By Joanne M. Chiedi, Department of Health and Human Services, September 18, 2019
Care Provider Facilities Described Challenges
Addressing Mental Health Needs of Children
in HHS Custody.
Facilities that care for children in the Office
of Refugee Resettlement’s (ORR’s) custody
face the difficult task of addressing the
mental health needs of all the children in
their care, including children who have
experienced intense trauma. According to
those who treat them, many children enter
the facilities after fleeing violence and
experiencing direct threats to their safety
during their journey to the United States.
Some children also experienced the trauma
of being unexpectedly separated from their parents as a result of U.S.
immigration policies. Facilities must promptly address children’s mental health
needs—not only to stabilize each child in crisis, but also to reduce the risk that
the child will negatively influence or harm others.
What OIG Found:
Facilities described the challenges inherent in addressing the mental health
needs of children who had experienced significant trauma before coming into
HHS care. Facilities reported that challenges employing mental health clinicians
resulted in high caseloads and limited their effectiveness in addressing
children’s needs. Facilities also reported challenges accessing external mental
health providers and transferring children to facilities within ORR’s network that provide specialized treatment. Policy changes in 2018 exacerbated these
concerns, as they resulted in longer stays in ORR custody and a rapid increase
in the number of younger children—many of whom had been separated from
their parents after entering the United States.