WASHINGTON — Separated from his father at the US-Mexico border last year, the little boy, about 7 or 8, was under the delusion that his dad had been killed. And he thought he was next.
Other children believed their parents had abandoned them. And some suffered physical symptoms because of their mental trauma, clinicians reported to investigators with a government watchdog.
‘‘You get a lot of ‘my chest hurts,’ even though everything is fine’’ medically, a clinician told investigators. The children would describe emotional symptoms: ‘‘Every heartbeat hurts,’’ or ‘‘I can’t feel my heart.’’
Children separated during the Trump administration’s ‘‘zero tolerance policy’’ last year, many already distressed in their home countries or by their journey, showed more fear, feelings of abandonment, and post-traumatic stress symptoms than children who were not separated, according to a report Wednesday from the inspector general’s office in the Department of Health and Human Services.
The chaotic reunification process only added to their ordeal.
Some cried inconsolably. Some were angry and confused. ‘‘Other children expressed feelings of fear or guilt and became concerned for their parents’ welfare,’’ according to the report.
The child who believed his father was killed ‘‘ultimately required emergency psychiatric care to address his mental health distress,’’ a program director told investigators.
Child psychiatrist Dr. Gilbert Kliman, who interviewed dozens of migrant children in shelters after zero-tolerance took effect, said the kids can move on with their lives after reunifying with parents but may never get over it.
As children they have night terrors, separation anxiety, trouble concentrating. As they become adults, they face greater risks of mental and physical challenges, from depression to cancer.
Among the separated children, he foresees ‘‘an epidemic of physical, psychosomatic health problems that are costly to society as well as to the individual child grown up. I call it a vast, cruel experiment on the backs of children.’’
The AP obtained a copy of the report in advance of the official release, the first substantial accounting by a government agency on how family separation under the Trump policy has affected the mental health of children. It was based on interviews with about 100 mental health clinicians who had regular interactions with children but did not directly address the quality of the care the children did receive.
“Facilities reported that addressing the needs of separated children was particularly challenging, because these children exhibited more fear, feelings of abandonment, and post-traumatic stress than children who were not separated,’’ said Deputy Inspector General Ann Maxwell. ‘‘Separated children are also younger than the teenagers facilities were used to caring for.’’
A second report Wednesday by the watchdog found that thousands of childcare workers were given direct access to migrant children before completing required background and fingerprint checks.
The report covers a period last year when facilities were overwhelmed by the policy under which at least 2,500 children were separated from their parents. They stayed behind in border custody while their parents were taken to federal court for criminal proceedings. Children held longer than 72 hours were transferred into HHS custody and placed in shelters that have traditionally cared for children who crossed the border alone.
Migrant children stay in the shelters, run by government-funded organizations, until released to a sponsor, usually a parent or close relative.
The watchdog said the longer children were in custody, the more their mental health deteriorated, and it recommended minimizing that time. It also suggested creating better mental health care options and hiring more trained staff.
The Administration for Children and Families, the HHS division that manages children, concurred with the recommendations and said it had already begun implementing them, including hiring a board-certified child, adolescent and adult psychiatrist to serve as a mental health team leader.
Department Assistant Secretary Lynn Johnson said in a letter to the watchdog that the average length of stay is much shorter now.
After a federal judge ordered the children reunified with their parents, guidance on how to do it kept changing and that led to further anxiety and distress, according to the report.
In one case, a child was moved from a Florida facility to Texas to be reunited with her father. After the child made several trips to the detention center, she was returned to the Florida facility ‘‘in shambles,’’ without ever seeing him.
The report found that mental health staff were overwhelmed. Usually there is one mental health clinician for 12 children, but during the period investigators studied, there were more than 25 children for one clinician.
A second Office of Inspector General report found 31 of the 45 facilities reviewed had hired case managers who did not meet Office of Refugee Resettlement requirements.