Abstract
As violence, inequity and poverty pervade El Salvador, Guatemala and Honduras, the number of children, family units and adults seeking refuge in the United States (US) continues to increase. Upon apprehension by Department of Homeland Security (DHS) Customs and Border Protection (CBP) or Immigration and Customs Enforcement agents (ICE), children enter a labyrinthine immigration system that can be further traumatizing and threatening to their health and well-being. The purpose of this article is to describe the impact of current and evolving immigration policy on the health of unaccompanied children, to delineate barriers to care and challenges they face prior to gaining legal relief, and to suggest policy recommendations that support health and safety for them from the point of apprehension to and through achieving legal status. By understanding the four unique phases of the immigration journey: pre-migration, migration, detention, and post-release, social service providers caring for newly arrived unaccompanied children can offer a trauma-informed approach that considers children's complex medical, psychosocial, educational, and legal needs. Case-based examples elucidate the role of social service providers at each phase of the journey. One community-based model is described in depth as an illustration of how cross-sector partnerships can be incorporated in an effort to mitigate stress and build resilience among this vulnerable population.