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Migrant children in government custody who were separated from their parents experienced intense trauma that shelters were unprepared to handle, according to a new report from the Department of Health and Human Services inspector general.

The findings echo reports from physicians and mental health advocates about lasting ills stemming from the Trump administration’s family separation policies. They come as the administration is trying to revise the so-called Flores agreement, a long-standing court order that outlines standards of care for migrant children and families.