(CNN) Juan has been detained in an unaccompanied child shelter for nearly a year, long enough to see the emotional impact prolonged confinement has on children.
"They get depressed. They cut their skin," he told CNN by phone from inside a Texas detention center.
Juan is not his real name. His attorney asked CNN to change his name for his safety.
The 16-year-old says he fled his native El Salvador after being threatened by gangs. During this past year, four sponsors have tried taking him out of detention; but all of them have been rejected by the government, he says. A sponsor is a parent, family member or friend who is granted guardianship.
Juan is caught in a record backlog that has 14,000 children experiencing longer detention times in shelters across America, according to a Department of Health and Human Services official. About 11,900 children were detained in June, that number rose to 12,800 in September.
As detention times increase, with some staying up to a year, caretakers have seen children exhibit mental health and behavioral problems, according to a source inside a large detention service provider. This source adds that the unaccompanied children are considered higher risk. And while, in years past, child shelters used to be mission-driven (to serve children), now they are at full capacity and more policy driven.
According to Immigration attorneys and advocates, complicated government rules are to blame for the backup.
Last spring, the Trump administration implemented new information-sharing policies between HHS and Immigration and Customs Enforcement that included stricter vetting of adults who sponsor unaccompanied children. It also required the fingerprinting of everyone in the home and the sharing of that information with ICE.
While the administration said the measure was paramount to ensuring the safety and security of children, the move sent shockwaves of fear through the undocumented community.
And those fears were realized when ICE announced the arrest of dozens of sponsors who had come forward to claim their children.
"We've arrested 41 individuals thus far," ICE senior official Matthew Albence testified before Congress in September.
"Unaccompanied alien children are particularly vulnerable to human trafficking, exploitation and abuse," HHS spokesperson Mark Weber said in a statement to CNN.
According to Weber, it takes an average of 59 days to place a child with a sponsor - with several children staying in custody more than 100 days.
Immigration attorneys and advocates worry about the potential side effects of the extended detention times and argue that not only is the confinement excessive but is a violation of the children's rights.
"They can say it's just to vet; but it's to target parents and to put fear on immigrant families," said Sophia Gregg, an attorney for Legal Aid Justice Center, a nonprofit organization that provides advocacy and legal support to immigrant communities.
Gregg argues a more accurate depiction of current detention times is increasingly "six to 10 months."
The Legal Aid Justice Center filed a class action lawsuit in July in US. District Court for the Eastern District of Virginia against the Trump administration on behalf of children who were in custody in Virginia for over five months while relatives tried to take them home.
Juan's story is similar, but with a slew of more holdups.
He says his sponsor candidates were three uncles and a family friend. To prove kinship, Juan says he was asked for family photos, messages and call logs. All of which Juan says were provided, along with fingerprints.
Then, Juan says that the government asked his uncle to rent a home. When he rented the home, the government then asked his uncle to buy Juan a bed and a chest of drawers to store his clothes. All of which Juan says his uncle purchased with great sacrifice.
A 36-year-old father in Florida who has been trying to reunite with his daughter, who is in a Texas shelter, told CNN he was asked for something similar. His daughter has been in detention for four months.
"The government changes the rules or adds more rules," Juan told CNN by phone from the inside of a Texas shelter.
Then, another type of hold up. The doctor.
Juan has a heart and kidney condition and says his sponsor was asked to find a cardiologist and a kidney specialist. Juan says his uncle set up a doctor's appointment for him.
But then, yet another hold up. The last name.
Juan says the government said his uncle's last name didn't match Juan's last name and rejected the sponsorship. Juan says he carries his mom's last name and not his father's.
HHS would not comment on specific cases, and instead pointed at the broken immigration system.
Weber, the spokesman for HHS, said at least three factors are at play. First, the Department of Homeland Security referred 50,000 children to HHS this year, which he said is the third-highest annual total. According to HHS, DHS referred 59,170 unaccompanied children to HHS in fiscal year 2016, and 40,894 in fiscal year 2017.
Secondly, the agency had been bogged down with the reunification of the more than 2,000 children separated under the "zero tolerance" policy. Less than 200 are still considered "unaccompanied" because they have not been reunified with family.
And thirdly, the Trump administration's policy that resulted in more strict vetting is a time consuming but necessary step to ensure children are not handed over to criminals or human traffickers.
It's "an utter fallacy," said Bob Carey, former director of HHS Office of Refugee Resettlement, about the current Trump administration's reasoning.
Carey worked at HHS from April 2015 to January 2017 and says it was "extremely rare" for children to remain in custody for more than 100 days tenure because of the constant effort to balance security and detention time.
In 2017 the average length of stay in custody was 48 days, according to a Health and Human Services report. In 2016 that number was 35. Now, 59.
One advocacy group believes the administration's policies could have the unintended consequence of exposing children to human trafficking.
"We are concerned this could happen," said Ashley Feasley, Director of Policy at the Migration and Refugee Services Office of the US Conference of Catholic Bishops.
Feasley says undocumented parents are afraid to come out of the shadows and sponsor their children because HHS can share their address and personal information with ICE. And adds, that undocumented parents are now asking a distant relative or family friends -- who are U.S. citizens or legal residents -- to sponsor their children, and that could put a child in the hands of a human trafficker or expose the child exploitation.
While Feasley says her office has not identified such a case, her field staff is on the look out for possible signs of abuse.
"That is a concern," Feasley told CNN. "A lot of protocols have been put in place; but that could be an unintended consequence. We could see children exploited."
As the Trump era policies keep unaccompanied children in detention longer by requiring stricter vetting, like fingerprints from their parents, an HHS watchdog memo shows the government didn't hold itself to the same standard when it rushed to open the Tornillo, Texas, shelter earlier this fall.
The HHS inspector general found that the department failed to conduct FBI fingerprint background checks for 1,300 staff members at the massive temporary Texas facility.
The Tornillo shelter houses about 1,800 unaccompanied migrant children aged 13 to 17, and as of early October, the average stay was 27 days, up from 20 days. CNN reported in September that HHS was planning to triple the facility's capacity to nearly 4,000 beds.
To respond to the ballooning number of children in detention, the report says, HHS relied on private contractors with less rigorous FBI background check hiring practices.
The memo acknowledges that officials have begun to address the background check issue. And HHS responded to the watchdog's memo by saying the department is working "to resolve the background check and clinical staffing issues identified in the report."
Abuse has been an issue at other shelters. In August, two men were accused of sexually abusing eight teenage boys and molesting a 14-year-old girl at two Arizona shelters.