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Asylum Grant Rates Following Medical Evaluations of Maltreatment among Political Asylum Applicants in the United States

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Abstract

Although many individuals applying for political asylum allege maltreatment and sometimes torture in their countries of origin, the utility of medical evaluations in asylum adjudication has not been documented. This study compares the asylum grant rate among US asylum seekers who received medical evaluations from Physicians for Human Rights (PHR), with rates among asylum seekers who did not receive PHR evaluations. Retrospective analysis was carried out on all asylum cases referred to PHR between 2000 and 2004 for medical evaluations for which adjudication outcome was available. Basic demographic information was obtained: age, sex, country of origin, English language ability, US region where adjudication occurred, whether legal representation was pro bono, type of evaluation, provision of oral court testimony, and whether asylum seekers were in detention. Cases were analyzed descriptively and with chi square tests. Between 2000 and 2004, 1663 asylum seekers received medical evaluations from PHR; the adjudication status (either granted or denied) was determined in 746 cases at the time of the study. Of these cases, 89% were granted asylum, compared to the national average of 37.5% among US asylum seekers who did not receive PHR evaluations. Medical evaluations may be critical in the adjudications of asylum cases when maltreatment is alleged.

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References

  1. Amnesty International. Amnesty international world report 2002. London, England; 2002.

  2. Basoglu M. Prevention of torture and care of survivors. An integrated approach. JAMA 1993;270(5):606–11.

    Article  PubMed  CAS  Google Scholar 

  3. Deborah EA. Law of asylum in the United States. 3rd ed. Boston: Refugee Law Center; 1999.

    Google Scholar 

  4. The Illegal Immigration Reform and Immigrant Responsibility Act Of 1996, Pub L. 104–208, enacted September 30, 1996. Available at: http://uscis.gov/graphics/publicaffairs/factsheets/948.htm.

  5. Human Rights First. In liberty’s shadow: US detention of asylum seekers in the era of homeland security, 2004. Available at: http://www.humanrightsfirst.org/asylum/libertys_shadow/Libertys_Shadow.

  6. US Department of Justice Executive Office for Immigration Review, Office of Planning, Analysis, and Technology. Immigration courts FY 2000–2004 asylum statistics, March 2006. Available at: http://www.usdoj.gov/eoir/statspub.htm.

  7. United States Citizenship and Immigration Service, Asylum Division, Refugee Asylum and Parole system, preliminary data, December 22, 2006.

  8. Executive Office for Immigration Review, FY 2005 statistical year book, (page K3), February 2006. Available at: http://www.usdoj.gov/eoir/statspub/fy04syb.pdf.

  9. Iacopino V, Özkalipçi Ö, Schlar C, et al. Manual on the effective investigation and documentation of torture and other cruel, inhuman or degrading treatment or punishment (“Istanbul Protocol”). Geneva, Switzerland: Office of the United Nations High Commissioner for Human Rights; 2001. UN publication HR/P/PT/8. Available at: http://www.unhchr.ch/pdf/8istprot.pdf.

  10. Lears LO, Abbott JS. The most vulnerable among us. Health Prog. 2005;86(1):22–5, 60.

    Google Scholar 

  11. Buchwald D, Manson SM, Dinges NG, Keane EM, Kinzie JD. Prevalence of depressive symptoms among established Vietnamese refugees in the United States: detection in a primary care setting. J Gen Intern Med 1993;8(2):76–81.

    Article  PubMed  CAS  Google Scholar 

  12. Silove D, Steel Z, Susljik I, et al. Torture, mental health status, and the outcomes of refugee applications among recently arrived asylum seekers in Australia. Int J Mig Heal Soc Care 2006;2(1):1–11.

    Google Scholar 

  13. Silove D, Sinnerbrink I, Field A, Manicavasaar V, Steel Z. Anxiety, depression and PTSD in asylum seekers: associations with pre-migration trauma and post-migration stressors. Br J Psychiatry 1997;170:351–7.

    PubMed  CAS  Google Scholar 

  14. Sack WH, Clarke G, Him C, Dickason D, Goff B, Lanham K, Kinzie JD. A 6-year follow-up study of Cambodian refugee adolescents traumatized as children. J Am Acad Child Adolesc Psychiatry 1993;32(2):431–7.

