Jun 182018

Ella Nilsen reports:

Undocumented kids in custody at the border think they’re getting help when they talk with a social worker or clinical psychologist, but what they say is often used to keep them in detention longer or even deport them, lawyers who work with these children say.

“They’ll encourage the kids to open up and disclose, but those notes are not protected by HIPAA or privacy law,” said Nithya Nathan, an attorney and senior program director for the Detained Children’s Program. “It’s our experience [kids] have a really limited understanding of where that information goes and how it can be used.”

Doctors and social workers have long provided care to undocumented kids held by the Office of Refugee Resettlement (ORR), the agency responsible for resettling minors who cross the border, including those seeking asylum. The appointments appear to be just like any other between a medical provider and a patient, but under the Trump administration, the US Department of Homeland Security is increasingly relying on medical and psychological records from these meetings to make decisions about the fate of these kids, numerous immigration lawyers who represent undocumented children told Vox.

Read more on Vox.

Comment:  This situation has been bothering me a LOT. Not only is our government ripping children away from their parents, which is an abomination in and of itself, but then children,  no longer having a parental figure they can rely on, can have their world further rocked and abused by trusting adults who then use whatever the children tell them to help the government deport them or detain them further?

This cannot be. The first rule is Do No Harm. This does harm and is therefore not to be adhered to.  Yes, minors often do not have the same extent of rights as adults, but the restrictions on their rights were generally put in place to protect their health or parental rights. They were not put in place to help the government prosecute or further harm children.

This has to stop.  Yes, there are things patients may tell us that we may be prohibited by law or ethics from keeping confidential, but the laws about confidentiality and privacy are there to protect the patients, not to make us tin star deputies of a punitive government.

The laws are there to protect patients.

If a patient were to reveal that yes, they came into this country and are attempting to perpetrate a fraud on the government and that they are not really the child of the adult they attempted to cross the border with — the therapist still can’t ethically disclose that. If, however, a patient were to confide that they were trying to come into this country to commit a terrorist act and that they had a specific plan, time, and place, then yes, the therapist can — and should – disclose/report that.

But kids talking to therapists about their fears and feelings about being in a strange country, ripped from their parents, and not knowing when they will see them again?

Are you kidding me, America?

To my fellow clinicians who are working in these settings and with these children:  I urge you to #RESIST any pressure from the government to disclose what, in your ethical core, you know you should keep confidential.




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