They called it ‘la perrera,’ meaning the dog pen. It was one of the U.S. Custom and Border Patrol’s processing centers, where migrant women and children slept side by side, in chilly temperatures, in a cage lined by wire, with thin metallic blankets to keep warm.
This is where the mother from Honduras was awakened in the middle of the night and separated from her 5-year-old daughter.
They didn’t see each other again for two months and, like hundreds of other migrant families forcibly separated at the border under a 2018 Trump administration policy, they have been left with the mental consequences of traumatic, often weekslong and monthslong separations. The little girl screamed a lot, was afraid of police officers and would hide when hearing sirens. Her mother has suffered from insomnia and nightmares.
The mother and daughter are now among 55 Baltimore-area families, and some 578 across the country, who are receiving free, confidential mental health services, after a federal judge held the government legally accountable for mental trauma brought on by the separation policy. Doctors say that the trauma resulting from family separations and detentions ultimately can lead to long-term psychological effects, such as anxiety, post-traumatic stress disorder and depression.
“I thought I was going to wake up and I was going to be in a cell,” said the Honduran mother, who asked to only be identified by her first name, Lilian, because she fled violence and fears for her safety.
Even after her daughter was reunited with her, the 29-year-old woman remained traumatized whenever she hears an alarm. After three years in Baltimore, Lilian still gets scared in her sleep, though with therapy, not as frequently as before.
More than 3,000 children were taken from their parents under Trump administration policies and put in government shelters or foster homes before the policy was largely curtailed under pressure in 2018. Recently, the Biden administration officially rescinded the family separation policy and later announced a task force to reunite families. According to the ACLU, the parents of 611 children haven’t been found.
Most of the Baltimore-area migrants getting help are from Latin America, particularly Guatemala, Honduras and El Salvador. According to a report last February from the nonprofit Physicians for Human Rights, many left their countries because of violence and credible fears that their children would be killed if they remained.
But their trauma was exacerbated when they got to the border and were forcibly separated, often given little information and put in poor, unsanitary living conditions. Many parents didn’t know if they would ever see their children again; some children thought their parents had deliberately abandoned them.
The Physicians for Human Rights report went so far as to assert that family separation “rises to the level of torture.”
Seneca Family of Agencies, a nonprofit mental health agency based in California, is spearheading the mental health effort through a $14 million federal government contract. Seneca has a referral relationship with providers in Baltimore that include Health Care for the Homeless, Health Center for Wellness, La Clinica del Pueblo and the Pro Bono Counseling Project.
At one of the contractors, Hope Health Systems in Baltimore, Oscar Mejia, a clinical mental health counselor, has been treating immigrants in the program since July.
He has seen a cases of detachment and depersonalization among children. Mejia also noted symptoms that range from irritability to angry outbursts, lack of positive emotions, nightmares and problems with concentration.
“When I hear these kids talking about those cold rooms where they are placed, this is a form of punishment,” Mejia said. “It is a torture that disfigures the image of a human being that takes away from many children the motivation and trust and desire to continue trying in this life.”
One of the migrants who is getting help, Edgar, 31, did not want to be identified by his last name because of the political violence he fled.
While the journey from his home country of Guatemala was surprisingly smooth, Edgar said the terror began when he and son, then 7, arrived in the United States. They were separated at a processing center; for four days, Edgar had no word about his son’s whereabouts.
Other migrants told Edgar that if children got too upset when they discovered their parents were gone, staff gave the kids something to calm them down.
“Young children were given injections to stop crying,” said Edgar, adding that he doesn’t know if his son was given what has been described in reports as tranquilizers.
He was reunited with his boy after 35 days. But Edgar said his son was not the same. The once cheerful child would say little except for yes or no. He would have crying outbursts. He was afraid to shower or sleep alone. He feared going to school and being separated from his parents again. When he saw a police officer at his new school in Baltimore, the boy was terrified and wanted to hide. The officer later visited him at home to try and ease his traumatic reactions to adults wearing uniforms.
Under the new program, Edgar’s father was able to get free therapy for his son, which just started two months ago. Edgar and his wife also plan to get counseling once their son gets the help he needs.
Mejia said parents have been wracked with anguish about what happened.
“That is a desperate feeling, that is a feeling of guilt, because ‘I wanted to protect my child and now I am powerless.’” the counselor said. “The fear related, the guilt related, the sadness related to that separation turns into a post-traumatic stress disorder and to the more severe cases of suicidal ideation and suicide attempts.”
Monica Guerrero Vázquez sees the same trend in her work as executive director at Centro SOL, which partners with Johns Hopkins University School of Medicine to promote health and opportunity for Latinos. While Centro SOL is not part of the official program, it is running two mental health groups for about 23 Latinos. The service is pro bono for underinsured and uninsured patients.
“People come to these groups without knowing what they have, and some of them are going through PTSD, anxiety and depression,” Guerrero Vázquez said. “We facilitate that conversation so they can talk about the different stressors and risk factors and then learn how to name what they feel.”
Many haven’t gotten help because of language barriers, as well as the fact that talking about negative feelings is not a common part of Latino culture.
“There is a systemic problem of exclusion of these individuals,” Guerrero Vázquez said. “These are people who don’t have resources in general, who don’t have access to mental health care at all, [and] who don’t have enough income to pay out of pocket.”
Seneca’s care for children and guardians is set to expire in July. Advocates say COVID-19 has created obstacles for the program, making door-to-door outreach to these families tough. But Seneca’s General Counsel Paige Chan said the agency is determined to reach as many eligible immigrants as it can.
Lilian’s advice for migrants who need mental health support in their new country: see a psychologist. Under the program, Lilian has been in therapy for the past six months, while her daughter has had therapy for the past year.
“People think it’s because you’re crazy or because you’re sick,” Lilian said. “But no, you really need to talk, you need to release what you have suffered, so you can feel clean, and feel good inside.”
Her daughter is adapting, making friends and going to a local school. But every once in a while, like when her mother leaves for her job as a cleaner, the girl, now 8, grows sad. Part of her is still afraid her mother may not come back.
Families can access services by calling or texting Seneca’s confidential and toll-free hotline at 844-529-3327 or emailing email@example.com.