This site contains resources for psychologists and social workers who want to write pro bono psychological evaluations for immigrants requesting asylum, protection under VAWA and the Conventions Against Torture, hardship waivers, cancellation of removal, and humanitarian release
This FREE skills building webinar series is being hosted by Division 56 Trauma Psychology of the American Psychological Association in collaboration with the co-sponsoring Divisions. The webinar will be followed by an opportunity to ask the presenters questions. The Refugee Mental Health Resource Network project is funded in part by a CODAPAR grant.
JOIN US FOR OUR SEPTEMBER WEBINAR
OF THE REFUGEE MENTAL HEALTH RESOURCE NETWORK:
The Refugee Crisis: Understanding and Addressing the Mental Health Needs of Families and Children Displaced by Armed Conflict
Kenneth E. Miller, PhD
This skill building webinar will take a more in-depth look at the effects of armed conflict on civilians with a focus on children and effective interventions in dealing with the various stressors. This webinar was scheduled in response to the request for information by those who were not able to attend the APA Convention in Washington DC and/or were not able to attend the invited address given by Dr. Kenneth Miller. The first portion of the webinar will be introductory remarks and an update for participation in the Refugee Mental Health Resource Network Database by Dr. Carll to be followed by the presentation by Dr. Miller.
Early research on the mental health of civilians displaced by armed conflict focused primarily on the direct effects of exposure to war-related violence and loss. Largely overlooked in this war exposure model were the powerful effects of ongoing stressors related to the experience of displacement itself. An ecological model of refugee distress is proposed, drawing on research demonstrating that distress among refugees and asylum seekers stems not only from prior war exposure, but also from a host of ongoing stressors in their current social environment. Implications of this model for addressing the mental health and psychosocial needs of refugees and other displaced populations will be discussed with a focus on children. Examples will be presented that demonstrate the growing influence of this ecological framework on the design and implementation of interventions with refugees and asylum seekers, in low and middle income countries as well as in higher income nations.
Elizabeth Carll, PhD is president of the APA Trauma Psychology Division and chairs the Refugee Mental Health Resource Network, an APA Interdivisional Project. She serves on the executive committee and is a former chair of the UN NGO Committee on Mental Health and consults to organizations and individuals in developing crisis management programs and trauma intervention services.
Kenneth E. Miller, PhD is a researcher and writer based in Amsterdam. He works with the Dutch organization War Child Holland, developing and evaluating mental health interventions for war-affected communities. He’s published numerous studies on war and mental health. His new book is entitled War Torn: Stories of Courage, Love, and Resilience (Larson, 2016).
Wed., Sept. 27, 2017, 12:00 pm – 1:00 pm Eastern
Register at https://divisions.wufoo.com/forms/q1ft3x3s09sfr5m/
Ingrid Encalada, an undocumented immigrant from Peru shown with one of her two children, was given a temporary stay of deportation after taking sanctuary in a Denver church for five months.CreditJohn Moore/Getty Images
“I did not raise you to cry,” my father would say when I fell off my bike, as he poured rubbing alcohol on my bloody 6-year-old knees. Not hydrogen peroxide — alcohol. Whenever I cried, which was usually when I did not get an A on a math test or saw a lost-dog poster or read about Anne Frank, my parents, immigrants from Ecuador, handed me a mirror to observe myself. They wanted to desensitize me to my own tears, to line my small heart with bulletproof glass, even if doing so meant making me hate my own weakness.
Undocumented life in America is hard on the mind and body. Poverty, precarious employment, poor access to health care, discrimination and trauma from the migration itself often lead to disorders like depression, anxiety and post-traumatic stress disorder. Access to mental health treatment is scant, the demands of simply surviving are overwhelming, the fear of being discovered discourages people from seeking care, and the stigma of mental illness has perpetuated a culture of silence that only worsens the suffering.
Enter the Trump administration. With its aggressive hunt for undocumented people like my family — capped off by the announcement on Tuesday that the president plans to end the Deferred Action for Childhood Arrivals program for the so-called Dreamers — the administration has placed new emotional and mental burdens on an already deeply stressed community. Thanks to DACA, I was able to get a state ID, land my first paid office job and fly without fear for the first time in my life. My best friend from college is in DACA, as are the children of nearly everyone I have interviewed for the dissertation I am working on. We know all too well people like the two young brothers from Maryland without criminal records who were deported after one of them, a soccer star, told immigration officials he had won a scholarship to college. Or the children on their way to school who filmed the detention of their parents on their phones while sobbing and screaming. Or the DACA recipient who hid in her closet as her father was arrested by armed ICE agents.
Some studies have found that the first wave of immigrants has a better mental health outlook than subsequent generations, which researchers say results from traditional family networks and values, as well as “lower expectations for success.” But such conclusions betray a misunderstanding. As a graduate student, I have interviewed dozens of undocumented people, including first-wave adults. Most of them speak of symptoms that we might call anxiety, depression and PTSD, even if the subjects themselves do not use this language, and have less familiarity with diagnostics and less access to treatment than their American-citizen children. These studies are from a more innocent time.
