Detained immigrant minors deserve more than two calls per week

Unaccompanied children who cross the U.S. border seeking safety and asylum are placed in the custody of the Department of Health and Human Services’ Office of Refugee Resettlement. As of December, 10,775 children were in ORR custody awaiting placements with relatives or foster families and the processing of their immigration cases.  

For many unaccompanied and separated immigrant children, their time in ORR custody can be extremely disorienting and traumatic. They are placed in a restrictive environment away from family and surrounded by strangers, face language barriers and must deal with the stress and uncertainty of waiting to be reunified with family. Regular family contact for children in ORR custody is vital to providing a sense of stability and security amidst these stressful and difficult circumstances, as well as preserving children’s ties with family members whom they may be separated from for days, weeks or even months at a time.  

Recognizing how crucial communication with caregivers is for children, domestic and international law mandate that children be allowed ongoing contact with their families and caregivers. However, despite mandates requiring ORR detention centers to facilitate contact between children and their families, in practice, unaccompanied children encounter communication policies that are woefully inadequate, inhumane and harmful to their well-being.  

ORR notes in its policy that children “must be provided the opportunity” to make a minimum of two telephone calls per week (with a minimum duration of 10 minutes each) to family members and/or sponsors. Although ORR policy states that this limit is a “minimum,” many advocates and children held in ORR custody describe that this guidance is used as a ceiling, with children being limited to no more than two 10-minute telephone calls per week, or in some cases, even less.  

As physicians specializing in the medical and mental health care of children, we believe that this is unacceptable. Research consistently shows that children need the support of a responsive caregiver for their well-being and appropriate physical, emotional, cognitive and social development. When children are separated from family members and limits are placed on their ability to communicate with them, children can experience toxic stress which can result in lasting and permanent changes in the architecture of the brain.  

Immediate effects can range from difficulty eating and sleeping to behavioral problems. ORR staff can then punish children with these behavioral problems by writing up “significant incident reports” which can lead to a child’s prolonged stay in custody and placement in a more restrictive facility. Over the long term, children who are restricted from communicating with their families may experience an inability to learn and persistent depression and anxiety.  

Beyond the research, these sentiments are shared by the children themselves. Former unaccompanied children held in ORR custody surveyed by the Vera Institute of Justice described the extent of contact with primary caregivers as inadequate. The report noted that “many of the young people Vera spoke to only received this minimum amount of time to connect with their family members, which they reported was not enough time.”  

One person quoted in the report said the calls “help us feel . . . more free that if we have a problem or something we can talk about it with our family.”  

At a minimum, children need regular access to their caregivers and family members for emotional support, to work out problems, to help cope with their challenging circumstances and to feel safe in the world.  

Ensuring children can speak with their family members should be an easy fix.  

We live in a time when technology has made remote communication readily available. Multiple platforms — from online conferencing to communication apps — already exist to enable such means of communication easily and cheaply. The solution does not require sophisticated changes to complex immigration laws. It is not a heavy lift for the government to do what is right and ensure children can, at the very least, be in touch with loved ones more frequently. ORR has the ability right now to make this change by updating its policies and explicitly extending the time allotted for such communication.  

However, when we contacted ORR last year urging a change in this policy, the agency responded by stating, "ORR encourages care providers to go above these minimum requirements in order to provide quality care for all children and encourages video calls when possible ..." This response ignores the reality that many of its providers limit children to two phone calls a week with their families — regardless of what their written policy states — and disregards the harm to children caused by ORR’s failure to ensure more phone contact for children in custody.  

As experts in child health and the effects of immigration, we agree that the following changes to ORR policy must be adopted immediately:

• Children should have unlimited access to telephone and video calls with all persons that are included in their approved list of telephone contacts. If the government is unable to provide children with unlimited access to calls, then it should provide each child at a minimum, access to speak with parents, caregivers, trusted sponsors and family members once a day. 
• Children should be permitted to make video calls with family members whenever video calls are feasible and would be beneficial to the child. 
• Children should have regular in-person visits with parents and caregivers whenever possible, including in the case of children whose parents or caregivers are being held in immigration detention.

While ORR detention facilities often share photos of child-friendly classrooms, dormitories and play spaces, the real challenges and restrictions unaccompanied children face while in custody, including restricted phone calls, are rarely made known to the wider public.  

Nelson Mandela said, “There can be no keener revelation of a society's soul than the way in which it treats its children.” Children deserve more than the minimum standard of decency. They deserve to be with their loved ones and, at the very least, be able to communicate with them without barriers. 

Annalise Keen, M.D., is a child, adolescent, and adult psychiatrist and an assistant professor at the University of Utah Huntsman Mental Health Institute and the faculty advisor for the University of Utah School of Medicine Asylum Clinic. Minal Giri, M.D., is a community-based pediatrician in Chicago who serves on the executive committee of the American Academy of Pediatrics Council on Immigrant Child and Family Health. Roya Ijadi-Maghsoodi, M.D., M.S.H.P.M. is a child, adolescent, and adult psychiatrist, and assistant professor-in-residence in the UCLA Department of Psychiatry and Biobehavioral Sciences. She co-directs the UCLA Psychiatry Asylum Clinic. All are members of the Physicians for Human Rights Asylum Network. Views expressed are those of the authors.