Immigration: Importance of Keeping Families Together

ISTSS Statement on the Importance of Keeping Families Together and the Traumatic Stress Associated with Child Separation from Parents and Caregivers

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The International Society for Traumatic Stress Studies (ISTSS) is an international interdisciplinary professional organization that promotes advancement and exchange of knowledge about traumatic stress by bringing together experts in mental health, policy, and service delivery from across the globe to address traumatic stressors and their immediate and long-term consequences.

Decades of research and clinical knowledge have repeatedly demonstrated that the relationship with a parent or primary caregiver is critical to a child’s sense of self, safety, and trust. Separation from caregivers during stressful and traumatic situations can cause irreparable harm in itself and often has longstanding and severe effects on children.

Recent practices and policies being implemented by the U.S. government have led to the separation of children from parents and caregivers who have been arrested for attempting to enter the U.S. Numerous experts and professional organizations have stated in clear terms the harm that is caused by such separation of children from their parents or caregivers. Informed by the substantial research and clinical experience of our membership, the ISTSS is compelled to amplify these concerns.

The negative effects of forced separation from parents or caregivers are extreme, both in the short and long-term. ISTSS urges decision makers, policymakers, and other leaders in the U.S. and around the world to keep families together and avoid practices and policies that separate children from parents or caregivers.

Further, it is imperative that appropriate trauma-informed services and supports be provided to children and families who have already experienced the trauma of separation. The reunification of these families must be immediately prioritized.

In providing assistance to these children and their parents – before, during, and after they are reunified – it is essential to recognize how the separation has affected them. In the initial moment of separation, particularly when separation is unexpected and when children are in unfamiliar situations, reactions may include extreme distress, quiet shock, and disorganized behaviors.

In the hours to days following separation, many children will have difficulties with falling asleep, staying asleep, and nightmares. Children who are able to sleep may be confused to wake in an unfamiliar setting. They may become preoccupied with traumatic memories – such as the recollection of being taken from parents and caregivers or preoccupied with intense, un-alleviated worry and fear about the safety and welfare of their parent.

Some children are likely to become aggressive, angry, or withdrawn. Children may also become focused on imagined or enacted harm to themselves. Attention, concentration, and learning are often seriously impaired for children in unfamiliar settings who are separated from their parents or caregivers. Some children will develop somatic complaints (such as headaches, nausea, pains) and research has even shown negative effects of such extreme stressors on children’s immune systems.


These are the known and well-demonstrated short-term effects of separation from parents or caregivers. Further, siblings should not be separated from each other, as this only compounds the traumatic separation from a parent or caregiver.

Long-term effects of separation from parents or caregivers, which may be mitigated somewhat by rapid reunification, are profound. These negative effects, particularly when this separation is traumatic or unexpected, include significantly increased risk even decades later for post traumatic stress disorder (PTSD), depression, anxiety, and substance use disorders. Moreover, the long-term effects of separation have been shown to extend beyond psychological symptomatology to include significant impact on brain development. Childhood separation from parents or caregivers has been linked to negative alterations in immune function, deleterious health behaviors, poorer physical health, and accelerated aging.

These long-term effects have been documented across cultures and across a range of circumstances surrounding the separation. These responses are likely to be worse for children who directly experienced or witnessed traumas prior to the separation from the caregiver, such as sexual, gang and/or domestic violence, since the psychological and neurobiological impacts of trauma are often cumulative.

ISTSS stands ready to share the scientific and clinical expertise of our members to address critical trauma and public health issues, such as preventing and ameliorating the traumatic consequences associated with family separations.

ISTSS is an international interdisciplinary professional organization that promotes advancement and exchange of knowledge about traumatic stress.