All of the immigrants I have interviewed and known throughout my life seem to accept chronic exhaustion, low self-esteem, fear and panic, low moods and fits of crying as normal for the melancholic migrant struggling to subsist without being arrested. Older immigrants are at the highest risk for mental health struggles, having aged out of manual labor, with grown children and dead parents, and being unable to receive health care.
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Immigration and Customs Enforcement arrested a man during a traffic stop near his home in Riverside, Calif.CreditMelissa Lyttle for The New York Times
My parents have lived in this country for 30 years, and they have seen their share of ghosts. I recently learned that my father hid his father’s death from me for three years because he did not want it to affect my mental health. Unable to travel, he could not bury him. I made my way through Harvard and Yale as an undocumented student. But even safe in my Ivy League college town, I have nightmares — of Immigration and Customs Enforcement officers, of swastikas. When I travel the country meeting undocumented immigrants for my dissertation, I see my father’s face in theirs and I know this astigmatism will always be with me. Anytime my parents take too long to text me back or when they call me at an unusual time, I panic. When I hear them say, “Just reminding you to wear sunscreen today!” I want to laugh in relief.
And then I worry that nothing but death will liberate me from the constant anxiety. We all live with the thought: My life as I know it might end now. Or now. Or now. The uncertainty is torture.
Here are some of the people I have met while researching my dissertation. Alejandro is a 49-year-old day laborer from Mexico who rents a room in Staten Island, to which he returns only at night to eat a dinner of oatmeal with milk and sugar, and then sleep. He has crossed the border four times to see his children but is too old for that now. Some of the trips were traumatizing. On one, a middle-aged man got so dehydrated that he could no longer swallow. “I can’t stop thinking of his face, the look in his eyes,” he says. Alejandro himself got so tired on that trip that he felt like giving up and surrendering to death, perhaps to be eaten by bobcats. But two young men lifted him up and pushed him by his shoulders up the slopes of a mountain. “They didn’t want me to die, and I didn’t want to let them down, so I lived,” he recalled. “I can’t stop thinking about them. When the news comes on, I worry I will see their faces.”
A woman named Sandy described a stampede in Queens after a fake post about an ICE raid circulated on social media. Panicked crowds knocked her down and dozens of people trampled over her, stepping on her head and neck. Pressed against a wall, she could not breathe and had a panic attack. A Mexican neighbor came back to pull her to safety.
William is a 16-year-old Dominican martial arts star who loves math and science but also struggles with anxiety and depression. “After the election, I thought I was lower than everyone in society, that I had no voice or role or place here — an alien, like people say,” he told me. He began to fear ICE was following him at all times and he had a nervous breakdown. “But then I got to a point where I didn’t care because I knew I was going to commit suicide and nothing would bother me after death,” he says. He was put on Zoloft and hospitalized for a week.
Claudia is a 60-year-old Colombian woman who is afraid to go to the doctor. She goes anyway because she’s being treated for cancer, but winds up running out of the doctors’ offices when the treatment is over, fearful that someone will turn her in. She tells me she doesn’t watch the news and has installed surveillance cameras outside her apartment in case agents come to her door. “They don’t want us in this country,” she says. “We have to be careful.”
Experts on immigrant mental health say they have already seen a spike in symptoms since President Trump’s inauguration. Roberto Gonzalez, an assistant professor of education at Harvard who studies undocumented youth, says he has seen parents pull their children from school out of fear. “This kind of elevated fear and anxiety can have detrimental physical and mental health effects in the long term,” he told me. “Many of the young people I’ve been studying have shown physical and emotional manifestations of stress: chronic headaches, toothaches, ulcers, sleep problems, trouble getting out of bed in the morning, eating issues.” It will get only worse, he said, with Mr. Trump’s DACA announcement.
Rosa Maria Bramble, a social worker who works with undocumented families, including former ground zero cleanup workers with PTSD, told me that news of stepped-up enforcement triggers symptoms in her clients. “I work with a number of people who fled their countries because of political violence or gender violence, and after they reached these shores their symptoms of PTSD began to mitigate,” she says. “Now they feel just as vulnerable and persecuted and terrorized as they did prior to being here.”
Spreading fear and anxiety, of course, is part of the administration’s plan. Thomas Homan, the acting director of ICE, recently said: “If you’re in this country illegally and you committed a crime by entering this country, you should be uncomfortable. You should look over your shoulder, and you need to be worried.”
A common Spanish refrain is that dirty laundry is washed at home. But silence equals death. In lieu of comprehensive immigration reform, what can we do? Churches, community health centers and nonprofit organizations can provide referrals to bilingual therapists and conduct workshops on self-care, explaining depression and anxiety from a culturally sensitive perspective. Licensed therapists, psychologists and psychiatrists can offer care for reduced fees to low-income clients, and clinics can hire more bilingual practitioners. Teachers can check in with students from mixed-status families. All of this would be smart from a public health perspective. But it is also a moral imperative.
