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April 21, 2022

Responding To: Innovating Protection for Migrant and Asylum-Seeking Children in U.S. Communities

Continuum of Care to Terra Firma: Providing Legal, Medical, and Mental Health Protection to Unaccompanied and Indigenous Immigrant Youth

Brett Stark, Esq., Co-founder, Terra Firma at Catholic Charities New York; Sofia Linarte, Managing Attorney, Unaccompanied Minors Program, Catholic Charities New York; Josephine Herman, Esq., Staff Attorney, Catholic Charities Community Services; Elizabeth Wood, Supervising Attorney, Unaccompanied Minors Program, Catholic Charities New York

When unaccompanied Indigenous youth flee Central America for the United States, finding an immigration lawyer and obtaining lawful status is only part of the solution. Discriminated against in their home countries through obstacles to education, health, and justice, these young people face language and cultural barriers in an already hostile U.S. immigration system, and they often struggle to integrate into their new communities in the United States. To best meet the needs of Indigenous unaccompanied immigrant children (“UIC”) institutionally and programmatically, lawyers, doctors, and mental health clinicians must cross-collaborate to overcome the multitude of barriers plaguing this population of young people and to yield successful outcomes.

In 2021, UIC arrived in the United States in record-breaking numbers. Remarkably, we saw the highest number of recorded arrivals on a single day, in a given month, and in an entire year. Upon their arrival to the United States, U.S. immigration officials send UIC to the custody of the Office of Refugee Resettlement (“ORR”) until the minors can be released to a custodian or family member in the community. The average length of time that a UIC spends under ORR custody can range from 118 to 348 days or longer, which can compound the trauma minors experienced in their home country and in their journey to the United States. Once UIC leave ORR custody, they face the additional challenges of acclimating to life in the United States while facing the prospect of being forcibly returned to their home country.

To safeguard their futures, UIC must find not only a lawyer to protect them from deportation, but sources of healing for physical and psychological needs as well. As background, violence perpetuated by transnational gangs like the Mara 18 and the Mara Salvatrucha (also known as MS-13) and drought in the Guatemalan highlands caused by climate change have pushed many Indigenous Guatemalans to migrate to the U.S. Importantly, Indigenous UIC also endure existing discrimination within Central American communities carried over from historical persecution, including genocide perpetrated just a generation ago, the aftermath of which is still felt today. Therefore, Indigenous Central Americans who belong to Mayan groups like the K’iche’, Mam, or Kaqchikel are one of the fastest-growing immigrant groups in the United States—and one of the most vulnerable. Upon arriving at their destination in the United States, they must struggle to adapt to new surroundings, support themselves, and obtain care. Indigenous UIC also struggle to find legal representation that not only assists them in vindicating their legal rights, but also understands their cultural background and treats them in a trauma-informed manner.

Evidence shows that UIC are at a high risk of developing mental health conditions. The complex trauma that Indigenous UIC experience in their home country, in transit to the United States, while under the custody of the U.S. government, and while adjusting to living with new familial arrangements in the United States can negatively impact their mental health and contribute to diagnoses such as post-traumatic stress disorder (PTSD), depression, and anxiety. This is especially true of minors who are exposed to stressors at a young age.

Notably, Central American youth from Indigenous groups like the Mayan Mam and K’iche’ face additional obstacles to accessing both legal and medical services, including language barriers, discrimination, and alienation from formal legal and educational systems that often do not comport with their own Indigenous traditions around health and justice. While publicly available government data does not track ethnic identities, Mayan Guatemalans make up 22.5% of all UIC currently in ORR custody if their numbers roughly correspond to their overall representation in Guatemala. Similarly, the overall number of Mam and K’iche’ language speakers has increased to become the ninth and eleventh most-spoken languages in U.S. immigration courts today.

Unfortunately, the U.S. legal system is not set up to support these youth, and instead, is often the site of retraumatization. Individuals facing the threat of removal from the United States do not have the right to an attorney in immigration court in the United States, so many migrants are forced to navigate the immigration process alone regardless of their age, vulnerabilities, or the merits of their case. Further, immigration courts do not have sufficient interpretation resources for Indigenous applicants, a fact that further frustrates the efforts of a person attempting to represent themselves in court. These challenges redound when coupled with hostile political environments nationally and locally, resulting in UIC declining to access basic services leading to potentially devastating impacts on public health. UIC deserve better.

