Unaccompanied Children Along the Southwest Border – a Partnership Effort Between Federal, State and Local Authorities

BACKGROUND:  Unaccompanied children (UCs) are undocumented migrant children under the age of 18 who come to the United States without a parent or guardian. Between October 1, 2013 and August 31, 2014, approximately, 66,127 UCs were apprehended at the southwest border, the highest total number in recent years.  The majority of them come to the United States (US) to reunite with family, escape poverty, gangs, violence, prostitution, smugglers, and traffickers who prey on these children. On June 2, 2014, President Barack Obama declared the influx of UCs to be a humanitarian situation and directed all federal agencies to work together in response.  In this presentation we will describe the roles of all partners, specifically of the United States Public Health Service (USPHS), public health implications, and recommendations to local and state health departments.

METHODS:  Children who are apprehended by Customs and Border Protection (CBP) upon crossing the border are placed in temporary holding facilities for up to 72 hours and then processed and turned over to the Administration for Children and Families (ACF), Office of Refugee and Resettlement (ORR). ORR then places children into residential facilities where they are reunited with family members who serve as sponsors. The USPHS along with other federal, state and local partners served in many different capacities, conducting medical screenings, case management, behavioral health screenings, and other technical assistance provided to the US Department of Homeland Security.

RESULTS:  Approximately 350 USPHS Officers were deployed between May 15, 2015 and August 15, 2014.  The USPHS assisted with screening and moving thousands of children from CBP to ACF and eventually reuniting them with family or sponsors.  The majority of the children were males between 15-17 years of age, primary from Guatemala, El Salvador, and Honduras.  Approximately 25% of the children were under the age of 12.  From October 1, 2013 through June 15, 2014, the US saw a 99% increase of UCs (26,206 vs. 52,193).

CONCLUSIONS:  This mission emphasized the importance of collaborative efforts between federal, state and local agencies and the importance of having a culturally competent public health workforce. These children have been exposed to chronic and pervasive trauma and are especially vulnerable to the impact of subsequent stress and trauma that can affect their health. It is recommended health departments be prepared to provide culturally-competent and trauma-informed services.