Every morning at 6:40, as he is going to work in construction, I text my father extravagant statements about my love for him. I do it again in the evening, urging him to rest, reminding him my dog has green eyes just like my grandfather, asking if he has ever been so adored, hoping that I can inoculate him and my mother against the evils of the current administration. We are a generation apart and have different ideas about what tactics can preserve the heart. Here is the child whom he taught not to cry, begging her father to accept her love as a substitute for everything else that is good and fair.
But love alone cannot cure what ails us, and neither can resilience or quiet strength.
The Center for Gender & Refugee Studies (CGRS) is launching a new project—a searchable database of qualified and pre-vetted country specialists and health professionals who serve as expert witnesses to support asylum seekers in the United States. This service will be offered to attorneys and experts alike, free of charge. In other areas of the law, the provision of expert witness referrals is highly developed and professionalized, but this will be the first project of its kind to do so in the asylum field. As many of you know, for nearly twenty years, CGRS has been providing expert referrals through our technical assistance program. We are thrilled to be creating this new resource that will greatly improve our ability to support your cases.
The Asylum Expert Witness Database is scheduled to go live in late 2017 and will contain detailed profiles for hundreds of experts, as well as information, including outcomes, about cases for which they have provided testimony. When available, we will also include sample transcripts of the expert’s prior testimony and any government challenges to an expert’s qualifications. Experts will be able to update their own profiles to include information about current availability and fee requirements. In the meantime, we will continue to provide referrals when requested through our website http://cgrs.uchastings.edu/assistance.
We are currently seeking information from attorneys about recommended country specialists or health professionals for inclusion in the database. Please send information about any recommended experts, including contact information, areas of expertise, and CVs, to CGRS at CGRS-ExpertDB@uchastings.edu. We will follow up with attorneys and the experts themselves as we get closer to the go-live date.
Thank you in advance for your assistance in this endeavor. We hope that the Asylum Expert Witness Database will further enhance the representation and resources provided to asylum seekers across the country.
We write to alert you to a new practice advisory, “Working with Child Clients and Their Family Members in Light of the Trump Administration’s Focus on ‘Smugglers,’” issued by CLINIC and Public Counsel available here. We hope it is useful for practitioners particularly in light of recent reports of enforcement against sponsors. We also encourage practitioners to report any instances of enforcement against sponsors or family members of unaccompanied children, so that we can identify trends, collectively strategize, and continue to develop best practices about how to best protect immigrant families. Please report these to me via email and to Rebecca Scholtz at rscholtz@cliniclegal.org.
September 14, 2017 | 12 noon – 1 pm ET
How to Optimize Your Work with Immigrants In our Current Political Climate: 5 Tips for Successful Interventions
Webinar Description:
The Pew Research Center (2012) estimates that as of 2010 there are 11.2 million undocumented immigrants in the U.S. Between 2001 and 2011 the number of immigrants who pass through ICE detention per year rose from 204,459 in 2001 to 429,247 in 2011 (National Immigration Forum, 2013). Migration represents a major challenge associated with mental health distress including high rates of depression, anxiety, somatic disorders, and substance use problems. Moreover, immigrants in the U.S. also report high rates of discrimination. In the United States the most recent immigration policies and rhetoric have contributed to increase fear and stress among immigrants. In particular, parents and children are reporting increased anxiety and fear of being separated. Additionally, immigrants report feelings of being “othered” and unwelcomed in their environment. Furthermore, the changing rhetoric and immigration policy is also driving undocumented populations to go underground.
This webinar will provide a brief overview of the stressors and mental health difficulties that immigration populations tend to experience and how the stressors have changed in light of the current sociopolitical climate. Additionally, strategies aimed at improving the care and wellbeing of immigrants will be reviewed. This webinar will also highlight harmful myths and erroneous beliefs about the immigration population in the U.S.
At the end of this session, participants will able to:
1) Identify stressors immigrant populations in the U.S. are currently facing; how mental health, in particular anxiety, is manifested among immigrant populations; and how the current stressors have shifted in light of current sociopolitical climate.
2) Employ brief, culturally appropriate therapeutic interventions and identify cultural nuances relevant to the immigrant population
3) Recognize and identify erroneous beliefs about immigrant populations that contribute to discriminatory behavior
Presentation level: Introductory
This webinar is eligible for 1 CE.
Research Citations:
Bas-Sarmiento, P., Saucedo-Moreno, M. J., Fernandez-Gutierrez, M., Poza-Mendez, M. (2017). Mental health in immigrants versus native populations: A systematic review of the literature. Archives of Psychiatric Nursing, 31, 111-121
Zapata-Roblyer, M.I., Carlos, F.L., Merten, M.J., & Gallus, K. (2017). Psychosocial factors associated with depressive symptoms among Latina immigrants in a new arrival community. Journal of Latino/a Psychology, 5(2) 103-117.
Rojas-Flores, L., Clements, M.L., Koo, J.H., & London, J. (2016). Trauma and psychological distress in Latino citizen children following parental detention and deportation. Psychological Trauma: Theory, Research, Practice, and Policy, 9(3), 352-361.
