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PadLet Instructions for Policy in the News

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PadLet Instructions for Policy in the News

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Brittany Chesley and Denise Cavalcante

Social Policy in the News

The New York Times published an article, “Zero Tolerance’ Immigration Policy Surprised Agencies, Report Finds” written by publisher Ron Nixon, who reported and described the overwhelming repercussions of the zero tolerance immigration policy implemented by President Trump and his administration. The zero tolerance immigration policy was intended to deter all individuals, including families from illegally crossing the United States border. The zero tolerance immigration policy was enforced without warning or properly preparing for the negative outcomes associated with separating families at the border. Upon illegal entry, adults were apprehended by the Department of Homeland Security and federally prosecuted, families were forcefully separated, and children were cared for by U.S Department of Health and Human Services. According to this press release, the Department of Homeland Security and the U.S Department of Health and Human Services were ill-informed and did not have an official plan, protocol, or policy for separating families.

Before President Trump signed an executive order to stop family separations, approximately 3,000 children were separated from their families and placed in the care of the U.S Department of Health and Human Services. Children who were separated from their families were placed in government run shelters, with some shelters not being notified that the children were recently separated from their parents, leaving them unaware of the child’s recent traumatic experiences. After President Trump signed an executive order ending family separations at the border, most children were reunited with their families. Some children were misplaced or unaccounted for, while others were not released back to families who were suspected to be unsafe, had reports of child abuse, or had criminal records. While families are no longer being separated at the border, Border Patrol continues to enforce the zero tolerance policy and single adults continue to be apprehended at the border and criminally prosecuted. In total, approximately 400,000 people were apprehended by Border Patrol in 2018.

Discussion Questions:

1. How can local, state, and federal policies use a trauma-informed approach before implementation to evaluate the risks of trauma?

2. If there was a protocol for separating the families, what should be included to address the consequences, risks of trauma, and mental well-being of the families?

3. Was the zero tolerance immigration policy implemented by the Trump Administration ethical?

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The Customs and Border Protection agency reported apprehending 16,658 people traveling with families in September, a record. Credit Credit Lynsey Addario for The New York Times

WASHINGTON - The Trump administration did not tell key government agencies about its "zero tolerance" immigration policy before publicly announcing it in April, leaving the officials responsible for carrying it out unprepared to handle the resulting separations of thousands of children from their families, according to a government report released on Wednesday.

The Department of Homeland Security, which apprehends border crossers, and the Department of Health and Human Services, which cares for separated migrant children, were both caught off guard when Attorney General Jeff Sessions announced plans to criminally prosecute anyone who crossed the border illegally, the report said.

"There must be consequences for illegal actions," Mr. Sessions said before dozens of sheriffs from counties on the United States' border with Mexico.

Because they did not know about the "zero tolerance" policy in advance, officials at the Department of Homeland Security said, they did not take steps to prepare for the resulting family separations. Staff members at the Department of Health and Human Services said their leaders told them not to prepare for an increase in children separated from their families because homeland security officials claimed that they did not have an official policy of separating parents and children, according to the report, which was prepared by the Government Accountability Office, Congress's nonpartisan investigative arm.

The enforcement of the policy led to the separation of nearly 3,000 children from their parents, setting off weeks of national protests, with Democrats and many Republicans calling on President Trump to end it. The president eventually relented and moved to halt the family separations, though the government struggled in some cases to reunite those it had already separated.

"This disturbing G.A.O. report shows the tragic consequences of carrying out a cruel and misguided policy impacting thousands of families without any preparation or prior notification to the agencies charged with implementing it," said Representative Frank Pallone Jr., Democrat of New Jersey, who requested the report.

Katie Waldman, a spokeswoman for Department of Homeland Security, said federal agencies had reunited thousands of children with their families under a court order.

"In addition, we have prevented the reunification of children with adults who were not their parents, or were unsafe for children," she said, citing reports of child abuse or parents with criminal records. She said the Trump administration continues to criminally prosecute single adults apprehended at the border. She declined to elaborate on other details of the report.

The report comes as the Trump administration is grappling with thousands of migrants, mainly from Central American countries, seeking asylum on the southwestern border. An estimated 7,000 migrants recently entered Mexico fleeing the grinding poverty and violence of El Salvador, Guatemala and Honduras. Many of the migrants said they were headed to the United States, frustrating Mr. Trump, who said without proof - then backtracked - that the caravan of migrants contains "Middle Easterners" and suggested that the migrants were induced to make the journey by his Democratic opponents.

Data released on Tuesday by Customs and Border Protection, the parent agency of the Border Patrol, showed that the agency apprehended 16,658 people in families in September, a record. Such arrests reached 107,212 for the 2018 fiscal year, which ended Sept. 30, exceeding the previous high of 77,857 in the 2016 fiscal year. In total, nearly 400,000 people were apprehended by border agents in the 2018 fiscal year.

The "zero tolerance" policy was supposed to serve as a deterrent to families traveling with children. But from the outset, the policy seemed poorly planned.

