Just under 4,000 [3,954] doctors, nurses, and other health professionals from 49 states signed onto a 58 page letter sent to Department of Homeland Security (DHS) Secretary Kristi Noem. The detailed document pleads for the immediate release of immigrant children held in immigration detention facilities, due to what the letter described as severe medical risks and psychological harm caused by their confinement.
As Texas Public Radio reports, three board-certified pediatricians and pediatric professors worked jointly on the letter. They included Dr. Anita Patel, Ashley Cozzo, and Lara Jones. Dr. Patel wrote that she traveled to the Immigration and Customs Enforcement (ICE) detention facility in Dilley, Texas and said she was disturbed by the conditions there:
“It's not just child detention. This is child imprisonment in substandard living conditions. They are knowingly exposing them to potentially deadly infectious diseases.”
The letter gave a stark assessment of the overall handling of children inside immigration detention facilities, including one passage in particular:
“Immigration Violations are civil, administrative matters. Yet children are being confined in detention environments that would be unfit for even violent criminals.”
But with little to no outside oversight, or transparency, Patel says she wrote the letter because she believes public pressure can lead to changes in how DHS oversees detention facilities.
One subsection of the letter to Secretary Noem addressed what it stated was peer-reviewed research which demonstrates that children in immigration detention centers experience:
- Post-Traumatic Stress symptoms
(documented in up to 100% of studied populations) - Depression
(affecting up to 50% of assessed children) - Anxiety Disorders
(present in up to 50% of children) - Developmental regression and delays (particularly with prolonged detention)
- Nutritional deficiencies and deterioration of chronic medical conditions
On Page four of the document, the letter cited 7 children’s deaths in 2018 and 2019 while in detention or after release, before documenting a series of specific cases of medical emergencies and cases of alleged medical neglect. But it turns out, past administrations already had successful, cost-effective alternatives in place other than having to detain children.
One example is, or was, the Family Case Management Program. As the ACLU pointed out, “It provided case management, referrals for support services, and legal orientation, in partnership with community-based non-governmental organizations, in order to make sure that vulnerable families’ most urgent needs were met and they had the information they needed to comply with legal obligations.
And according to the government’s own records, the program achieved a 99% compliance rate with people appearing for court hearings, at an estimated cost of roughly $36 per day per family, compared to more than $319 per day for detention. Critics said ironically it was budget cuts by the first Trump administration in 2017 that killed the cost-saving measure.
Immigration legal advocacy group Refugee and Immigrant Center for Education and Legal Services (RAICES), reports 300 to 500 children and infants are detained by ICE on any given day in Texas. In mid-December 2025, the nonpartisan, nonprofit Marshall Project analysis found ICE had booked at least 3,800 children into detention since President Donald Trump took office January 20, 2025.
While the letter was addressed to Secretary Noem, it was also cc’d to the leadership of the U.S. House and Senate oversight committees, which included the chairman and ranking member of each committee.
But ICE has since responded, pushing back on accusations of improper conditions. In a news release dated February 25, 2026, entitled, Debunking the mainstream media lies about South Texas Family Residential Center in Dilley, Texas, the statement reads: ICE is correcting the record and reaffirming the safe, humane and family-friendly conditions at the South Texas Family Residential Center in Dilley, Texas:
“The Dilley facility is a family residential center designed specifically to house family units together in a safe, structured and appropriate environment,” said ICE Director Todd M. Lyons. “What’s important for people to remember is that ICE detains to deport — so detention is not punitive, and Dilley is not a ‘correctional center’ or anything like that. It’s a place where families who have been in the U.S. illegally can get medical care, educational services, recreational opportunities and essential daily living needs while they await deportation.”