Presenter’s Biography:
Dr. Montoya provides evidence-based treatments to individuals with a variety of presenting concerns including, mood and anxiety disorders, trauma (e.g. sexual, physical, and verbal abuse; torture), and substance use. While her treatment approach is cognitive behavioral, when appropriate, she incorporates humanistic, psychodynamic, and mindfulness-based approaches, and experiential techniques to support client self-discovery. She received specialized training in psychotherapy for PTSD, depression, anxiety, and other specific concerns. Dr. Montoya also provides psychological evaluations for immigration cases often used in asylum, extreme hardships, or removal of conditions of inadmissibility.
Asylum Evaluations Continued: A More In-Depth Look at Evaluating Special Populations
June 23, 12-1pm ET
This skill building webinar will take a more in-depth look at cultural competence and difficult revelations when evaluating two frequently encountered asylum seekers: Hispanic populations and survivors of gender based violence. Information about participating and being listed in the Refugee Mental Health Resource Network will also be discussed. The first portion of the webinar will focus on culturally competent evaluations of Hispanic immigrants including vulnerable children. The Hispanic population of the United States is almost 57 million. Presently, the U.S. has become the second largest country in the world with an Hispanic population and requires sensitivity to diversity because of the many cultural backgrounds (there are 20 Spanish speaking countries plus Puerto Rico). Discussion of the evaluation will include the necessary information to provide in the asylum report including the legal standard that must be met, background information, collateral sources, hardship statements, use of psychological tests, and working with attorneys. The special issue of unaccompanied minors will also be discussed. The second portion of the webinar will take an in-depth look at some of the challenges faced by psychologists when evaluating female asylum seekers. This group consists predominantly of survivors of gender-based violence at the hands of intimate partners, immediate family or community. Discussion will include the multiple ways a history of trauma impacts the evaluation, exploring the sensitive topics around intimate partner violence, and specific issues related to survivors from West Africa (i.e. forced marriage, FGM) and Central America (partner violence within the context of pervasive gang violence). Using standardized measures to anchor the evaluation and promote an understanding of the client’s experience will be discussed.
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SPECIAL REPORT
Fleeing violence, asylum-seekers rely on psychologists to back up their story
s she prepared to testify, the woman knew this hearing could determine everything. If the judge found her story credible, she could be granted asylum and allowed to stay in the United States. If not, she could be deported back to her home country, where she had been gang-raped by armed soldiers. She worried she’d be murdered soon after she got home.
So she recounted everything she remembered. But there were a few questions she couldn’t answer.
“The judge was very interested in certain details of the experience, like exactly how many men raped her, and what color was the wall,” recalled Megan Berthold, who was then a clinical social worker at the Program for Torture Victims in Los Angeles.
The woman said she didn’t know.
For this asylum-seeker, as with many others, gaps in memory or inconsistencies in her story could have gotten her deported. Yet, when it comes to trauma, what might seem like a sign that testimony isn’t credible can itself be strong evidence that the story might be true. Berthold’s job was to explain this paradox to the judge.
She was there as a forensic psychological evaluator, a role she has played in hundreds of asylum cases. We think of US immigration law squarely in the world of politics, with people caught in the crosswinds of violence around the globe and each American administration’s policies. But based on interviews with nearly 20 health providers and immigration lawyers, STAT found that many of these cases pivot on the knowledge of clinicians like Berthold.
To stay in the United States, asylum-seekers need to prove that they are at risk of persecution in their home countries. But often they have little evidence to back them up. The paper trails from their past lives — such as hospital or police records — are often inaccessible. If they were tortured in a secret government prison or persecuted by the police, that kind of official record may not exist at all.
Instead, what remain are the stories that migrants tell, and whatever marks those experiences have left on their bodies and minds. So these cases depend on doctors and psychologists who can translate scars and symptoms into evidence — and who can tell when a person’s ability to testify may have been altered by trauma.
That means that many asylum-seekers depend on a network of clinician volunteers, trained by nonprofits such as Physicians for Human Rights and HealthRight International.
These evaluations do seem to make a difference. In the 540 or so evaluations Physicians for Human Rights provides a year, asylum is granted in about 90 percent of cases. By comparison, in 2015, the overall rate for asylum seekers was 48 percent.
The better outcomes stem partially from the fact that those who are able to get this kind of expert testimony are almost always represented by a lawyer, which isn’t true for many asylum-seekers. Even so, both lawyers and judges see these evaluations as essential.
Yet asylum-seekers who are fortunate enough to have a lawyer frequently can’t get a forensic evaluation: There just aren’t that many clinicians who do them. The ones who do volunteer often aren’t able to take on all the cases that the nonprofits send their way. Other times, they are faced with bureaucratic roadblocks that make the evaluations nearly impossible. And some worry that the demand for these evaluations will only increase with a president who has made fiercely anti-immigration promises.