According to the Government Accountability Office report, days after Mr. Sessions announced the policy, leaders of agencies at the Department of Homeland Security, including Customs and Border Protection, sought guidance from the Kirstjen Nielsen, the homeland security secretary, on how to enforce it.

In May, the department finally issued a memo directing border agents to refer all individuals crossing the border illegally to the Justice Department for prosecution. Adults were turned over to Immigration and Customs Enforcement and placed in detention facilities. Migrant children were sent to the Department of Health and Human Services.

Under a 1997 court agreement, migrant children cannot be detained for more than 20 days.

Many of the children were placed in government-run shelters thousands of miles away from their parents. But the report found that in some cases, officials at the Department of Homeland Security did not notify staff at the shelters that a child had been separated from his or her parents. One shelter's officials told the Government Accountability Office that for some of the children in its care, they had learned that the child was separated only when the child told them.

It was not until July 6, 16 days after Mr. Trump signed an executive order aimed at ending the family separations and 10 days after a federal court halted the policy, that federal agencies developed a system to determine whether children were separated from their parents, the report said.

Most of the separated children have been reunited with their families under a court order. But Mr. Pallone said the administration took too long to develop a process to identify and reunite families.

"The gross failures detailed in this report will be long remembered, but hopefully never repeated," he said.

A version of this article appears in print on , on Page A16 of the New York edition with the headline: Agencies Had No Notice Of 'Zero Tolerance' Policy. Order Reprints | Today's Paper | Subscribe

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'Zero Tolerance' Immigration Policy Surprised Agencies, Report Finds

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WASHINGTON - The Trump administration did not tell key government agencies about its "zero tolerance" immigration policy before publicly announcing it in April, leaving the officials responsible for carrying it out unprepared to handle the resulting separations of thousands of children from their families, according to a government report released on Wednesday.

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Collegiate Counseling Services: Rapid Access to Care versus Effective Treatment

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Collegiate Counseling Services: Rapid Access to Care versus Effective Treatment

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Kathryn Wilson, Madilynne West, and Elisabeth Stanley

Mental health treatment on college campuses has been growing and changing the past several years as a result of an increased demand for services. Over the years, Penn State has collected data reflecting the utilization of mental health resources on college campuses. These reports have identified several alarming trends in treatment provision through university and college counseling centers. Although treatment provided in counseling centers has effectively decreased student distress, the demand for services has led to limitations in treatment options, as well as prioritizing rapid-access to services. These changes can impact the overall provision of care as well as the quality of ongoing care provided in counseling centers.

The 2018 Center for Collegiate Mental Health (CCMH) found that college counselors and students using counseling services identified anxiety and depression as prominent reasons students seek treatment. In six years, student utilization of college and university counseling centers increased on average by 30-40%. This increase in demand has left counseling centers with the task of balancing rapid access to treatment - serving all students seeking treatment - versus being more exclusive with clients, leading to more in-depth services. Further complicating the situation, college students with threat-to-self characteristics, including suicidal ideation, attempts, and self-injury, use services 20-30% more on average than those without threat-to-self characteristics.

The report found that counseling centers approach toward new clients affected treatment outcomes. While counseling centers that scheduled clients for specific appointment times and counselors were not able to see as many people, they saw them more frequently and for longer periods of time. This resulted in better treatment outcomes and reduced symptoms compared to counseling centers that absorbed all clients regardless of current caseloads. The report noted this finding ought to inform higher education policy-makers. Other important things for policy-makers to note, according to the article, is how self-reported rates of anxiety and depression continue to rise, as well as threat-to-self characteristics, and rate of students receiving counseling has grown substantially, with 54.4% of students having previous counseling when seeking treatment.

Over the years, the demand for mental health services on college and university campuses has led to difficulty finding balance between prioritizing absorption versus treatment. This issue has policy implications for local college/university counseling services in how they admit new clients, comparing the rapid-access, absorption approach to a scheduled, more intentional approach. This research can inform program and policy change for college campuses nationwide.

Discussion Questions

1. What are the arguments for rapid access of care (seeing more students) versus being able to see less students but providing more personalized and in-depth care?

2. What alternatives that you can think of to address the increasing use of mental health services in how clients are admitted into services?

3. The report mentioned that concerns of depression and anxiety are most often present amongst students seen in the clinic, and they are continuing to increase each year. Are there any reasons that the rates of depression and anxiety may be increasing each year? Are there any preventative measures that could be in place to help students before the step of seeking services from the clinic?

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UNIVERSITY PARK, Pa. - Mental health treatment in higher education is a complex practice that has been rapidly evolving in response to a growing demand for services. For example, between fall 2009 and spring 2015, student utilization of university and college counseling centers increased by an average of 30-40 percent (CCMH 2015 Annual Report). While treatment provided by counseling centers has been found to be effective in decreasing student distress (CCMH 2017 Annual Report), many years of escalating demand have led to treatment limits and prioritization of rapid-access services, which may be impacting the ability of centers to provide ongoing treatment (CCMH 2016 Annual Report).

