Session
Protecting the Human Rights of Asylum Seekers and Survivors of Human Trafficking
APHA 2022 Annual Meeting and Expo
Abstract
Program Evaluation of the Chicago People’s Rights Collaborative’s Asylum Evaluation Training
APHA 2022 Annual Meeting and Expo
Background
The Chicago People’s Rights Collaborative (CPRC) is a medical-legal collaborative that provides forensic asylum evaluations (AE), testimony for asylum seekers. CPRC conducted a program evaluation of their virtual, asynchronous training on how to provide forensic evaluations.
Objectives:
To evaluate:
Attendance goals – 200 RSVPs within three months of training publication, 25% of attendees being fully-licensed clinicians
Completion rate – approximately 25% of RSVPs complete training within three months of training publication, 25% of those fully-licensed clinicians
Whether attendees believe training met learning objectives (average >4 on Likert of 1-5)
Training planning and execution, through interviewing organizers, assessing planning process, and tracking training completion
Methods
Mixed-methods study included qualitative analysis of participant responses and interviews with training volunteers, and quantitative analysis of RSVPs, completion, and individual session ratings.
Results
Three months after publication of training, there were 618 unique RSVPs. 36 people completed the training and 115 partial completions. Fully-licensed clinicians comprised 32% of RSVPs and 39% of who completed the training. Responses (n = 508) indicate that trainees believe full-training and session-specific learning objectives were met (average for all objectives >4/Agree).
Attendee responses (n= 508) show most seek training to prepare them to complete AEs and build their network.
Interviews (n=8) showed a need for more rigorous competency-based assessment capacity.
Conclusions
CPRC’s AE training aligns with competencies established by Physicians for Human Rights and the Society of Asylum Medicine. This is an opportunity to create training that assesses competency and develops AE networks.
Abstract
Analyzing the outcomes and success of a medical school student-run political asylum clinic and its implications on public health
APHA 2022 Annual Meeting and Expo
Background: Every year, thousands of human rights abuse victims flee their home countries for political asylum in the US. Traversing an unintuitive legal system, asylees often rely only on their own testimony, in which government attorneys may exploit minor inconsistencies and that judges often view skeptically. However, a forensic affidavit offers objective evidence of prior human rights abuses. Applicants denied asylum are deported or go underground in the US and thus are at high risk for poor health outcomes, abuse, and death.
Description: Pro bono asylum clinics run by medical schools bridge the gap between asylees and forensic evaluations. We analyzed the content and outcomes of affidavits produced by the Downstate Asylum Clinic from 2007-2021.
Results/ Lessons Learned: Of the 75 affidavits analyzed, 35 had a legal outcome; of these, 32 were granted asylum/WOR. This 91% success rate is nearly double the national rate of 46% during the same timeframe1, illustrating that forensic evaluations substantially increase the likelihood of being granted asylum. The most prevalent reported trauma types were physical assault, threats of violence/death to oneself, and verbal/emotional abuse. Our biggest obstacle to providing evaluations was evaluator availability.
Recommendations: Medical student and resident participation in forensic asylum evaluations — including examining clients, note-taking, and drafting the affidavit — can save significant time for the evaluators, enabling them to take on more cases. Increasing the number of evaluations promotes public health, as those granted asylum remain in the US where they can access employment, live without fear for their safety, and have better access to healthcare.
Abstract
Addressing Human Rights Violations in U.S. Asylum Proceedings: Findings from the Midwest Human Rights Consortium
APHA 2022 Annual Meeting and Expo
Background: The world is experiencing the period of greatest global forced migration since World War II (UNHCR, 2020). The U.S. is the largest recipient nation for people fleeing their home countries to claim asylum because of lack of safety (UNHCR, 2020). Yet, many asylum seekers with credible fear about returning to their home countries are denied asylum; a human rights violation (Transactional Records Access Clearinghouse Immigration Project, 2021). Existing research indicates that including a medical or mental health forensic evaluation as part an asylum claim correlates with higher rates of asylum compared to claims that do not include an assessment (Atkison et al., 2021). Nonetheless, most asylum seekers do not receive a medical or psychological forensic asylum assessment (Lustig et al., 2007). Reasons include limited workforce capacity, lack of attorney knowledge about the value of forensic asylum assessments in immigration proceedings and the lack of coordinated referral networks.
Description: The Midwest Human Rights Consortium (MHRC) was established in 2019. It’s mission is to provide a coordinated referral network for forensic asylum assessments and ongoing training and consultation to medical and mental health providers who conduct evaluations around Chicago. MHRC has received and serviced over 100 referrals for medical and psychological forensic asylum assessments.
Lessons Learned & Recommendations: The authors will discuss the process of establishing an integrated coalition, developing an educational model to increase mental health and medical workforce capacity and present outcome data from our referral network to highlight emerging best practices in medical-legal collaborations for asylum seekers.
Abstract
Qualitative findings from a human trafficking community needs assessment conducted within a health sciences center
APHA 2022 Annual Meeting and Expo
Background: Texas has the second highest incidence of human trafficking (HT) in the nation and is number one in HT hotline calls—impacting over 300,000 Texans in the past decade. In response to this public health crisis, Texas passed HB 2059 in 2019, which requires all healthcare providers with direct patient contact to complete training in HT. In response to this legislation, a Health Sciences Center developed the Social Justice and Human Trafficking Collaborative (SJHTC) to develop and implement interventions to reduce the rates of HT in the state and nationally. To inform the work and efforts of the SJHTC, the study team conducted a community health needs assessment.
Objectives: The study aimed to utilize assessment data to guide the development of potential trainings and resources related to HT. The specific study objectives included: 1) provide qualitative data based on participants’ experiences of HT; 2) assess perceptions and awareness of HT of participants; and 3) identify levels of knowledge of HT participants.
Methods: This exempt study (IRB study #A22-4244) was led by faculty and students affiliated with the HTSJC. The study population was current employees (faculty and staff) and students (from all TTUHSC programs and schools) and key community collaborators. Participants included individuals ages 18 and older; there was minimal risk in participation. Exclusion criteria included participants less than 18 years of age and/or not employees, students, or community members. Reading of the information sheet and survey, completion of the survey, and survey submission and/or participation in a focus group and/or key informant interview constituted consent. The study methods included a digital survey, focus groups, and key informant interviews. The research team conducted thematic content analysis of the qualitative data.
Results: This presentation focus on the qualitative components—focus groups (n=6) and interviews (n=8)—conducted in January-February 2022 using semi-structed interview guides and trained facilitators. Recurrent themes included the need: 1) for education on how to identify trafficked persons and report HT; 2) for increased community resources; and 3) to change stigmas associated with trafficked persons.
Conclusion: Key recommendations emerged, including: 1) use baseline data for future studies; 2) fill gaps in HT knowledge in current programs, courses, and departments; 3) improve current and/or create new training curriculum; 4) create educational campaigns focused on different vulnerable populations; and 5) raise awareness on legalities when reporting possible HT. These findings and recommendations will guide future SJHTC trainings, activities, and events.