https://revealnews.org/article/migrant-children-suicide-thoughts-us-custody/.

On a Saturday night in April 2021, a 15-year-old migrant from Guatemala told a friend he was so desperate to get out of a government-sponsored emergency shelter that he was contemplating suicide. He badly wanted to be reunited with his uncle. The friend told an adult there. It was his 33rd night in confinement at the emergency shelter in the Kay Bailey Hutchison Convention Center in Dallas. But the shelter didn’t appear to be prepared to deal with the child’s mental health needs. The records in the boy’s case, obtained by Reveal from The Center for Investigative Reporting through a public records request and subsequent lawsuit, underscore the confusion at the massive 2,300-bed facility: Three different entries in his record describe what happened in three different ways. In one part of the government’s record, a supervisor from Culmen International – a military contractor awarded nearly $30 million to manage the emergency shelter – said the child should be taken to an on-site medical clinic for evaluation. The teen said he missed his family and confirmed that he did feel suicidal. He conceded what his friend reported seeing: that he tightened the identification badge lanyard around his neck. But he insisted he wasn’t trying to end his life. “Child dreams about getting out of here,” a staffer wrote. “Child appears sad but not desperate.” One entry in the report says the child was seen at the medical clinic, where he confirmed thoughts of suicide and the clinic determined he was “just sad.” The boy was told “his feelings are normal,” according to case notes. But in another part of the record, a staffer said they were never informed about the boy’s suicidal ideation or attempt once he arrived to the clinic. A third entry says the child hadn’t been to the clinic at all. That same evening, the teen was back in his sleeping cot in Pod G with a staffer watching over him for his safety, still far from the family he was longing to be reunited with. Early the following morning, Jackie Sanchez-Perez, a federal worker on loan to the Office of Refugee Resettlement to help run this emergency shelter, tried to find the boy to make sure he was safe. Sanchez-Perez demanded help from the Culmen command desk, the records state, and a runner escorted her to the 15-year-old at his pod. She introduced herself and told the child that he wasn’t in any trouble. He told Sanchez-Perez that he knew what this was about: “those thoughts.” The ones that drove him to think about ending his life. She was concerned that he never got the help he needed at the shelter, and he was transferred to a local children’s hospital for mental health care. In President Joe Biden’s first three months in office, Reveal found nearly 600 episodes in which migrant children in the government’s custody said they’d considered or attempted suicide, either before or since arriving in the United States. Records document 141 instances in which migrant children expressed thoughts of suicide while in Office of Refugee Resettlement custody and at least 10 times when they attempted suicide. Children often complained about their length of stay, the isolation they felt after their friends were released and the suffering they experienced being away from their families. The children were in custody an average of 37 days at the time of the episode. The records indicate that no children died by suicide. In the vast majority of cases, children ages 6 to 17 told staff they’d considered or attempted suicide before ending up in custody. The children often shared their experiences with staffers in response to questions during a standard intake process. Notes in the government’s data indicate that the youth often were placed on safety plans and assigned counseling and close monitoring. They sometimes landed in hospitals because the government-sponsored programs – emergency shelters, licensed shelters and foster care – were unable to tackle the challenge alone. Federally funded permanent shelters, in a vast network across the country, are licensed by the states and therefore subject to oversight. Foster programs, which are also state licensed, provide a family-like structure and relative freedom when compared to shelters. The emergency shelters, however, operate without a license and are often run by military contractors with experience in logistics, not necessarily in caring for migrant children. Records indicate a particularly acute issue at these emergency shelters, such as the convention center where the teen was held in Dallas. In a span of just a few weeks last year, at least 20 children in emergency shelters received outside treatment because their mental health needs weren’t met on-site. That’s a far higher proportion than at state-licensed shelters, indicating just how sweeping the need is and how unprepared the emergency shelters were to meet it. Culmen and Sanchez-Perez referred questions to the Office of Refugee Resettlement, which is responsible for the care of migrant children. The federal refugee agency conceded that it was moving a large volume of children into understaffed emergency shelters and that children were entering physical facilities before case management operations were in place. The agency also defended what occurred at the emergency shelter that weekend last year, saying children who attempt suicide are routinely transferred to emergency rooms to get the care they need. The government’s record doesn’t indicate whether the teen was ever reunited with his uncle. Exterior of the Kay Bailey Hutchison Convention Center in Dallas. The Kay Bailey Hutchison Convention Center stands in Dallas. In 2021, the U.S. government set it up as a 2,300-bed emergency shelter for unaccompanied migrant children. Credit: Ron Jenkins/Getty Images Liz Castillo, a senior organizer with the nonprofit advocacy group Detention Watch Network, said the frequency of suicidal episodes affirms her organization’s position that migrant children’s shelters are incapable of handling the care of vulnerable children who’ve already experienced considerable trauma before arriving at the United States. “For years now, we’ve been reckoning with the consequences of our inability or unwillingness to address the systemic issues underlying our reception and care of migrant children,” Castillo said. “It’s not surprising that children in ORR custody frequently experience mental health crises.” The Cost of Keeping Children Separated From Their Families When something especially notable happens with a child in a given program’s care – a pregnancy, an allegation of abuse, a thought of suicide – a shelter must produce a Significant Incident Report to alert the refugee agency. Reveal first sought reports in 2019 related to suicidal episodes among children in shelters and sued the federal government in 2020 after it failed to deliver the records. Through settlement negotiations, Reveal ultimately obtained full narratives about suicidal episodes among migrant children from late January to late April 2021, the first three months of Biden’s administration. The government’s records don’t include children’s names or information on their case outcomes. The records divulge the cost of keeping children, especially those who’ve already endured tremendous trauma in their countries of origin and on their journey to the United States, separated from their families and isolated from their communities. The refugee agency refused to provide its contracts with the companies housing migrant children, citing internal policy. In April 2021, the agency outlined staffing ratios for emergency shelters: one mental health clinician for every 50 migrant children, though the requirement kicked in only after 20 days and the service could be rendered remotely. By comparison, licensed shelters are generally expected to provide one mental health clinician for every 12 children from the moment the operation begins. The data obtained by Reveal is the best window available into how mental health crises are handled in a patchwork system that’s sometimes ill-equipped to tackle serious episodes, leaving migrant children to bear the tremendous toll. As Reveal’s ongoing investigation into the detention of refugee minors has shown, prolonged detention can fundamentally change children. From 2014 to 2020, the government held nearly 1,000 children for longer than a year. In some cases, children have been held for extended periods even though they have family in the United States willing and able to care for them.