Paramedics were called regularly to treat children suffering from panic attacks so severe their hands would constrict into balls and their bodies would shake. The outbursts often occurred after other children were taken away to be reunited with families, dashing the hopes of those left behind at the largest emergency shelter set up by the Biden administration to hold minors who had crossed the U.S.-Mexico border alone.

The conditions described by a federal volunteer who spent two weeks in May at the shelter at Fort Bliss Army Base in El Paso, Texas, highlight the desperation and stress of thousands of children held at unlicensed facilities, waiting to reunite with relatives.

Some had marks on their arms indicating self-harm, and federal volunteers were ordered to keep out scissors, pencils or even toothbrushes that could be used as a weapon. While girls made origami and braided friendship bracelets, a large number of the children spent the day sleeping, the volunteer said. Some had been there nearly two months.

The volunteer spoke on condition of anonymity because she was not authorized to talk publicly about what she witnessed on the base from May 12 to May 25. She said she was compelled to speak out because of the despair she observed. Much of what she described mirrored what advocates who visited the shelter recently recounted to The Associated Press and what children there told them.

The conditions raise concerns about why it is taking more than a month on average to release the children when most have family in the United States. More staffing has been added since the emergency shelters were opened this spring amid an unprecedented arrival of migrant children, and the flows have subsided.

“I think there is a general consensus that no child should be in these emergency shelters for more than two weeks,” said Aaron Reichlin-Melnick, policy counsel for the advocacy group American Immigration Council.

Lawyers and advocates question why most of the children are at unlicensed shelters.

As of May 31, nearly 9,000 children were kept at unlicensed sites, compared with 7,200 at licensed shelters, court filings by the U.S. government said. While the unlicensed facilities were running at near capacity in May, the licensed facilities were only about half full, according to a report filed by the agency tasked with the children's care.

Advocates say the government should be pouring more resources into the safe release of children, and those without relatives or a family friend, known as a sponsor, should be immediately going to licensed facilities that are required to have a care worker for every eight children during the day and a mental health clinician per every 12 children.

The volunteer was one of more than 700 at the time, when Fort Bliss housed more than 4,600 children in giant, air-conditioned military tents filled with cot-style bunkbeds. The number of children there is now down by nearly half, at fewer than 2,500.

The volunteer said she met children who had been there 54 days. She saw bubbly girls grow angry and quiet and sleep so much they had to be woken to eat.

Several had panic attacks after seeing friends leave to join their families. One day, ambulances were called four times, the volunteer said.

“Paramedics would come into the tent and take them away on a stretcher because their hands would constrict up, their heads would sometimes go to one side, and their limbs would shake and it was obvious that it was very uncontrolled,” she said.

The children could call their families twice a week.

An official from the Department of Health and Human Services did not comment specifically on the allegations regarding first responders treating children suffering from panic attacks and other concerns about the minors’ safety, but said the administration was working on expanding indoor recreation space, mental health support, wellness activities and educational services. The official said mental health services and counseling are available to everyone at the emergency facilities.

The record arrivals of migrant children have tested the Biden administration, with the U.S. government picking up nearly 60,000 children traveling without their parents across the Mexican border from February to May.

The government’s goal is to unite every child safely and swiftly with their parents or sponsors, but it takes time to do the extensive screening that includes interviews, background checks and sometimes home visits, the government official said.

The administration has maintained it followed best practices when it opened 14 emergency intake sites this spring to respond quickly to overcrowding at Customs and Border Protection facilities, and said improvements are being made constantly.

They include the addition of virtual case managers to assist staff on the ground to expedite the release of children, and efforts to identify complicated cases or children without relatives or sponsors to move them to licensed facilities.

The number of children in the shelters has dropped from a high of more than 23,000 to 16,000. Four emergency shelters have closed, while two more are slated to close soon.

The government is no longer anticipating Fort Bliss will need to expand to 10,000 beds, the official said.

Attorneys and advocates say the Fort Bliss shelter should be shuttered as soon as possible.

Advocates say better options are being underutilized like the convention center in Long Beach, California, where immigration attorneys meet with children regularly, and musical performers and yoga instructors have been invited in.

A Pomona, California, facility is housing about 500 children but has space for more than 2,000. It has consistently met its goal of reunifying 20% of the children by the end of each week, said Lindsay Toczylowski, executive director of Immigrant Defenders Law Center in California.

“One of the questions I have is why are children continuing to be held in places like Fort Bliss, where conditions are being reported as so dire, when there are places like Pomona?” she said.

The government said every shelter offers mental health care, and it has added more behavioral health, spiritual and educational services, including at Fort Bliss, which also opened more indoor recreational space.

Even so, none of the emergency shelters can properly care for children with the trauma of fleeing violent homelands, said Leecia Welch, an attorney at the nonprofit National Center for Youth Law who monitors the care of immigrant children in U.S. custody to ensure the facilities adhere to conditions set out by a long-standing court settlement.

“There is not enough focus on releasing children to their families," said Welch, whose team visited Fort Bliss on June 3 and 4.

Releasing children in U.S. custody has become more critical since Texas Gov. Greg Abbott this month directed a state agency to discontinue licenses for facilities sheltering migrant children.

Advocates fear shelters could close and result in more minors in unlicensed shelters like Fort Bliss.

The volunteer said she could see the toll it was taking.

With more than 900 girls there at the time, the volunteers divided them into pods to better care for them. Her pod watched over 25 girls. Some required one-on-one supervision 24 hours a day after showing a tendency to harm themselves, she said.

Weeks after she was admitted to Fort Bliss, a shy 13-year-old girl was finally given a new pair of shoes to replace the tattered ones she wore when she left Guatemala and walked for days, the volunteer said.

When she got them, she held them to her chest, she said.

The government notified the volunteers on May 24 that they were no longer needed because the contractor had hired enough staff to have one worker for every 15 children.

“I know that this is very upsetting news to many of us and that we all have concerns about the children being treated humanely after we leave,” the email stated, assuring the volunteers they would be let go gradually.

The contractor, Rapid Deployment Inc., declined to comment, referring questions to the administration.