As immigration enforcement intensifies across the United States, pediatricians are stepping into an unexpected role: helping immigrant families prepare for the possibility of separation. Families are experiencing the harsh reality that them being detained or deported can happen at any time, leaving their children who were born in the U.S. at risk. In the face of growing terror and panic, health care providers and advocates are offering legal advice on guardianship arrangements to protect children.
In California, one in three children lives in a mixed-status family—defined as at least one but not all parents are undocumented. The cops-and-robbers reality has compelled pediatricians like Dr. Fernández to tread lightly in discussions with families. Parents such as Briana and Daniel are indeed faced with tough choices on what their children’s futures hold.
Briana’s pediatrician urged that she draw up a legal guardianship plan for her infant son in the event that she were to be detained. Now this recommendation led Briana to make an appointment to set up formal arrangements that would guarantee her son’s care. The doctor outlined the process: drafting a simple document that would allow a trusted friend to care for her son if necessary.
The Growing Need for Guardianship Plans
Briana’s decision to think ahead is an illustration of a larger trend underway among immigrant families. By getting within the orbit of a local nonprofit, she plugged into a network which helped families prepare guardianship paperwork. The urgency of this planning cannot be overstated, as for many parents this threat of deportation is ever-present.
Unfortunately, Daniel’s family is not alone in facing these scary new realities. His pediatrician told him to think about who would look after his youngest son if he got arrested. In answer to that call, Daniel and his wife got to work. They signed a durable power of attorney, designating their 28-year-old daughter as guardian for their adult son.
The weight of these decisions is heavy. Daniel stated, “If it was just me, it would be one thing, but I have a family and kids and their well-being is in jeopardy, and that’s terrifying.” He described the emotional toll, saying, “I feel something like a void inside of you, like a vacuum that’s sucking you somewhere.”
The Psychological Impact on Children
The psychological toll of knowing that separation might be around the corner is a serious factor. As the chief of child and adolescent psychiatry at NYU, Dr. Fernández has seen children’s mental health take the toll. He’s been on the ground when kids have to vocalize their fears about their parents being deported. He thought of that 10-year-old boy who was worried. In one shocking episode, the young boy asks his mother whether his dad should stop riding the subway to be off the radar.
Moreover, he noted heartbreaking cases such as a toddler who refused to eat for days after missing his father and a teenager who nearly overdosed after panicking over her father’s potential deportation. Experiences like these demonstrate the psychological trauma being imposed on children just by what immigration enforcement looks like today.
Dr. Powell emphasized this concern, stating, “One in terms of just the psychological trauma of your parents being taken without notice and not knowing when you will see or talk to them again, but just in terms of the safety and health of these kids.”
The Role of Pediatricians in Crisis
Pediatricians are on the front lines of this crisis. Unable to practice their trade, clinics have experienced a staggering increase in canceled appointments. In reality, many are facing attendance declines as much as 40%. This troubling trend is a testament to how fear of deportation is pushing families away from the medical treatment that they need most.
Dr. Powell elaborated on the challenges faced by immigrant families: “There’s always been barriers for those families in terms of navigating a health care system in a country that is unfamiliar to you and in a language that you’re trying to learn.” The new stress created by fear of ICE operations has made these challenges even more challenging.
Yet in the face of these challenges, health care providers remain deeply committed to their role in supporting families. Dr. Gutierrez remarked, “As much as we can clarify and support families in these really hard decisions, the better we can try to mitigate some of these fears and anxieties.” Once the kids are out of earshot, pediatricians talk to parents in hushed tones. They directly assist families in thinking through their guardianship options.
