In October 2019, a teenage boy crossed the U.S. border into Arizona alone, fleeing for his life after being assaulted and threatened by gang members in Mexico. He’d hoped to find safety in the U.S, but instead, according to court filings, he ended up at a Texas children’s hospital where he’s been heavily sedated and forcibly injected multiple times over the past six months.

When an attorney visited the 16-year-old in November, she described him as having “a glazed over, vacant expression much of the time.” He told her he’d been taking around 20 pills per day.

“I want to leave because when I get mad they give me shots,” said the boy, whose name is redacted in the public court filings. “I think the last time was about a month ago. When they give me a shot, it makes me feel sad. And then I will sleep for a day. When I wake up after, I feel desperate. My body feels desperate.” 

In the last months of the Trump administration, other immigrant youth in government custody have been drugged and isolated for long periods, according to court records. The documents describe children languishing for months, including a young “nonverbal” girl who was separated from her father at the border over a year ago and is now unable to directly communicate with her family in Guatemala.

The shocking descriptions, which have not previously been reported, were filed as part of a long-running lawsuit against the federal government over its treatment of “unaccompanied minors,” children who arrive at the border alone, often fleeing violence or abuse in Central America. Lawyers in the case say six such kids in the custody of the Office of Refugee Resettlement (ORR) were held indefinitely at Nexus Children’s Hospital in Houston, with at least three placed on “excessive medication.” 

Leecia Welch, an attorney with the National Center for Youth Law, visited Nexus on Nov. 13 and initially found it to be “a typical medical facility” for children, with brightly colored hallways and an outdoor play area, according to a declaration she filed in federal court. But when she began speaking with three kids in the behavioral health wing at Nexus, Welch noticed they appeared to be groggy and dazed. 

Welch, who noted that she has interviewed “hundreds of children in government custody,” including in psychiatric hospitals, said the 16-year-old told her he had trouble sleeping, a problem he never had in Mexico and attributed to his heavy medications. He described spending hours alone in his room watching TV, and leaving for therapy, meals, and activities, but never school. 

“I do not have school here,” he said. “I have not had any school at Nexus the entire time I have been here.”

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It was a stark contrast to the shelter in Arizona where the boy had first been housed in the U.S., which he said allowed a trip to the museum and more time outdoors. Then, in January 2020, he described being awoken at 3 a.m. and told to pack his things. He was sent to a more restrictive facility in Washington state, which he said did not allow him outside. His next stop was Nexus, where he said staff had also placed him in physical restraints.

“When I get angry, I know how to calm myself,” he said. “They use physical restraints when I get angry but that makes me angrier. But it’s been a month that I haven’t been angry. I am doing better. I was told I would leave soon.”

A fifteen-year-old that Welch interviewed “appeared to be so overmedicated he could barely talk or maintain eye contact” during their 20-minute conversation. The boy’s speech was slurred, and he mostly “lay in bed drooling and staring blankly at his TV,” Welch wrote. “He did look at me intensely for one brief moment and asked when he could go home.”

A spokesperson for the Department Health and Human Services’ Administration for Children and Families, which oversees ORR, declined to comment, citing ongoing litigation.

A spokesperson for Nexus Health Systems, which runs Nexus Children’s Hospital, gave a statement saying the company “has provided superior medical care to children for over 20 years.”

 “Although due to healthcare privacy constraints we cannot comment on the care of specific patients, we stand by our clinicians’ decision-making and our associated clinical policies and procedures,” the statement said. “Nexus’ focus in every case is—and will remain—the well-being of our patients.”

As part of a 1997 court settlement known as the Flores agreement, federal authorities are supposed to transfer unaccompanied minors from Border Patrol custody to a state-licensed childcare facility within 72 hours, or release them to a relative or sponsor living in the U.S. But in some instances, these children require more intensive care than a typical group home or shelter can provide due to medical or behavioral issues. 

