Policy Statement on Establishing all Health Care Settings as Safe Zones
for Children and Families
The American Academy of Child and Adolescent Psychiatry (AACAP) affirms that all healthcare settings must prioritize safe, effective, and life-saving care for all children and families. Fear of immigration enforcement activity in or near clinical settings undermines privacy, delays care-seeking and disrupts the therapeutic alliance. Immigration-related fear and stress can affect both U.S. citizens and non-citizens and negatively impact health outcomes, including anxiety, depression, trauma-related symptoms, behavioral issues, substance use, sleep disturbances, developmental challenges, and safety concerns. Children may also experience indirect physical health consequences through impairments in nutrition, housing stability, healthcare access, and caregiver support.
Research shows that immigration-related fear reduces health care utilization, including decreased use of primary care and increased reliance on emergency services among children in mixed-status (households with members having different citizenship or immigration statuses) communities. These patterns increase costs and reduce the effectiveness and efficiency of care. Health care settings must function as trusted, trauma-informed environments that support timely access to care.
AACAP supports policies that designate clinical facilities including inpatient units and other higher levels of care, school-based, outpatient and community clinics as safe zones for patient care, free from immigration enforcement activity within all clinical spaces, including interviews, surveillance, detentions, arrests or separation of children from their families. These protections allow clinicians to provide care without intimidation or disruption that may interfere with treatment.
AACAP supports trauma-informed practices across health care settings that:
- Promote visual cues e.g., identification badges for role clarity and transparent communication
- Ensure access to qualified interpreters and culturally appropriate services
- Minimize the presence of law enforcement in clinical spaces whenever possible
- Protect patient privacy and confidential information
- Foster safe, respectful, and collaborative professional interactions with children and families
In acute situations, health care staff should follow established emergency protocols and engage appropriate local authorities as needed.
AACAP supports policies and practices that ensure all children and families can access care in environments that promote safety, trust, and dignity.