The families and children migrating from Central America have suffered terrible traumatic experiences, and a recent report by Physicians for Human Rights (PHR), a non-profit advocacy group, addresses the serious, long-term medical consequences of this trauma. These important findings provide compelling support for more humane immigration policies, and inform best practices for lawyers working with immigration clients.

Trauma Suffered by Young Migrants

Multiple studies link trauma to long-term negative health outcomes, including chronic disease, impaired cognitive development, and mental health conditions. With analysis by medical school faculty and students from Weill Cornell Center for Human Rights, the report is significant for its sole focus on child asylum seekers. Out of the 183 children in the study, nearly 80% experienced direct physical violence, 71% experienced threats of violence or death, 59% witnessed acts of violence, and almost 20% experienced repeated sexual violence or exploitation. Sixty percent of the children experienced some form of gang violence, and 47% experienced violence perpetrated by family members. A constant theme among the children was the lack of protection from law enforcement in their home countries. (Eighty-nine percent were from El Salvador, Guatemala, and Honduras.)  Many also reported traumatic experiences during transit to the U.S. through dangerous terrain, with inadequate food or water, where they remained vulnerable to continued acts of violence.

In addition to the physical aftereffects of this abuse, PHR found that 76% of the children were suspected to have or were diagnosed with at least one major mental health diagnosis, including PTSD (64%), depression (40%) or anxiety (19%). Many suffered from dissociative reactions, flashbacks, nightmares and suicidal thoughts, among other symptoms. Even once the children were in stable environments, “the lasting impact of trauma was evident in their ongoing difficulties with emotional regulation, social interactions, and bonding with parents and other caretakers.”

U.S. Immigration Policy

PHR urges an end to current U.S. immigration practices that expose young migrants to further harm, including an end to family separation, ensuring initial medical screenings, improving healthcare access by establishing standards of care for children in U.S. custody, and minimizing detention. Immigration detention has increased significantly under current policy despite the fact that it increases rates of anxiety, depression and PTSD among all age groups. PHR advocates for increased federal funding to improve detention conditions, as well as creating alternatives to detention and reducing delay in the asylum process. The report further cites the unprecedented turn-back policy where a growing number of asylum seekers have to assert their U.S. asylum claims from Mexico, putting them at risk of further persecution and limiting access to legal counsel.

Finally, reducing trauma requires addressing violence in the immigrants’ home countries – the main underlying cause of Central American migration.

Trauma-Informed Lawyering in Immigration Cases

Lawyers in immigration cases must acknowledge and adapt to a client’s trauma beyond what is required by basic attorney professional responsibility.  A trauma-informed approach helps resolve the inherent tension between presenting a compelling application and minimizing additional trauma for clients who relive traumatic events when telling their stories. This is certainly true in asylum cases.

Best Practices for Trauma-Informed Lawyering:

  • Be sensitive when discussing traumatic experiences. It may take several meetings before your client is ready to share details. Elicit stories through open-ended questions (“what involvement did the police have?”), not judgmental ones (“why didn’t you go to the police?”).
  • Adapt to your client. Help a highly emotional client focus on what facts are important. If a client is withdrawn or angry, build additional trust by listening first before asking about more traumatic experiences.
  • Remember that trauma affects memory formation. If your client cannot remember the traumatic event itself, elicit feelings or unrelated memories from around the same time. Any inconsistencies are not necessarily lies. Because differences in the application and the final interview might jeopardize a claim, attempt to reconcile them early. Include details in the application without locking the client into any unnecessary facts.
  • Know when to seek professional help. Immigration clients tend to be resilient and may minimize their experiences. Professional help can determine a diagnosis and provide the interviewer with context for a client’s unemotional behavior or apparent holes in the story.

PHR’s new insight into the negative, long-term health effects of trauma among child asylum seekers advances medical science, and provides an important resource for advocates seeking an end to policies and practices that only serve to cause more harm.