Nexus describes itself on its website as “a child’s home away from home during recovery from complex medical issues,” including those with behavioral problems “who may have been unsuccessful in traditional rehabilitation environments.” According to court filings, Nexus is an “out-of-network facility” that contracts with ORR to care for immigrant youth until they can be sent elsewhere, such as a foster home in the U.S., a group home with a less-intensive level of care, or back to their home country on a deportation flight.

Intensive hospital stays are supposed to be brief—usually only a few days until the child is stabilized and can return to a more normal setting. But four of the six kids that Welch found at Nexus had been there for longer than six months.

She described meeting a 15-year-old girl who’d been sent to Nexus “due to her weight, diabetes, and issues with her knees.” The girl said she’d been at the hospital for seven months and was still being held there even after meeting a weight loss goal set by a doctor, which she was told would allow her to leave. The girl said she preferred the freezing-cold Border Patrol “hielera” holding cell where she was first detained after crossing the border.

“I liked the hielera better than here because of how they treat people here,” the girl said. “It’s not well. They don’t treat people well. They try to be rude to me, but I don’t let them get away with it. They are not nice to the other kids.”

The mother of a fourth immigrant child held at Nexus, described by Welch as a 2-year-old with “very serious medical needs,” declined to speak with the attorney. As Welch prepared to leave the Houston facility, she said staff mentioned they had a fifth patient who came from federal government custody and had been there “a very long time.” 

Welch described being led to a section of the hospital for kids with more intensive physical health needs and entering a room to find “a small child with perfectly coiffed pigtails under a pink Minnie Mouse blanket.” The girl, Welch said, “was connected to machines and was unable to move or establish eye contact.” 

The girl appeared to be well cared for, but Welch later learned she had been separated from her father in August 2019 after they crossed the border together. Her father, Welch said, “was deported before his daughter was in a position to safely return to home country with him; they remain separated and without any direct contact.”

Welch noted that, “although this child has now lived far longer than her predicted life expectancy, her long-term prognosis remains poor, and without swift intervention, she and her father may never see one another again.”

Welch declined to be interviewed, citing the pending litigation, but said the government needs to do a better job of monitoring and tracking the care that children receive. 

“We just don’t know how many other children are going into hospital settings and having these things happen,” Welch said. “Even if ORR wanted to, they couldn’t go online and tell you, ‘This many kids have been forcibly injected over the last six months.’ They just don’t have the data; I find it horrifying. It’s just a black box.”

Robert Carey, who led ORR under the Obama administration, said he could not recall any incidents during his tenure where immigrant youth were subjected to forced injections. Carey said such measures would only be appropriate as a last resort in cases where children had “severe mental health needs.”

“At minimum, an investigation would be conducted to determine if in fact that was happening and, if so, why, and what oversight was being conducted or in place by ORR staff,” Carey said.

Carey said he expects the incoming Biden administration to overhaul ORR, which falls under the umbrella of the Department of Health and Human Services. Under Trump, the agency has been involved in multiple scandals, including the failure to reunite families that were separated at the border under the so-called “zero tolerance” policy.

“Children have been poorly treated, obviously. Laws and standards appear to have been violated. It’s not good.”

“It’s been politicized,” Carey said. “Children have been poorly treated, obviously. Laws and standards appear to have been violated. It’s not good.”

The Nexus allegations aren’t the first time the Trump administration has been accused of providing questionable medical treatment to immigrant youth. In April 2018, plaintiffs in the Flores case filed court documents describing how multiple children at Shiloh Treatment Center near Houston were held down and injected with psychotropic medications. In one incident, a girl claimed a Shiloh staff member threw her against a wall and choked her until she fainted. 

Shiloh issued a statement in 2018 denying any wrongdoing and maintaining that children at the facility “have been found to be properly cared for and treated.” The judge overseeing the Flores case ordered the government to abide by Texas laws on the  administration of drugs to minors, and to remove them from Shiloh unless they pose “a risk of harm to self or others,” a determination to be made by a licensed psychologist or psychiatrist.

Scott Lloyd, a former ORR director under Trump, told VICE News that forcibly medicating minors can be justified in cases where they have severe mental health issues and may be behaving aggressively. He emphasized that staffers, operating in deeply difficult situations, typically have the best interests of children at heart.

