proceeding.

Attorney General Jeff Sessions has stated that this policy is intentional and designed to deter border crossings. Although the total number of families affected by this unethical treatment of children is unclear, the Department of Homeland Security recently confirmed that from April through May of this year, nearly 2,000 children were separated from their families by the U.S. Border Patrol. As a country, we have entered a new low in the handling of those “tired masses yearning to be free.”

Many of these families are fleeing trauma and violence in their home countries, only to be faced with the new trauma we have inflicted through forcible separation. The impact of these traumas on young children and their developing brains is real. Trauma is different from the typical stressors children experience in their normal daily life; those are the healthy stresses from which children learn and grow.

This trauma, the trauma of being forcibly separated from a parent by strangers and then transported to other strangers for prolonged periods of time, is different. This kind of trauma overwhelms the body. It causes feelings of terror and helplessness. Stress hormones flood the body.

Without the nurturance and calming support of a caring adult who is known to the child, these traumas can alter the structure of the developing brain. Long term, we know that this toxic level of stress can affect other organ systems, leading to long term adverse health outcome such as mental illness, substance abuse, cardiovascular disease, and premature death.

This scientific research surrounding toxic stress encourages us to rethink aspects of the criminal justice system. Children should not be used to punish families. Governmental organizations, including Substance Abuse and Mental Health Services Administration(SAMHSA) and the Centers for Disease Control (CDC) have crafted clinical guidelines to address toxic stress.

Nurses can and must use these guidelines to permanently shift this culture of punishment, which is clearly unhealthy, to a culture of humanitarianism that promotes health.

Last week, the National Association of Pediatric Nurse Practitioners issued a statements opposing the policy of separating children from their parents caught entering the U.S. illegally. Count on the nurses to do the right thing. Other organizations, too, notably the American Academy of Pediatrics and the American Public Health Association, have strongly opposed the horrific policy of separating children from their parents.

We must make our voices heard in this humanitarian crisis. This is not how we believe America, the land of immigrants that should welcome those who are hungry, needy or escaping violence, should behave. As nurses, we are outraged our country has chosen to not do the right thing. What is the right thing? It starts with keeping the family together and including the best interest of the child as a Federal policy.

Deborah Gross is a professor in the school of nursing at Johns Hopkins University. Ellen Olshansky, PhD, RN is a professor and chair of the Department of Nursing of the Suzanne Dworak-Peck School of Social Work and professor emerita at University of California, Irvine Sue & Bill Gross School of Nursing. She is a member of the board of directors of the American Academy of Nursing (AAN). Sarah Oerther, MSN, RN is an American Academy of Nursing Jonas Health Policy Scholar and communications chair of the Public Health Nurse Section of the American Public Health Association.

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