Documentation

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Tuesday, July 7th to Wednesday, September 30th

Please join us in an online, open forum on telehealth. NCB is providing an opportunity for clinicians to ask each other questions, share observations and adapted telehealth protocols for the SoT population via an online forum and technical exchange. This conversation will be a forum for peer-led informational exchange. NCB staff will assist in facilitating and monitoring the conversation.

Directions: Please watch Eugene Augusterfer’s presentation and interview Telemedicine in Mental Health first. Then feel free to join us in this open forum. All are welcome to join this forum, whether you have an account on Healtorture.org or not. For more information on using the forum, please read the directions on the first post. Please keep your comments respectful, relevant, factual, and do not share identifying information about clients per client privacy and HIPAA regulations. This forum will be open from July 6, 2020 through September 30, 2020.

Articles

Asylum grant rates following medical evaluations of maltreatment among political asylum applicants in the United States

Lustig SL, Kureshi S, Delucchi KL, Iacopino V, Morse SC. Asylum grant rates following medical evaluations of maltreatment among political asylum applicants in the United States. J Immigr Minor Health. 2008 Feb;10(1):7-15. Abstract (free), full text PDF available by subscription

Context, evidence and attitude: the case for photography in medical examinations of asylum seekers in the Netherlands

By Park R, Oomen J. Published in Social Science & Medicine, 2010 Jul;71(2):228-35. Link below is to abstract; full article is available for purchase.

Summary written for www.HealTorture.org by CVT Intern Joseph Walker:

Asylum policy in Western Europe primarily aims to restrict entry to refugees, despite the fact that all European Union members are signatories to international asylum conventions.

Examining Asylum Seekers: A Health Professional's Guide to Medical and Psychological Evaluations of Torture

Examining Asylum Seekers: A Health Professional's Guide to Medical and Psychological Evaluations of Torture is published by the organization, Physicians for Human Rights. Copies of the manual can be ordered from their website.

When writing affidavits, see especially section VII. Written Reports and Oral Testimony, p. 95-151.

Helping Refugee Trauma Survivors in the Primary Care Setting

Written for primary health care providers who may be treating refugees or other survivors of war trauma and torture. Primary care physicians and providers often must identify and educate survivors before encouraging them to seek mental health services, if appropriate. The manual includes assessment questions for health care providers to ask patients and facilitate the treatment process.

Torture survivors: What to ask, how to document

Miles, Steven H; and Garcia-Peltoniemi, Rosa.

Excellent article for medical practitioners who may not realize that they are treating torture survivors with tips on how to proceed. "In this article, we propose an approach—based on studies that address cross-cultural issues or use multicenter, multivariate, meta-analytic methods—that can enable you to better identify survivors of torture, assess and document consequent morbidities, and refer them to appropriate treatment programs. We focus on individuals who were tortured months or years earlier rather than on recently traumatized patients."

Webinars

HealthRight International's Human Rights Clinic Photo Database: A Reference Tool Documenting the Long-term Physical Sequelae of Torture

Our presenters have recommended these additional resources:

The Manual Examining Asylum Seekers is intended to provide medical professionals with the information necessary to conduct these potentially life-saving evaluations. It includes an overview of political asylum law and procedure in the United States, explains the physician's role in verifying signs and symptoms consistent with torture, and reviews components of appropriate written and oral medical testimony. The manual is designed to be a resource for newcomers to asylum evaluations as well as veterans with questions on specific issues.

Books

Istanbul Protocol: Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

United Nations High Commissioner for Human Rights, 1999

When considering psychological consequences of torture, see, particularly, section VI, Psychological Evidence of Torture, pages 43-56.

When writing affidavits, see, particularly, Annex IV, Guidelines for medical evaluation of torture and ill-treatment, pages 70-72.

Available in a variety of languages.

Resources

Columbia University P&S Asylum Clinic

Founded in 2010, The Clinic is composed of psychiatric, medical, and gynecological physicians, clinical social workers, and psychologists who have received training in identifying the physical and mental sequelae of abuse and torture. After an evaluation, the physician will compose an affidavit outlining any symptoms and signs that are relevant to the client's narrative. By providing independent medical examinations, the Clinic provides valuable evidence as part of an asylum applicant’s legal case.

Physicians for Human Rights

Physicians for Human Rights (PHR) is an organization of health professionals, scientists and concerned citizens using the medical and forensic sciences to investigate and prevent violations of international human rights and humanitarian law. They offer access to order publications related to the evaluation and treatment of torture survivors. They offer training materials relevant for health professionals who perform medical evaluations of asylum seekers.

Toolkit to Set up an Asylum Clinic

This toolkit, from Physicians for Human Rights, guides interested parties in setting up an asylum clinic at a medical school. As the PHR website says, clinicians "offer pro bono physical and psychological evaluations to document evidence of torture and persecution for men and women fleeing danger in their home countries. Survivors of human rights abuses are entitled to seek safe haven in the United States, but often find themselves immersed in lengthy and complex legal procedures that could ultimately result in deportation— resulting in further abuse, torture, and even death... These clinics