“As bad as it sounds, when you get down into the details of it, it’s actually something that you see happening every day in families,” said Lloyd, who was first thrust into the spotlight after he personally refused to let detained immigrant girls undergo abortions, spurring an ACLU lawsuit. “Even when it’s antibiotics, sometimes kids just don’t want to take drugs, but that’s just what they need at the moment. And on top of that, you have teenagers who just don’t want to do anything that you tell them to do because they’re teenagers.”

A 2018 report by Reveal from the Center for Investigative Reporting found that housing and supervising immigrant children for the federal government is big business, with $3.4 billion paid out to 71 companies, including Shiloh, over a four-year period. Nearly half of that money went to homes with serious allegations of mistreating children, Reveal found, including shelters accused of neglect and sexual and physical abuse.

Beyond the Flores case, forced injections have been a point of litigation in a separate class-action lawsuit filed on behalf of immigrant youth held in “highly restrictive psychiatric facilities” and jail-like “secure” detention centers. The suit claims kids end up trapped in such places for months or years, with no hearings or protections to provide a path out.

“I felt like I had no one to help me and no option but to take the daily medication,” said one child quoted in court records. In that case, staff at Shiloh would allegedly “force the child’s mouth open if they tried to refuse to take the medication.” Others were given forced injections. 

“Two staff grabbed me, and the doctor gave me an injection despite my objection and left me there on the bed,” one child said, according to court filings.

Since March 21, the Trump administration has turned away thousands of unaccompanied minors on the grounds that they present “a serious danger of the further introduction of COVID-19” into the U.S. Under an order signed by Trump, at least 8,300 children who traversed the border alone have been detained by the Border Patrol and sent back to Mexico or their home countries, according to CBP data provided to lawyers in the Flores case.

The same bunch of Nov. 23 court filings that detail the situation at Nexus also describe grim conditions at a Border Patrol outpost in Weslaco, Texas. A lawyer in the Flores case visiting to monitor conditions found an 8-year-old boy from Guatemala who said he’d been separated from his mother for two days. They crossed the border together, he said, but she was sick and could barely walk. The boy saw his mother loaded onto an ambulance, while he ended up as the only child on a bus full of adults headed for a Border Patrol station, where he’d been waiting for her since.

“I am alone in my room,” the boy said. “I do not know why I am alone. It makes me feel abandoned. I feel very alone. I have been completely alone for an entire day. I am sleeping on a cushion that is on the floor. I do not have a pillow, but I do have a thin silver nylon blanket. I use my coat as a pillow. I am the only one in the room when I sleep. It is very cold. It is always very cold.”

Asked about the court filings, Tom Gresback, a spokesperson for U.S. Customs and Border Protection in the Rio Grande Valley, said: “As a matter of policy, CBP does not comment on pending litigation. Lack of comment should not be construed as agreement or stipulation with any of the allegations.” 

In September alone, according to CBP data referenced in court filings, at least 36 kids were held in Border Patrol stations for more than three days, including 16 for over five days. Among them were a 6-month-old infant (held 13 days), a 5-month-old infant (15 days), and a 2-month-old infant (16 days). The monitor who visited the Weslaco station said children reported being housed in cells with 16-20 others, with no social distancing, soap, or hand sanitizer.

“Many children reported that they were very cold,” wrote the monitor, Denise A. Rosales. “During an interview, one child commented on how nice the sun was. She said she had not seen the sun in over two days.”

In a Dec. 4 court hearing in the Flores case, attorneys for immigrant youth and the government said they are close to finalizing a settlement agreement that could lead to “steps forward” on conditions for unaccompanied minors detained at the border. 

The issues of forced injections and lengthy stays in restrictive psychiatric or jail-like settings are being litigated in a separate case, with a trial currently set for March. In the meantime, the 16-year-old who’d been forcibly injected still remains at Nexus.

The teen said he hopes to leave the hospital soon. He has plans for his life.    

“I will be happy when they give me the good news that I’m leaving this place,” the boy said. “My dream is to be a firefighter. It’s my dream to help people.”