“I would like one for all of my cases, because all of my asylum clients have documentable psychological and often physical trauma,” said Jesse Rockoff, an immigration attorney at UnLocal, a nonprofit in New York. “But you have to pick and choose, because you don’t want to overwhelm this system that is already overloaded with too many requests. I’m terrified that my picking and choosing is going to come back and bite me, and is going to get someone deported or killed.”
‘Getting to the truth of a case’
Remembering the wall color or the exact number in a group of assailants might be hard for anyone. But for the Los Angeles asylum-seeker, Berthold saw it as more than just an everyday memory lapse. It was partially a symptom of post-traumatic stress disorder.
This case took place in the early 2000s. Because of their clients’ perceived vulnerability, none of the providers or attorneys STAT interviewed was willing to describe in detail the numerous recent cases where asylum-seekers’ testimony was similarly affected by trauma. Many said that those who have successfully gone through the asylum process might have spoken out about their experiences before the election of President Donald Trump, but are now too afraid, even though much of the president’s anti-immigrant rhetoric has focused on those without legal documentation. They worry that their legal status may somehow be affected by changing policies, or that they will simply become targets of xenophobia.
Berthold revealed nothing that would identify her patient, but she did describe some of the horrors that the Los Angeles asylum-seeker had undergone, and how that affected her symptoms.
“They had AK-47s, and a knife at her throat,” said Berthold, who is now an assistant professor of social work at the University of Connecticut, and who trains both licensed clinicians and students to provide these evaluations. “She had no viable option of physically escaping, so she escaped in her mind, she disconnected herself.”
That explanation sounds relatively straightforward, but the underlying neuroscience of trauma is anything but.
In a PTSD patient’s brain, the amygdala — an almond-shaped lump that responds to both pleasure and fear — becomes an oversensitive alarm, like a fire detector that rings every time you put the kettle on. Meanwhile, the part of the prefrontal cortex that would normally act as a “reset” button doesn’t seem to be working properly: A person will go into panic mode at the slightest provocation, and have trouble calming down again, even when there is no danger.
“But that is a very CliffNotes version of a much deeper problem,” said Dr. Charles Marmar, the chair of psychiatry at New York University School of Medicine, who began studying PTSD in 1976.
Marmar and other researchers have used brain imaging and animal studies to describe a confusing epic of neurotransmitters that reshape brain circuitry in PTSD. The plot is convoluted, and still incomplete.
It involves an initial flood of stress hormones that can disturb the ability to perceive a traumatic experience fully. After that, there also seem to be imbalances in everything from the chemicals that help people regulate blood pressure to the brain’s own version of opioids.
“I have heard judges say, ‘I don’t know if this has happened to them because they didn’t emote enough.’”
MEGAN BERTHOLD, UNIVERSITY OF CONNECTICUT
The resulting symptoms can seem contradictory. Some people have holes in their memory, images and details they can’t recall; others are haunted by horrific flashbacks and nightmares they can’t forget. Some seem emotionless, numb; others are so overcome they can hardly speak. Some are too fearful to perform everyday tasks; others become alarmingly reckless.
Those symptoms can provoke bafflement or suspicion at any point during the asylum-seeking process. Before going to court for this kind of case, an immigrant is interviewed by an asylum officer, and the application could simply be approved. But if there is doubt about the veracity of the person’s story, or if the person has been apprehended by the Department of Homeland Security, then the case goes before a judge, with a government attorney acting as a kind of prosecutor.
“I have heard judges say, ‘I don’t know if this has happened to them because they didn’t emote enough,’” said Berthold.
“A judge is in this difficult position of trying to interpret the testimonial style, the coherence of the recollections,” said Judge Dana Marks, president of the National Association of Immigration Judges.
Even though forensic evaluations are put forward by the asylum-seeker’s lawyer, the judge is able to mine them for objective facts, said Jeffrey Brauwerman, an attorney in Fort Lauderdale, Fla., and a former immigration judge.
“These medical and psychological evaluations can be an essential tool in assisting a judge in getting to the truth of a case,” said Marks. “We do get training on … cultural issues and the psychological issues — that’s part of how you train a judge to be a good judge — but the reality is that we also have to make our decision based on the individual record of the case that comes before us.”
Megan Berthold, an assistant professor at the University of Connecticut School of Social Work, has been a forensic psychological evaluator in hundreds of asylum cases.STEVEN G. SMITH FOR STAT
Late-night forensics
Getting that kind of evidence in asylum cases often means asking clinicians to perform a high-wire balancing act.
Serena Chaudhry volunteers as a psychological forensic evaluator with Physicians for Human Rights — but she also has a full-time practice as a clinical social worker, is pursuing a doctorate, and has a family.
When she lived in New York, she was part of a wide network of local volunteers, and over two years she only got a handful of evaluation requests. Now, she lives in New Orleans, where there are many fewer clinicians doing this work: In November alone, she did between six and eight evaluations.
She has tweaked her clinical schedule to keep a two-hour chunk free every week for those asylum-seekers. The write-ups then take between two and five hours, depending on the complexity of the symptoms.
“I do the write-ups at night, at 9 or 10 o’clock, after my day is done and my kids are in bed, and the rest of my life has come to standstill,” she said.
