Fourth Circuit Revives Challenge to Mental Health Treatment of Unaccompanied Minors

The Richmond-based federal appeals court found the government was responsible for the mental health treatment of a traumatized 16-year-old Mexican immigrant and others in its care.

Immigrant children play outside a former Job Corps site that now houses them on June 18, 2018, in Homestead, Fla. (AP Photo/Wilfredo Lee)

RICHMOND, Va. (CN) — Citing the differences between mentally unwell unaccompanied minors and pre-trial immigrant detainees, an appeals court revived a challenge against a rural Virginia juvenile detention facility Tuesday.

The 39-page opinion, authored by Chief U.S. Circuit Judge Roger Gregory, reversed a federal court opinion which found the children’s claims, including alleged physical abuse in place of medical and mental health care, failed to meet the standard required to survive dismissal. 

“The statutory and regulatory scheme governing unaccompanied children expressly states that these children are held to give them care,” wrote Gregory, a Bill Clinton appointee. “Such children ‘shall be promptly placed in the least restrictive setting that is in the best interest of the child.’”

The class action was brought by an unnamed Mexican plaintiff who was 16 at the time he was transferred to Shenandoah Valley Juvenile Center (SVJC), a facility contracted under the federal Office of Refugee Resettlement for unaccompanied minors with mental health issues requiring high-level treatment. The complaint paints John Doe as a victim of abuse while growing up who experienced more trauma as he made his way over the U.S. border.

“Doe has not mustered sufficient evidence to show an underlying constitutional violation with regard to his mental health claim,” U.S. District Judge Elizabeth K. Dillon, a Barack Obama appointee, wrote in a December 2018 opinion after refusing to consider additional evidence from experts claiming the facility was failing to meet treatment requirements.

Gregory discussed that testimony in his opinion, which pointed to the need for more medical expertise to better understand the issues the children face. 

He wrote that claims made in briefs filed by the facility asked his court to follow other circuits that have treated “immigrant detainees as equivalent to pretrial detainees, applying the deliberate indifference.” But he noted those cases deal with adults, not children “whom the Government holds for the purpose of providing care.”

Gregory pointed to the mental health screenings used to determine if a child needs placement at SVJC or someplace else. 

“By explicitly accounting for the mental health needs of the children it accepts, SVJC’s intake process confirms its intent to treat those needs for children in its care,” he added. 

While Gregory was joined by U.S. Circuit Judge Barbara Milano Keenan, an Obama appointee, but his argument was lost on the third member of the panel, U.S. Circuit Judge Harvie Wilkinson III, who penned a 10-page dissent decrying the opinion as an act of judicial overreach. 

“Today’s case features an invitation to try our hand at institutional governance and to do something we are utterly unqualified to do,” wrote the Regan appointee, who expressed similar concerns during October’s oral arguments in the case. “Determine what constitutes acceptable mental health care.”

Wilkinson noted other circuit courts have found the deliberate indifference standard to be the best tool in such cases and the opinion could face an uphill battle if appealed to a higher court. 

“The majority does not even attempt to argue that constitutional text supports its move,” the judge wrote. “A deliberate indifference standard is much more faithful to that edict.”

Advocates for immigrant children celebrated Tuesday’s opinion, calling it a vindication for the ongoing fight to get much-needed mental health treatment to an already traumatized group.

Jonathan Smith, executive director for the DC-based Washington Lawyers’ Committee for Civil Rights and Urban Affairs, pointed to sections of the complaint which alleged treatment, such as being strapped to a restraint chair and extended periods of isolation, as abuses for which the facility should be held accountable.

“The Court’s decision makes clear that detention center staff must provide for care and treatment of the children in their custody consistent with professional judgment and standards,” he told Courthouse News in an emailed statement.

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