    Article  PubMed  CAS  Google Scholar 

  15. Boehnlein JK, Kinzie JD, Sekiya U, Riley C, Pou K, Rosborough B. A ten-year treatment outcome study of traumatized Cambodian refugees. J Nerv Ment Dis 2004;192(10):658–63.

    Article  PubMed  Google Scholar 

  16. de Jong JTVM, Komproe IH, Ommeren MV, Masri ME, Araya M, Khaled N, van de Put W, Somasundaram D. Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA 2001;286(5):555–62.

    Google Scholar 

  17. Mollica RF, McInnes K, Poole C, Tor S. Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry 1998;173:482–8.

    Article  PubMed  CAS  Google Scholar 

  18. Mollica RF, McInnes K, Sarajlic N, Lavelle J, Sarajlic I, Massagli MP. Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. JAMA 1999;282(5):433–9.

    Article  PubMed  CAS  Google Scholar 

  19. Keller A. Mental health of detained asylum seekers. Lancet 2003;362:1721–23.

    Article  PubMed  Google Scholar 

  20. Physicians for Human Rights and the Bellevue/NYU Program for Survivors of Torture. From persecution to prison: health consequences of detention for asylum seekers, 2003. Available at: http://www.phrusa.org/campaigns/asylum_network/detention_execSummary/.

  21. Silove D, Steel Z, Watters C. Policies of deterrence and the mental health of asylum seekers. JAMA 2000;284(5):604–11.

    Article  PubMed  CAS  Google Scholar 

  22. FileMaker Pro 6.0v4, Copyright 1984–2002 FileMaker, Inc.

  23. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2000;284:3043–5.

    Google Scholar 

  24. Human Rights Watch. September 1998 Report: Locked Away: Immigration Detainees in Jails in the United States.

  25. Keller A. Mental health of detained asylum seekers. Lancet 2003;362:1721–23.

    Article  PubMed  Google Scholar 

  26. Kuck CH. Study on asylum seekers in expedited removal as authorized by section 605 of the international religious freedom act of 1998: legal assistance for asylum seekers in expedited removal: a survey of alternative practices. 2004, United States Commission on International Religious Freedom. Available at: http://www.usdoj.gov/eoir/statspub.htm.

  27. United States Citizenship and Immigration Service. 2003 yearbook of immigrant statistics. Asylum cases filed with uscis asylum officers by asylum office and state of residence, 2003. Available at: http://uscis.gov/graphics/shared/statistics/yearbook/2003/Table19D.xls.

  28. US Department of Justice Executive Office for Immigration Review, Office of Planning, Analysis, and Technology. Immigration courts FY 2000–2004 asylum statistics, March 2006. Available at: http://www.usdoj.gov/eoir/statspub.htm.

  29. Iacopino V, Allden K, Keller A. examining asylum seekers: a health professional’s guide to medical and psychological evaluations of torture. Physicians for human rights. August, 2001.

  30. Peel M, Iacopino V. The medical documentation of torture. San Francisco, Calif.: Greenwich Medical Media Ltd; 2002.

    Google Scholar 

  31. Weinstein HM, Dansky L, Iacopino V. Torture and war trauma survivors in primary care practice. West J Med 1996;165:112–8.

    PubMed  CAS  Google Scholar 

  32. Rassmussen OV. Medical aspects of torture. Dan Med Bull 1990;37(1):1–88.

    Google Scholar 

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Acknowledgements

We gratefully acknowledge Barbara Ayotte, Alicia Yamin, Susannah Sirkin, Gina Cummings and Paul Rocklin, all of Physicians for Human Rights, and Karen Musalo of the Center for Gender and Refugee Studies at the University of California, Hastings College of the Law, for their thoughtful contributions to earlier versions of this manuscript.

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Correspondence to Stuart L. Lustig.

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Lustig, S.L., Kureshi, S., Delucchi, K.L. et al. Asylum Grant Rates Following Medical Evaluations of Maltreatment among Political Asylum Applicants in the United States. J Immigrant Minority Health 10, 7–15 (2008). https://doi.org/10.1007/s10903-007-9056-8

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  • DOI: https://doi.org/10.1007/s10903-007-9056-8

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