Trauma- and community-based holistic services may present a way forward for UIC, and tangible solutions may be found by developing existing models of coordinated medical-legal-mental health care. Catholic Charities Community Services, the oldest provider of legal services to detained unaccompanied immigrant children in New York, serves UIC who move through the U.S. immigration machine, from the moment a minor is placed under ORR custody in New York until the minor leaves ORR to live with a guardian in the New York City area. Catholic Charities’ Continuum of Care program provides a link connecting UIC to lawyers, doctors, and mental health clinicians integrated into the primary care setting once a UIC leaves ORR custody. Catholic Charities’ Continuum of Care program successively proceeds through the following phases:

  1. Catholic Charities identifies ORR-detained UIC who are on track to be released to family members or sponsors in New York City.
  2. Once Catholic Charities confirms that a UIC has left ORR custody to live with a sponsor in New York City, Catholic Charities checks to see if the minor is scheduled for an hearing in immigration court and contacts the minor to verify their interest in receiving free legal, medical, and/or mental health services.
  3. If the UIC wishes to receive these services, Catholic Charities makes a referral to the appropriate providers and the UIC signs a representation agreement to receive pro bono legal representation.

From there, Catholic Charities offers holistic services to UIC through a medical-legal partnership with Montefiore Medical Center in New York City’s South Bronx called Terra Firma that is designed to address the complex medical, mental health, and legal needs of newly arrived UIC and families seeking humanitarian protection in the United States. Medical-legal partnerships allow UIC to begin their lives in the United States with the greatest opportunity to heal, learn, and fulfill their full potential. Early engagement with mental health resources helps facilitate disclosure of children’s painful histories and improve children’s chances of winning immigration status, and the Terra Firma model has proved fruitful in securing positive outcomes for UIC in a multitude of ways. At Terra Firma, health care professionals work side-by-side with pro bono immigration lawyers in a state-of-the-art community health center to create a child-centered approach that improves legal outcomes, promotes physical health, and enhances emotional well-being.

Additionally, Catholic Charities has also turned to community-based providers and subject matter experts to refine the services we provide to Indigenous UIC. As an example, Catholic Charities organized trainings with legal, medical, and mental health partners on working with Indigenous Central Americans such as the organization CIELO (Comunidades Indigenas en Liderazgo), an Indigenous-led organization based in Los Angeles, and with Indigenous leaders who have shared their personal and professional experiences in uplifting Indigenous communities. Drawing from these trainings, the legal team at Catholic Charities improved its push to identify and win legal claims for Indigenous UIC. Notably, Catholic Charities created a Know-Your-Rights training specifically tailored to Mayan UIC,and developed a screening tool for common fact patterns to better identify immigration options for Mayan UIC and to delve deeper into their cases.

Moreover, we have encouraged community-building among Indigenous UIC in New York City through innovative programming. In late spring 2021, Terra Firma created a Mayan affinity group whose meetings were held via Zoom due to the COVID-19 pandemic. This initiative created space for Mayan young people to meet with a K’iche’ Maya attorney and youth activist as well as with a K’iche’ young adult who himself had been through the U.S. immigration process. Participants expressed their appreciation of the discussion and shared that the experience contributed to a better understanding of how their backgrounds and life experiences may contribute to immigration options, such as a claim for asylum.

As the number of Indigenous Central American migrants arriving in the United States continues to increase, Catholic Charities re-affirms its mission to support Indigenous young people’s autonomy and ability to thrive in the United States. The Terra Firma program has proven results for rehabilitating traumatized minors, winning immigration status for UIC, building community among young people, and integrating children into American civic life. By promoting the well-being of immigrant children through direct services and advocacy that are responsive to their specific needs, we also strengthen local communities and inform public policy.

Brett Stark, Esq., is legal director and co-founder of Terra Firma at Catholic Charities New York, where he represents unaccompanied immigrant children in federal and state litigation, specializing in asylum and Special Immigrant Juvenile cases.

Sofia Linarte is the managing attorney with Catholic Charities' Unaccompanied Minors Program. Ms. Linarte hails from Central America, grew up undocumented in South Texas, and knows firsthand the life-altering impact competent legal representation can have on a young person facing removal from the United States.

Josephine Herman, Esq., is a staff attorney at Catholic Charities Community Services and is the recipient of an Equal Justice Works fellowship which focuses on improving legal representation for Indigenous Central American migrant children.

Elizabeth Wood is a supervising attorney with Terra Firma at Catholic Charities' Unaccompanied Minors Program in New York.


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