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Photo of William C. Silverman William C. Silverman

William C. Silverman is a partner responsible for leading Proskauer’s global pro bono efforts, which provide assistance to individual clients and nonprofit organizations in litigation as well as transactional matters. He focuses on identifying and securing pro bono opportunities and partnerships for Proskauer…

William C. Silverman is a partner responsible for leading Proskauer’s global pro bono efforts, which provide assistance to individual clients and nonprofit organizations in litigation as well as transactional matters. He focuses on identifying and securing pro bono opportunities and partnerships for Proskauer lawyers and ensuring widespread participation in these projects.

Bill has robust private and public sector experience and a strong criminal and civil background. He has worked extensively on government investigations and white collar criminal matters, as well as complex civil litigation in federal and state courts. He also served as an assistant U.S. attorney in the Southern District of New York, where he led criminal investigations, conducted trials and handled Second Circuit appeals.

Throughout his career, Bill has dedicated himself to the promotion of equal access to justice through pro bono service, particularly in the area of family court, anti-trafficking, and immigration.

Bill spearheaded a partnership among several law firms, corporations and the New York City Family Court to provide free legal advice to pro se litigants. The New York City Family Court Volunteer Attorney Program now has more than 400 volunteer attorneys from 40 major firms and corporations. Bill also helped build a coalition of organizations in a successful effort to secure additional Family Court judges in New York. He is now part of an effort spearheaded by Chief Judge Janet DiFiore to simplify the New York Court System from 11 trial courts to three.

Bill serves as counsel to the New York State Anti-Trafficking Coalition. In that capacity he has been a strong advocate for changes in the law and public policy to protect victims of human trafficking and bring perpetrators to justice. He also represents individual clients in this area, including a successful federal lawsuit brought on behalf of a trafficking victim against her traffickers. For his work, he was named by domestic violence nonprofit Sanctuary For Families as one of “New York’s New Abolitionists.”

Bill has spoken at numerous conferences and events, including New York Chief Judge Jonathan Lippman’s Hearings on Civil Legal Services and the American Bar Association’s Equal Justice Conference. In 2014, he attended a meeting at the White House with Vice President Joe Biden and other policymakers on the need for access to legal services in immigration proceedings.

Bill has been recognized for his public service with the Abely Pro Bono Leadership Award from Sanctuary For Families and Columbia Law School (2019); the Special Leadership Award for All-Around Excellence in Corporate Social Responsibility & the Law from City & State Reports (2015); the Commitment to Justice Award for Outstanding Partner from inMotion (2008); and the Matthew G. Leonard Award for Outstanding Pro Bono Achievement from MFY Legal Services (2007).

Outside of his work at the firm, Bill serves on various committees and non-profit boards. Bill is currently chairman of the Fund for Modern Courts, a non-partisan citizen organization devoted to improving New York State courts, and is formerly chairman of Legal Information For Families Today (LIFT), an organization devoted to unrepresented litigants in Family Court.

Photo of Sydney Juliano Sydney Juliano

Sydney L. Juliano is an associate in the Labor & Employment Department and a member of the Employee Benefits & Executive Compensation Group, where she focuses on ERISA Litigation.

Sydney works on a variety of ERISA litigation matters, including fee- and investment-related breach…

Sydney L. Juliano is an associate in the Labor & Employment Department and a member of the Employee Benefits & Executive Compensation Group, where she focuses on ERISA Litigation.

Sydney works on a variety of ERISA litigation matters, including fee- and investment-related breach of fiduciary duty claims, benefit claims, and claims by trustees of multiemployer plans for withdrawal liability and delinquent contributions. Sydney is also a frequent contributor to Proskauer’s Employee Benefits & Executive Compensation Blog.

Sydney maintains an active pro bono practice, including representing clients in immigration and family court matters.

Sydney received her J.D. from the University of Virginia School of Law, where she was an Articles Editor of the Journal of Law and Politics and Director of Coaching for the Extramural Moot Court team.  While at UVA, she worked at the U.S. Attorney’s office for the Southern District of Florida.