The 2018 Center for Collegiate Mental Health (CCMH) Annual Report, found that college students seeking treatment (and the professionals who treat them) continue to identify anxiety and depression as the most common concerns for seeking treatment, among dozens of other concerns. For the first time in five years, anxiety did not increase in prevalence whereas depression increased slightly again. Most other areas of self-reported distress remain flat or are even decreasing.

"As institutions confront the cumulative impact from years of rising demand for mental health services, it is critical to remember that we have spent more than 15 years actively working to prevent suicide, increase help-seeking, and train our communities by identifying and referring students at risk to treatment. As a result, institutions must be creative and wholistic in their response to a new level of demand that will not go away; but must not forget that we actively worked to create the very demand we are seeing, and our first job is to grow service capacity quickly in order to effectively support, and treat, students who are identified and referred," said Ben Locke, senior director of Penn State Counseling and Psychological Services, and executive director of CCMH, on increased demand and importance of an array of services.

As with past years, the 2018 report found that self-reported lifetime prevalence rates of "threat-to-self" characteristics (self-injury, suicidal ideation, suicide attempts) increased for the eighth year in a row, highlighting the important service that counseling centers serve in supporting students at risk and our broader national success in identifying and referring students who need help. Students reporting life-time threat-to-self characteristics, when seeking treatment, use an average of 20 to 30 percent more services than students who do not (CCMH 2015), which further increases the strain on counseling centers as they seek to balance being responsive to new students in distress while also providing effective treatment for those who need it.

The 2018 report specifically examined the impact of two high-level center policies on treatment outcomes for the purpose of informing higher education policy-makers: (1) how counseling center's systems for handling new clients impact treatment outcomes, and (2) whether access to counseling center electronic medical records, by health care staff, impact treatment outcomes. Regarding systems for handling new clients, also known as "clinical models," the report found that counseling centers that assign new clients to counselors with a dedicated appointment time demonstrated significantly greater symptom reduction, significantly more appointments per student, and significantly shorter wait times between appointments than counseling centers that require counselors to absorb new clients regardless of their existing caseload. In addition, the 2018 report found that policies governing access to electronic medical records, by health center staff, were not associated with significant differences in treatment outcomes, suggesting that treatment outcomes are determined by other aspects of counseling center operations.

"In addition to eight-year trends and a national population-level perspective on college students seeking mental health care, the 2018 CCMH report provides specific and actionable findings that should be used by administrators to inform policy decisions related to mental health care in higher education. In particular, the take-home message from the last four reports is that counseling centers are doing everything they can to accommodate the growing demand for service, such as prioritizing rapid access to care. However, this report highlights the negative impact associated with enacting these adjustments to services, such as providing a decreased dosage of treatment, and consequently less effective services. While it is critically important that counseling centers are responsive to the growing number of students who are identified and referred, it is equally important for institutions to recognize the value of policies that support effective treatment of students in distress," said Locke.

These are some of the findings in the 2018 CCMH Annual Report:

Anxiety and depression (as reported by students and their counselors) continue to be the most common presenting concerns for college students, as identified by counseling center staff. Anxiety did not increase in prevalence for the first time in four years, whereas depression continued to increase in 2017-18.

Student's average rates of self-reported anxiety and depression continue to increase while other areas of self-reported distress remain flat or decreasing.

The average rate of self-reported "threat-to-self " characteristics increased for the eighth year in a row among students seeking treatment. Nearly 36 percent of students seeking treatment endorsed having experienced serious suicidal ideation in their lifetime but only 8.2 percent of students seeking treatment report serious suicidality in the last month. Clinicians identified suicidality as a current concern for just under 10 percent of students.

The prevalence rate of students who have received prior mental health treatment continue to remain largely flat over eight years. However, the rate of students who have received prior counseling has trended up over the last three years, with 54.4 percent of students seeking treatment indicating they have been in counseling before.

The 2018 Annual Report describes 179,964 unique college students seeking mental health treatment; 3,723 clinicians; and more than 1,384,712 appointments from the 2017-18 academic year. This is the 10th year the report has been produced.

The Center for Collegiate Mental Health at Penn State is an international practice-research network of nearly 550 colleges and universities focused on understanding and describing college student mental health. CCMH collects and analyses de-identified data on college students seeking mental health treatment at colleges and universities in the U.S. and internationally.

The full report can be found online at http://ccmh.psu.edu/publications/.

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Annual collegiate mental health report examines trends and policy implications | Penn State University

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UNIVERSITY PARK, Pa. - Mental health treatment in higher education is a complex practice that has been rapidly evolving in response to a growing demand for services. For example, between fall 2009 and spring 2015, student utilization of university and college counseling centers increased by an average of 30-40 percent (CCMH 2015 Annual Report).

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Collegiate Counseling Services: Rapid Access to Care versus Effective Treatment