She does what she can, sometimes negotiating with the lawyers so she can have a bit more time. But she hopes that a training session in April will allow more clinicians to take on the task.
The dearth is especially great in northern Louisiana, around the LaSalle Detention Facility, built among the forested hills of Jena, where saw logs and pulpwood are harvested next to cotton and soybean farms. Getting there from New Orleans can be a trek: a four- or five-hour drive each way, on top of the time spent getting into the center, doing the evaluation, and then writing the report.
“I do the write-ups at night, at 9 or 10 o’clock, after my day is done and my kids are in bed.”
SERENA CHAUDHRY, CLINICAL SOCIAL WORKER
That problem is not unique to Louisiana. Immigration detention centers tend to be remote — making those sessions harder to work into a clinician’s schedule — and sometimes distance isn’t the only barrier.
“We’ve had evaluators go to a center after scheduling a whole day of travel, and the individual isn’t brought out: They just aren’t made available for the evaluation,” said Meredith Fortin, who runs the Physicians for Human Rights Asylum Network.
Each center can have a different policy about letting in evaluators.
“We also get requests for individuals who are in detention enters that won’t let evaluations to take place there, so we have to arrange for them to be transferred to somewhere where they can arrive in shackles with an armed guard,” Fortin said.
Lindsay Harris, a lawyer with the immigration and human rights clinic at the University of the District of Columbia, wrote in an email that a detention center in Farmville, Va., “changed the rules on us mid-representation and would no longer allow a psychologist to meet using [videoconferencing]technology.”
According to an Immigration and Customs Enforcement official, the Farmville Detention Center has not refused any requests, but there have been “technological challenges” with this kind of equipment. The official added that it is up to each individual detention center as to whether a psychological evaluator is allowed in. The ICE field office has to approve all forensic evaluations of detainees, either inside or outside of the center, and then it is up to the center to provide the necessary space or transportation, he said.
“Comprehensive medical care is provided from the moment detainees arrive and throughout the entirety of their stay,” ICE spokesman Brendan Raedy wrote in a statement responding to STAT’s questions.
Testifying takes a ‘huge toll’
For psychological evaluators, the division between procuring evidence and providing treatment can be thin.
When there’s physical evidence of trauma, the clinicians who examine scars and write a report tend not to provide treatment. But lawyers recognize that some asylum-seekers simply wouldn’t be able to stand trial without getting their symptoms under control.
“When I saw the psychologist, there were some things I thought were normal about me, because of what I went through over the years,” said a Nigerian woman who was granted asylum a few years ago and now lives in Bridgeport, Conn. “I thought it was normal to want to kill myself all the time, to end it all, each time I think what I’m going through, that there was no one to help.”
She remembers wanting to jump in front of a train every time she went near the station. “I thought it was normal,” she said.
She didn’t want to talk about her traumatic experiences when she began to apply for asylum, she said, “but they said I had to. Each time I talk about it, it brings back old hurtful memories and I get depressed, I go into my shell again, it reminds me of everything. Each time I talk about, it’s like it just happened.”
Her physical and psychological evaluators, at Yale and the University of Connecticut, respectively, helped guide her through the process, so that she was able to tell her story and get asylum — but she still has trouble talking about it.
“The process necessitates them to talk about the trauma in quite a lot of detail, and that’s exactly what they cannot do.”
DIYA KALLIVAYALIL, CAMBRIDGE HEALTH ALLIANCE
“It takes a huge toll on them,” said Diya Kallivayalil, a psychologist at Cambridge Health Alliance in Massachusetts, who specializes in trauma and has provided many forensic evaluations. “The process necessitates them to talk about the trauma in quite a lot of detail, and that’s exactly what they cannot do.”
Her patients respond in all kinds of ways. “They can become suicidal, they can become psychotic,” she said.
Sometimes they go to great lengths to avoid their lawyers because describing their experience is so emotionally difficult. “In some examples, they have left the state, and we have had to write to the court to ask for more time, so we can care for the patient so he can participate in his own case,” Kallivayalil said.
Even convincing an asylum-seeker to see a psychological evaluator can be a challenge: Many of them come from countries where those services aren’t accessible, and where mental health issues are deeply stigmatized.
“In Khmer, one way that ‘mental health’ is translated is ‘chikkuid,’ which essentially translates as deranged,” said Berthold. “It connotes somebody who is floridly psychotic and completely out of their mind.”
Then, when an asylum-seeker can be convinced to come in for an evaluation, and the clinician has explained again the purpose of these sessions, the evaluation itself can be a long process.
“I do at least two to three sessions, and they are pretty lengthy, because when you are dealing with a trauma patient, you need to really earn their trust,” said Paula Madrid, a New York psychologist specializing in trauma who has done evaluations both as a volunteer for HealthRight International and as a paid expert witness. “About 50 percent of the clients who come in subsequently tell me they had nightmares the night of the evaluation. It was retriggered. I end up doing a little bit of trauma therapy just to ensure that they will be psychologically safe.”
