Practices at Texas center constitute child abuse
Imagine separating children from their parents and remanding them to a facility in which staff routinely force powerful, psycho-active drugs into their bodies. Something from Nazi Germany or a dystopian science-fiction novel? No, this took place in Shiloh Treatment Center in Manvel, Texas. The U.S. Office for Refugee Resettlement contracted with this and other facilities to provide care for undocumented children separated from their parents at the U.S.-Mexican border while courts and agencies decide the status of the families. Some children were remanded to tightly supervised facilities. I learned of the Shiloh center from reportage in The Washington Post and the Center for Investigative Reporting.
Located south of Houston, the locked Shiloh residential facility cared for 44 children, 32 of whom were migrants, in trailers and other small structures. Inmates were under constant surveillance. An investigation into practices at this center became public in March. The center countered with statements that it had been repeatedly inspected and approved by state and federal agencies and consular representatives from countries from which children originated.
U.S. District Judge Dolly Gee ruled in Los Angeles on July 30 that the U.S. government, through its Shiloh contractor, must cease giving psycho-active drugs to minors without the consent of their parents or guardians. The judge further ordered that children should be removed from the Shiloh center except in cases where a child was at risk of injuring himself or others. This determination required consultation with a specialist in child psychiatry. The judge pointed out that actions at the Shiloh center violated the 1997 Flores settlement, which set
standards for detention, treatment and release of immigrant children.
Earlier reports of inappropriate treatment of children at Shiloh emerged in 2014, prompting Texas Congresswoman Sheila Jackson Lee to call for its closure. Intermittent newspaper reports alleged abuses at the center.
The doctor who authorized drug treatment for children at Shiloh lacked credentials in adolescent and child psychiatry. Orderlies and other staff had leeway in determining dosages. Children reported being given medications three to four times daily without explanation. Drugs were forcibly given by mouth or injection to children who refused to take them. Children were threatened with longer detention or bodily harm if they declined their medication.
Drug practices at the center represent poly- pharmacy at its worst. Multiple drugs were given without clear treatment plans. Medications included powerful chemicals for treating anxiety, depression, agitation, seizures, migraine and bipolar disorder. Medications were given without parental consent. Children reported a variety of side effects related to their medications: nausea, depression, weight gain, dizziness, sleepiness.
One child received 10 different medications by mouth or injection.
Children were denied telephone contact with their parents or guardians. Some reported physical abuse.
Federal court decree should end abuse at the Shiloh center. What is the status of children held in other centers? Who monitors their care?
Where does the buck stop in this and other alleged instances of abuse of migrant children? The chain of responsibility flows from the president, who appointed Alex M. Azar II secretary of the Department of Health and Human Services. (The toll-free phone number for HHS is 1- 877- 696- 6775).
Next in the chain is Don Wagner, acting assistant HHS secretary for the administration of children and adults.
Scott Lloyd is the director of the Office of Refugee Resettlement, which contracts with private agencies to care for children.
Our senators and representatives can launch formal investigations and hold hearings on the care of migrant children.
Ultimately, the buck stops with you and me. We are the final protectors of children at risk, wherever they may be. Rather than read and forget accounts of the Shiloh center, we must demand through every means at our disposal that every child in federal or state custody for any reason be treated with kindness and respect. Failure to do so should be grounds for dismissal beginning with departmental and division heads.
Clif Cleaveland, M. D., is a retired internist and former president of the American College of Physicians. Email him at ccleaveland@ timesfreepress.com.