Mental-Health Experts Say They Have Limited Access to Immigrant Kids

The following is a story from the National Journal by Erin Durkin. They have given Las Cumbres permission to run their story on our website. The access to immigrants a major obstacle in treating trauma for many of children and families who will eventually settle in the United States. We are most grateful to Erin Durkin and the National Journal for covering this topic and allowing us to share it.


Mental-Health Experts Say They Have Limited Access to Immigrant Kids

Lawmakers included more money in the 2020 spending bill so outside groups can offer services to unaccompanied immigrant children, but access remains an issue.


Immigrants - AP photo Eric Gay.jpg

Erin Durkin

Jan. 12, 2020, 8 p.m.

Congress is hoping to beef up mental-health services for immigrant children who show up at the border alone or who are separated from their parents, by providing limited funds to outside childhood-trauma specialists. But some of these mental-health professionals have faced barriers to working with children in government custody, according to experts working on the issue.

For the second year in a row, appropriators have directed $4 million to go to the National Child Traumatic Stress Network to address the needs of unaccompanied immigrant children. The network consists of groups that provide clinical services, offer training programs, and develop new interventions for families and children that experience trauma, among other services. The money will be doled out in grants.

Lawmakers are also pressuring the health department’s Office of Refugee Resettlement, which oversees the shelters and care providers for unaccompanied immigrant kids, to work with this network. ORR currently is required to screen children when they first enter their facilities for mental-health concerns and provide at least one individual counseling session per week.

But a report from the Health and Human Services Office of Inspector General, released in September, found that ORR facilities reported challenges hiring mental-health clinicians and accessing external mental-health providers. Clinicians within the facilities did not feel they could address the intense trauma the children faced. “Mental health clinicians expressed concerns about feeling unprepared to handle the level of trauma that some children presented, despite their prior training and experience,” the report stated.

The National Child Traumatic Stress Network is working on building a formal relationship with ORR. The organization is focused on two priorities for 2020: ensuring that network members have access to children who need treatment, and providing training to staff within the shelters, including mental-health clinicians, on how to respond to children experiencing trauma, said Ellen Gerrity, associate director and senior policy adviser for the National Center for Child Traumatic Stress, which oversees and coordinates grantees within the network.

Gerrity said a formal relationship with ORR could be one where network members are provided direct access to the children in the agency’s custody through contracts, grants, or a memorandum of understanding between the relevant federal agencies.

When community health groups began their work in 2019 to focus on unaccompanied immigrant children, some of the groups faced barriers to providing services, Gerrity said.

“Many organizations and institutions that wanted to help the children were not allowed access to the children,” said Gerrity, who said ORR was “quite protective” about granting access to the kids.

“It made it harder to get those who were trained, willing, and available to help the children with the trauma and the mental-health issues that they clearly were facing,” she added. “The staff and the children themselves were not getting that access to that care at first. But some of our centers who have been working with populations or with individuals involved significantly at the border—they had greater opportunity to talk about it more, to build relationships, and to be able to get access, and that’s what we’re seeing over time.” Stacey Frymier, director of child and family services at Las Cumbres Community Services, Inc., in New Mexico, said she was surprised at the level of privacy around ORR shelters. The group, which is part of the National Child Traumatic Stress Network and a recipient of 2019 supplemental funding, linked up with an ORR shelter in El Paso after meeting a boy in their care on his day in court, she said.

“One of the things that we did on our trips to El Paso each month was sit in on one of the immigration judges' juvenile docket on his court dates with the kids, and that’s actually what helped link us to that particular shelter,” she said. “There was a very young—he was six at the time, just turning seven—a little guy who was accompanied in court by one of the shelter staff.

“We were still new to the project at that point and so touched by this tiny child alone in court, so we talked with his worker afterwards and got to know this guy, and he was really great,” she added. “That’s how we got connected with this shelter. But, you know, while that whole thing was unfolding, the judge and the attorneys were even hesitant to say the name of shelter in the courtroom.” Frymier said the 2019 funding supported the group’s efforts to train the staff at the facility, which she described as having a “strong clinical team,” in basic trauma-informed principles.

“Because they have a lot of containment around the privacy of their kids, we’ve really focused on building relationships with the staff and providing consultation to them about their services as opposed to providing direct services ourselves, but we have met a number of the children,” she said.

HHS did not respond to a request for comment on what the agency was working on with the NCTSN or to questions about whether groups were blocked from seeing the children in ORR custody. Congress included language in the 2020 appropriations report encouraging the ORR to continue collaboration with this network.

“This funding will build on the progress we have made since establishing this effort in last year’s appropriations bill,” House Labor-HHS Appropriations Subcommittee Chair Rosa DeLauro, who spearheaded efforts to secure $4 million for the network, wrote in an emailed statement to National Journal.

“Specifically, ORR worked with NCTSN to provide training to mental health clinicians in ORR facilities on evidence-based child trauma treatments and interventions,” DeLauro added. “This training will further enable professionals to help kids who have psychological and emotional troubles given the circumstances they are in. It also provides guidance to the clinicians on how to best deal with the secondary trauma they may experience while helping these youngsters through their difficulties.”