Critics decry long-distance counselling for migrant teens

Critics decry long-distance counselling for migrant teens
HOMESTEAD, Fla. - The U.S. government is providing long-distance video counselling to teens housed at the country’s largest child migrant detention centre as officials struggle to accommodate increasing numbers of minors illegally crossing the U.S.-Mexico border. Some mental health experts and human rights advocates say that’s the wrong way to help the young people, who arrived in a strange country with no parents and few belongings and often encountered gang violence or became ill on the way to the U.S.

A private company contracted by the U.S. Department of Health and Human Services to run the centre in Homestead is piloting the program and has hired clinical counsellors and case managers in Texas, about 1,600 miles (2,575 kilometres) away.

Counsellors are often the first to hear reports of rapes or beatings that children suffered either in their home countries or at the hands of gangs as they journeyed north from impoverished villages in Guatemala’s western highlands, Honduras or El Salvador. Some teenage girls have arrived at the facility pregnant.

“Migrant children already find it extremely hard to communicate their feelings and trust professionals,” said Martha Vallejo, a clinical social worker in Miami who has counselled minors after their release from migrant detention centres. “How can they feel at ease talking to someone behind a screen?”

Case managers are also using video conferencing to talk with children and their relatives before the minors are released from custody. One of Homestead’s residents, a 17-year-old Guatemalan boy who learned shortly after arriving in the U.S. that he had tuberculosis, told Amnesty International researcher Brian Griffey that is how he communicated with his case manager.

Elena Reyes, director of Florida State University’s Center for Child Stress & Health, acknowledged that long-distance counselling is increasingly being used in remote locations where there aren’t enough providers. But she said it was hard to imagine that there isn’t a larger pool of bilingual applicants who could provide in-person counselling at the Homestead facility, located about 30 miles (48 kilometres) south of Miami.

Comprehensive Health Services, the government contractor, said it was enlisting counsellors and case managers in Texas to work remotely with the clients because they have not gotten enough applicants from the Miami area. The contractor holds frequent job fairs, said Health and Human Services’ spokesman Mark Weber.

The head of a local non-profit organization, which is part of a national network of child trauma professionals, said the company had not contacted them. Claudia Kitchens, Kristi House’s director, said the group already sends specialists to two smaller child migrant shelters in the area. It has an office 3 miles (5 kilometres) away from the facility.

Providing services through teleconferencing is not completely new: The federal government previously had used it to conduct court hearings for migrant teens. Telehealth counselling has also been expanded to treat active-duty soldiers or veterans dealing with depression or post-traumatic stress disorder. But the Homestead facility is the only one of 168 child migrant facilities nationwide using it for counselling.

Homestead has the country’s largest child migrant facility in the nation, with 2,200 minors, and officials say capacity may grow to 3,200. A 1997 court agreement setting conditions for the detention of minors generally bars the government from keeping them for more than 20 days. But some children have told lawyers and congressional delegations they have been held there for months. Over the past year, Immigration and Customs Enforcement has jailed more than 100 of those teenagers who turned 18 while being held at the centre.

Employing a remote method of counselling is yet another affront, migrant advocates said.

“A lot of the children we spoke to had not even seen a cellphone,” said J.J. Mulligan, an attorney with the Immigration Law Clinic at the University of California, Davis, who has visited the facility. “Asking them to share the most intimate traumas with a stranger over a computer screen seems completely tone-deaf and incapable of offering the mental health they desperately need.”

Democratic Florida U.S. Rep. Ted Deutch said he was concerned that the government already had increased the number of children each counsellor treats: now 20 instead of the previous 12.

“The question is whether you can use technology to meet the ratios,” Deutch said. “The most important thing is, are these kids taken care of the way they need to be?”
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