The role of mental health professionals in political asylum processing (original) (raw)
Related papers
2015
The use of psychological assessments as evidence has become a frequent part of the asylum determination process in the United States. This exploratory, qualitative study focused on the personal and professional experiences of psychologists who provide these assessments. First the political, legal, and social situation of asylum seekers to the United is discussed. Then the mental health challenges that asylum seekers commonly experience are reviewed. Finally, parameters of the assessment process and common challenges are highlighted. Six psychologists with experience assessing asylum seekers were asked about their experiences providing these assessments and training for the work, and their responses were analyzed qualitatively for common categories and themes. Several major categories of experiences arose in participants' answers. They discussed a) the location of assessment experiences, b) experiences working with interpreters, c) assessing for trauma and PTSD, d) the use of psychological measures, e) writing the assessments, f) experiences with the asylum system and process, g) adapting to cultural differences, h) personal and professional impact of this work, i) professional dilemmas, j) methods of self-care and coping, and k) training experiences. Across these categories, the tension between social advocacy and clinical integrity, and the cultural challenges to usual professional praxis arose as salient themes. Finally, the limitations and implications of the current study are addressed.
The mental health needs of asylum seekers and refugees - challenges and solutions
BJPsych international, 2016
Global events like wars and natural disasters have led to the refugee population reaching numbers not seen since the Second World War. Attitudes to asylum have hardened, with the potential to compromise the mental health needs of asylum seekers and refugees. The challenges in providing mental healthcare for asylum seekers and refugees include working with the uncertainties of immigration status and cultural differences. Ways to meet the challenges include cultural competency training, availability of interpreters and cultural brokers as well as appropriately adapting modes of therapy. Service delivery should support adjustment to life in a foreign country. Never has the need been greater for psychiatrists to play a leadership role in the area.
Forensic mental health professionals in the immigration process
The Psychiatric clinics of North America, 2012
This article adds to the existing literature on the role of mental health professionals in assisting attorneys in the asylum and refugee determination process primarily in the United States. The authors describe the legal context for asylum and refugee processing, challenges in conducting evaluations, diagnostic considerations, and specific competencies needed for mental health evaluators. Various cases are presented to illustrate key points. These cases purposely do not include any identifying information of any specific client, yet they are representative of the range and scope of issues that arise in this context.
Journal of Immigrant and Minority Health, 2019
This review brought together research investigating barriers asylum seekers and refugees (AS&R) face in accessing and negotiating mental health (MH) services. The candidacy framework (CF) was used as synthesizing argument to conceptualize barriers to services (Dixon-Woods et al. in BMC Med Res Methodol 6:35, 2006). Five databases were systematically searched. Twenty-three studies were included and analyzed using the CF. The seven stages of the framework were differentiated into two broader processes-access and negotiation of services. Comparatively more data was available on barriers to access than negotiation of services. The Identification of Candidacy (access) and Appearances at Services (negotiation) were the most widely discussed stages in terms of barriers to MH care. The stage that was least discussed was Adjudications (negotiation). The CF is useful to understand inter-related barriers to MH care experienced by AS&R. A holistic approach is needed to overcome these barriers together with further research investigating understudied areas of candidacy.
Journal of Infant, Child, and Adolescent Psychotherapy
This paper presents the story of a family of four refugees from Central America seeking asylum in the United States, and of the experience of a group of psychoanalysts, members of the New York University Postdoctoral Program Immigration and Human Rights Work Group, who evaluated each member of the family and wrote affidavits in support of their applications for asylum. The work described provides an example of how clinicians can apply their skills and understandings outside the consulting room to address the dire needs of refugees who have fled from their homes. We discuss the process of refugees seeking asylum and the role of a psychological evaluation in the asylum process. We elaborate on the content and process of the evaluations of each member of the family with a focus on the trauma suffered and its sequelae on two schoolaged children, their adolescent aunt, and their courageous and protective mother. We also address the analysts' experience of doing psychological evaluations and writing affidavits for asylum seekers who have experienced trauma.
Mental Health of Refugees and Migrants
Psychology of Inequity, Volume 2, Chin, J.L., Garcia, Y.E., & Blume, A. (Eds.), Praeger., 2022
This chapter discusses refugee and migrant mental health and well-being in national (US) and international contexts, and provides an explanation of the legal terms and issues that have profound implications for practitioners and service providers. Vignettes are presented to capture key aspects of what is commonly encountered in the field, i.e. issues that practitioners can expect to arise, and which need to be prioritized for effective assessment and service provision, further elaborated in subsequent discussions. These often highlight tensions between best practices for mental health & well-being and (increasingly common) legal, governmental and institutional practices, which violate human rights and even their own laws or regulations. Given this context and historical trajectory, there are similar risks for the present and future for psychological health in this population. This chapter aims to cover overarching matters relevant to refugee & migrant mental health and well-being, such that readers would require additional training to be equipped to practice and serve in this area.
Clinical issues in mental health service delivery to refugees
American Psychologist, 1991
Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.
The European Journal of Public Health, 2010
Background: Asylum seekers (AS) and refugees often suffer from severe psychopathology in the form of post-traumatic stress disorder (PTSD). As PTSD impacts memory functions, and as asylum applications rely on personal accounts, AS with PTSD are at more risk of being rejected than refugees. Methods: We studied the mental health of failed asylum seekers (FAS, N = 40) and a matched sample of AS (N = 40). Participants were administered structured interviews on sociodemographics, flight, exile and standardized questionnaires on PTSD, anxiety, depression and pain. Results: Both samples were severely affected; >80% exhibited at least one clinically significant condition. Conclusion: Given the great vulnerability of these individuals, long and unsettling asylum processes as practised in Western host countries seem problematic, as does the withdrawal of health and social welfare benefits. Finally, high rates of psychopathology amongst FAS indicate that refugee and humanitarian decision-making procedures may be failing to identify those most in need of protection.
The Fast Track Refugee Assessment Process and the Mental Health of Vulnerable Asylum Seekers
Psychiatry, Psychology and Law, 2015
On 5 December 2014, the Australian Senate passed the Maritime Powers Legislation Amendment (Resolving the Asylum Legacy Caseload) Bill 2014 (Cth). This article discusses the intersections between an aspect of the new law À the 'fast track assessment' Refugee Status Determination (RSD) procedure, mental ill health and vulnerability of asylum seekers. Insecure visa status, post-arrival stressors and living in constant uncertainty and fear of rejection and repatriation are known to compound existing pre-migration trauma for asylum seekers. The 'fast track assessment' procedure, in which a large number of asylum seekers' claims for protection will be processed under the new law, suggests a likely worsening of mental distress, despair and deterioration. The combined nature of mental health and legal support are an increasing feature of a coordinated and much needed integrated response to assist vulnerable asylum seekers living in the community. It is suggested that asylum seekers with an existing mental health condition who receive negative outcomes during the RSD process are particularly vulnerable. All asylum seekers should have mental health support made available to them when visa decisions are handed down or shortly afterwards.