 The removal of children from their families and communities brought short and long term harm to many native communities.While many schools had infirmaries and provided medical care in later decades, abuse of various kinds and crowded conditions in the first decades of the IRS history led to poor health and even death for a percentage of those enrolled.It has been argued that the psychological and emotional trauma resulting from both the abuse and the removal of the children from their families and culture has resulted in substance abuse, greater domestic violence, unemployability, and increased rates of suicide.