“Every single separated kid has been terrified. We’re [seen as] the enemy.”

Migrant children seperated from their parents during the Trump administration’s “zero tolerance” policy last year suffered intense trauma, as detention facilities proved inadequately equipped to provide mental health care as mandated by the Flores agreement, according to a new report from the Human and Health Services’ (HHS) Inspector General.

“According to program directors and mental health clinicians, separated children exhibited more fear, feelings of abandonment, and post-traumatic stress than did children who were not separated,” the report says. “Separated children experienced heightened feelings of anxiety and loss as a result of their unexpected separation from their parents after their arrival in the United States. For example, some separated children expressed acute grief that caused them to cry inconsolably.”

By the time the “zero tolerance” family separation policy imposed under former Attorney General Jeff Sessions ended in June 2018, several thousand families had already been split apart. The report explains how a poorly organized and understaffed operation worsened the suffering of children who were already being taken away from their parents. It is based on visits to 45 different detention facilities during August and September 2018, months after the policy was ended amid public outcry.

“Care providers at the facilities were dealing with an unexpected younger population—the number of kids under 12 increased from 14 percent in April 2018 to 24 percent in May 2018 at the advent of the Trump’s so-called zero tolerance policy,” wrote Common Dreams, noting that many of the children were too young to understand what was happening, intensifying their emotional distress.

“You get a lot of ‘my chest hurts,’ even though everything is fine” medically, a clinician told the report’s investigators. The children described emotional symptoms, saying, “Every heartbeat hurts,” or “I can’t feel my heart.” “Some separated children expressed acute grief that caused them to cry inconsolably,” read the report.

Under the 1997 Flores agreement, migrant children are only to be held in detainment facilities for 20 days before being released. If no guardian can be found, children are meant to be put in a “facility licensed by the states and held to the same standards as foster care and group homes, providing access to education, safe food and water, decent bedding, outdoor exercise, suitable clothing, English language classes, medical care, and so on,” explains the Nation’s Sasha Abramsky.

The rules are also supposed to require one staff psychiatrist for every 12 children, but clinicians were so understaffed some of them had to take on 25 alone. “Staff described making appointments with psychiatrists and psychologists for dates that were 2 or 3 months away,” read the report.

The understaffed mental health clinicians felt challenged in providing comfort to the children, who had often already fled poverty and violence in their home countries. “Every single separated kid has been terrified. We’re [seen as] the enemy,” one program director explained in the report.

Trump Administration Trying To Remove Flores Agreement

The Trump administration announced a rule change to the Flores agreement on August 21 that would lift the 20-day limit, remove state licensing authorization of facilities in order to give that power to ICE, and disallow designated lawyers to enter detainment facilities. Critics argue the inhumane treatment of detained children so far lends zero reason to allow the Trump administration more power over immigration policy:

“Federal attorneys dared to go to court recently to argue that they weren’t obligated to provide them with soap, toothpaste, toothbrushes, bedding, and even food fit for human consumption,” writes the Nation’s Sasha Abramsky.

“Compounding the shameful behavior, earlier this week it was revealed that Customs and Border Protection will not be vaccinating inmates in its facilities—despite the fact that three children have died of flu in detention centers this year, and despite the fact that, as I reported for The Nation earlier this year, volunteer doctors and nurses working with immigrants released from these centers report an alarming incidence of flu and other dangerous pulmonary and infectious diseases,” Abramsky continued.

Nineteen states and the District of Columbia have so far challenged the rule change in court, leaving the Flores agreement’s future uncertain. The rule is supposed to go into effect 60 days after its announcement.

“The advice that we’re giving our clients is to brace themselves,” Hardy Vieux of Human Rights First, an advocacy group that provides legal representation to asylum seekers, told the Atlantic. “We’re going to see a lot more people detained for longer periods of time in facilities that are not licensed, and significant physical- and mental-health ramifications for the children that we serve.”