In the case of the woman who was gang-raped, Berthold’s testimony was one of the pieces that helped her win her case — but Berthold also helped her get through the emotional fallout of having to testify about her traumatic experience for some 12 hours over five or six hearings.
“What she felt at the end was, ‘Now I feel like I can face anything, I got through my torture, I stood up to the judge, I kept sticking with what I knew to be true, and he believed me and I got asylum,’” recalled Berthold. “But it was really rough.”
Global Detention Project Newsletter MAY 2017 NEW FROM THE GDP
Austria Immigration Detention Profile
Austria has sharply increased the number of people it places in immigration detention after years of declining detainee populations. While it continues the controversial practice of placing immigration detainees in “Police Detention Centres,” the country opened a new dedicated immigration detention centre in 2014, which is partly operated by the controversial multinational security company G4S. The country has also announced plans to significantly boost removals, focusing mainly on people from the Middle East and sub-Saharan Africa. Read profile here.
Belgium Immigration Detention Profile
Belgium has long received scrutiny for its immigration control policies, in particular its controversial use of forced deportation flights. However, the numbers of people placed in detention annually has declined substantially during the past 15 years, even as the detention of asylum seekers at borders has increased. The country has also pioneered the promotion of “alternatives to detention” for families. However, this policy suffered an important setback as the government announced that families would again be detained in closed centres starting in 2017. Read profile here.
GDP SUBMISSIONS & RECOMMENDATIONS
Submission to the UN Committee on Economic, Social, and Cultural Rights: AUSTRALIA
Read the submission here.
Submission to the UN Universal Periodic Review: ARGENTINA (in Spanish)
Joint submission for the Universal Periodic Review by ANDHES, CAREF, CELS, Centro de Justicia y Derechos Humanos de la Universidad Nacional de Lanús, COPADI, GDP, IARPIDI and Red de Migrantes y Refugiados en Argentina. Read the submission here.
Statement to the Working Group on the Use of Mercenaries
The GDP’s Executive Director made a statement to the Working Group on the Use of Mercenaries panel on “Private Military and Security Companies in Places of Deprivation of Liberty and Their Impact on Human Rights,” 27 April 2017. Read the statement here.
EXTERNAL PUBLICATIONS
Putting Immigration Detention in Interdisciplinary Perspective
Michael Flynn published a 2-part essay for the Border Criminologies network at University of Oxford discussing lessons learned from the interdisciplinary study of immigration detention systems. Available here.
Statelessness and Immigration Detention
The Institute on Statelessness and Inclusion interviewed the GDP’s Mariette Grange about the detention of stateless persons and the importance of international human rights standards in safeguarding the rights of this vulnerable population. Available here.
Border Securitization and Containment VS. Fundamental Rights: the European Union’s “Refugee Crisis”
GDP Associate Researcher Izabella Majcher’s article for the Georgetown Journal of International Affairs. Available here.
Challenging Immigration Detention: Academics, Activists, and Policy-makers
Edited by Michael Flynn and Matthew Flynn (Edward Elgar, forthcoming 2017)
Governments increasingly rely upon detention to control the movement of undocumented migrants and asylum seekers. Approaching detention from an interdisciplinary perspective, this new edited volume brings together leading writers and thinkers to provide a greater understanding of why it is such an important social phenomenon and suggest ways to confront it locally and globally. More information available here.
UPCOMING EVENTS
“Walls, Borders, and Bridges: Law and Society in an Inter-Connected World”
The GDP has organized a session titled “Challenging Immigration Detention” at the annual International Meeting on Law and Society which will be held in Mexico City on 20-23 June. Participants on the panel will include Michael Flynn (GDP), Hindpal Singh Bhui (UK Inspectorate of Prisons), Niels Frenzen (USC Gould School of Law), Michael Young (University of Texas at Austin), Matthew Flynn (Georgia Southern University), and Denise Gilman (University of Texas at Austin). More information about the conference is available here.
“Mass Influx? Law, Policy and Large-Scale Movements of Refugees and Migrants”
Presentation by Izabella Majcher entitled “The EU Hotspot Approach and Expansion of De Facto Immigration Detention” at the 2nd Annual Conference of the Refugee Law Initiative (RLI) which will take place on 5-7 June 2017 at the University of London. More information is available here.
Annual Meeting of the International Detention Coalition
Geneva, 16 June 2017. More information is available here.
“The Global Refugee Crisis: Empirical Evidence and Policy Implications for Improving Public Attitudes and Facilitating Refugee Resettlement,” Victoria M. Esses, Leah K. Hamilton, Danielle Gaucher. (2017). in Social Issues and Policy Review. Vol. 11 Issue 1. pp. 78-123. http://onlinelibrary.wiley.com/doi/10.1111/sipr.12028/full
“The contemporary refugee crisis: an overview of mental health challenges,” Derrick Silove, Peter Ventevogel, Susan Rees. (May 2017) in World Psychiatry Vol. 16 Issue 2. pp. 130–139 http://onlinelibrary.wiley.com/doi/10.1002/wps.20438/full
“Global Justice, International Law and Development,” Paul Battersby and Rebekah Farrell (2017) In International Development: A Global Perspective on Theory and Practice. Edited by Paul Battersby and Ravi Roy. SAGE Publications Ltd. pp. 373 – 391.
