RESUMO
While the number of medical human rights programs has increased, there is substantial unmet need for forensic evaluations among asylum seekers throughout the United States. From September 2019 through May 2020, the Mount Sinai Human Rights Program has coordinated pro bono forensic mental health evaluations by telephone or video for individuals seeking protected immigration status who are unable to access in-person services. The national network clinicians conducted 32 forensic evaluations of individuals in eight U.S. states and Mexico seeking immigration relief. Remote forensic services have been a relevant solution for individuals in immigration detention, particularly during the COVID-19 pandemic.
Assuntos
Infecções por Coronavirus , Emigração e Imigração , Transtornos Mentais/diagnóstico , Saúde Mental , Pandemias , Pneumonia Viral , Refugiados/psicologia , Telemedicina , Betacoronavirus , COVID-19 , Direitos Humanos/psicologia , Humanos , Transtornos Mentais/psicologia , México , SARS-CoV-2 , Estados UnidosRESUMO
Immigrant children who faced forced separation from their parents may be at heightened risk of developing mental health disorders, including depression, post-traumatic stress disorder (PTSD), and anxiety disorders. This cross-sectional study assessed the mental health of children being held in U.S. immigration detention who had been previously separated from their mothers. We interviewed 73 mothers about their eldest child age 5-17 using the Parent-Report version of the Strengths and Difficulties Questionnaire (SDQ). Among these children, many had elevated scores for emotional problems (49%), peer problems (21%), and total difficulties (15%). Male children demonstrated significantly higher rates of abnormal peer problems compared to females. Younger children (age 5-11 years) also demonstrated significantly higher rates of abnormal conduct problems, hyperactivity, and total difficulties. Scores did not differ significantly based on length of separation. Results reveal that children who had been separated from their parents experience high levels of mental health distress, which are especially high in younger children. Regardless of length of separation, these children would benefit from comprehensive mental health treatment with a culturally-responsive and trauma-informed lens.
Assuntos
Emigrantes e Imigrantes/psicologia , Transtornos Mentais/diagnóstico , Mães/psicologia , Comportamento Problema/psicologia , Adolescente , Adulto , Transtornos de Ansiedade , Criança , Pré-Escolar , Estudos Transversais , Depressão , El Salvador/etnologia , Feminino , Guatemala/etnologia , Honduras/etnologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , México , Pessoa de Meia-Idade , Pais/psicologia , Transtornos de Estresse Pós-Traumáticos , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
INTRODUCTION: Every year, thousands of women flee gender-based violence in Honduras, El Salvador, and Guatemala (sometimes collectively referred to as the Northern Triangle) in an attempt to seek asylum in the United States. Once in the United States, their legal teams may refer them for a psychological evaluation as part of their application for asylum. Licensed clinicians conduct in-depth interviews in order to document the psychological impact of the reported human rights violations. METHOD: Using archival de-identified data from a human rights program, this study gathered the experiences of gender-based violence reported by 70 asylum-seeking women from Honduras, El Salvador, and Guatemala who participated in pro bono psychological evaluation. Descriptive data were analyzed using a modified consensual qualitative research (CQR-M) method. RESULTS: These asylum seekers reported exposure to systemic violence, including severe intimate partner violence, as well as physical and sexual assaults, and threats of death by organized criminal groups in their communities. Additionally, over a third of women reported experiences of violence during their migration. The majority of asylum seekers endorsed symptoms associated with anxiety (80%) and depression (91%), as well as trauma-and stressor-related symptoms (80%). DISCUSSION: The results of this study elucidate the many forms of gender-based violence experienced by women in this region, the physical and psychological sequelae of this persecution, and the systemic forces that prevent them from remaining in their countries of origin. The research results also highlight the potential impact of trauma on the women's ability to testify effectively during asylum legal hearings, elucidate factors that may contribute to their resilience in light of the human rights violations they survived, and suggest implications for clinical practice.