AAN statement on separation of families at US border

June 19, 2018

The American Academy of Nursing strongly urges US Secretary of Homeland Security (DHS) Kirstjen Nielsen and US Attorney General Jeff Sessions to reverse the recently released policy guidance on “Zero Tolerance Immigration Prosecutions.” 

The purpose of this policy is to deter illegal immigration into the U.S. by prosecuting adults that enter the country unlawfully, during which time they are separated from their children that accompanied them during the journey. This includes those seeking asylum by attempting to cross into the US after fleeing from poverty, war, gang and domestic violence. Once separated from their parents, immigrant refugee children are placed into the US Department of Health and Human Services’ Office of Refugee Resettlement. Children remain in US federal custody until they are matched with and released to a sponsor. The sponsor may be a close relative, to include the parent that was prosecuted during the same border crossing, but only if they were released and then ask DHS to release their children back into their custody. (Read the DHS Fact Sheet: Zero Tolerance Immigration Prosecutions – Families.) 

Studies support that forcibly separating children from their parents increases the likelihood of toxic stress levels for these children, and may have long-lasting negative effects on their health and psychological well-being. Toxic stress is the result of experiencing frequent and ongoing adverse events, particularly in the absence of protective behaviors. Many of these children have fled existing difficult and stressful situations at home to come to the US, exacerbated by their journey to the border, and now are exposed to the uncertainty of whether or not they will be reunited with their parents. 

The American Academy of Nursing has long supported the reduction of toxic stress associated with adverse childhood experiences (ACEs) to improve the health of the nation. ACEs can affect brain development and impair mental, physical and emotional health for children that may have long-lasting negative effects throughout life. The Academy convened a Critical Conversation in October 2017 on “Toxic Stress in Children Living in Poverty” to start the conversation with cross-sector partners to identify and implement promising practices to prevent toxic stress in at-risk children. The Academy subsequently published “Critical conversation: Toxic stress in children living in poverty” in the March/April 2018 issue of its journal, Nursing Outlook. In 2016, the Academy released a policy brief on “Support for humanitarian aid to refugee children,” which advocates for nurses to provide culturally-sensitive health services for vulnerable children, including mental health services. The Academy also supports integrated legal representation within health care. 

The Academy reiterates its opposition to the inhumane policy of separating a large and growing number of immigrant children from their parents at the US border. The damaging toxic stress this practice burdens children with is not politically or morally justifiable. The Academy implores the administration to reverse this policy, for the health and safety of the children who are directly impacted by it and for their long-term health. As nurse leaders we have an obligation to stand against this harmful action and urge the nation to cease such unwarranted and unnecessary action.

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About the American Academy of Nursing
The American Academy of Nursing (www.AANnet.org) serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy's more than 2,500 Fellows are nursing's most accomplished leaders in education, management, practice, and research. They have been recognized for their extraordinary contributions to nursing and healthcare.