“The Protection of Asylum Seekers in Australian-Pacific Offshore Processing: The Legal Deficit of Human Rights in a Nodal Reality” in Human Rights Law Review (2017) 17 (1): 33-71. https://academic.oup.com/hrlr/article/17/1/33/2525422
“A Lesser Evil? The European Agenda on Migration and the Use of Aid Funding for Migration Control,” Davitti, Daria and La Chimia, Annamaria, (April 11, 2017). UCD Working Papers in Law, Criminology & Socio-Legal Studies Research Paper No. 07/17. https://ssrn.com/abstract=2966042
“UN Principles on the Right of Anyone Deprived of Liberty to Bring Proceedings Before Court,” Andenas, Mads and Tofte, Tobias Skurdal (April 26, 2017). University of Oslo Faculty of Law Research Paper No. 2017-19. https://ssrn.com/abstract=2958671
“Border Criminologies and the Changing Nature of Penal Power,” Mary Bosworth. (2017). in The Oxford Handbook of Criminology. Edited by Alison Liebling, Shadd Maruna, Lesley McAra. Oxford University Press.
What Challenges and Opportunities Do Psychologists, Policymakers, and Other Immigration Policy Stakeholders Face in Light of Current U.S. Immigration Policies?
This webinar has been organized by several divisions of the American Psychological Association (APA)— Developmental Psychology (APA Division 7), the Society for the Psychological Study of Social Issues (APA Division 9), the Society for Theoretical and Philosophical Psychology (APA Division 24), and the Society for Community Research and Action (APA Division 27)—in partnership with Fordham Law School’s Feerick Center for Social Justice and the APA Immigration Working Group. This webinar is part of a larger collaborative project that was made possible through an APA Public Interest Leadership Conference (PILC) Health Equity Dissemination Award.
Presenters
Wendy Cervantes, M.A.
Senior Policy Analyst
Center for Law and Social Policy (CLASP)
Presentation: Policy Implications for Immigrant Children and Families: Challenges and Opportunities
Luis H. Zayas, Ph.D.
Dean and Robert Lee Sutherland Chair in Mental Health and Social Policy The University of Texas at Austin School of Social Work
Presentation: Using Clinical Evaluations to Advocate for Immigrant and Refugee Children
About the webinar:Wendy Cervantes will open the webinar, providing an overview of the children impacted by U.S. immigration policies—including citizen children living in mixed-status families, undocumented children, and unaccompanied children. Cervantes will cover the pressing immigration policy issues impacting these children, including a brief historical overview and recent policy proposals such as the Trump administration’s immigration executive orders. She will also discuss challenges and opportunities and speak to how researchers and practitioners can help inform the policy discussion. The presentation by Dr. Luis H. Zayas will follow, focusing on how mental health evaluations can be used to advocate for two groups of children: (a) citizen-children whose parents are in deportation proceedings and are fighting to cancel their removal, and (b) refugee children held in family detention centers with their mothers. Zayas will describe briefly the conditions of each set of children and discuss the unique and overlapping features of clinical evaluations conducted with both groups. Zayas will discuss the content and purpose of the evaluation report and the professional’s testimony in immigration court and use of the report in asylum hearings. He will also discuss ways in which psychologists can be advocates in the media, class-action lawsuits, immigration court, and legislative bodies.
Wendy Cervantes is a Senior Policy Analyst at the Center for Law and Social Policy where she leads the organization’s cross-sector policy agenda aimed at supporting low-income immigrants and their families. Previously, Ms. Cervantes was the Vice President of Immigration and Child Rights at First Focus. She also served as Director of Programs at La Plaza, Indianapolis and managed the immigrant and refugee families portfolio at the Annie E. Casey Foundation. Ms. Cervantes holds an M.A. in Latin American Studies and Political Science from the University of New Mexico and a B.A. in Communications from the University of Southern California.
Luis H. Zayas, Ph.D., is Dean of the School of Social Work at The University of Texas at Austin, where he holds the Robert Lee Sutherland Chair in Mental Health and Social Policy. He is also a Professor of Psychiatry in the Dell Medical School of The University of Texas at Austin. Zayas is a licensed psychologist and licensed clinical social worker in Texas. His book, Forgotten Citizens: Children, Deportation, and the Making of American Exiles and Orphans (Oxford, 2015), describes the plight of U.S.-born children who live under the shadow of their undocumented immigrant parents’ deportability or actual deportation. He continues to advocate for justice for immigrant and refugee children in the United States.
Thank you to Serena Dávila, JD, of the APA Immigration Working Group, for helping to make this webinar possible. Serena is a Senior Legislative and Federal Affairs Officer in APA’s Public Interest Directorate.
Jean Hill, Ph.D.
Executive Director
Society for Community Research and Action
Division 27 of the American Psychological Association
