To Get Approved for Asylum, Some Immigrants Head to the Psychologist

Immigrants seeking asylum after facing persecution abroad have to convince government officials to let them stay in the United States. But how does an asylum seeker prove that she experienced trauma, resulting in a well-founded fear of returning home, especially after physical wounds have healed?

That's where mental health practitioners, working pro bono, come in. They interview asylum seekers and write up extensive psychological evaluations that are provided to the government. The stakes don't get any bigger: If the affidavit from the psychologist along with the rest of the application is approved by asylum officers, the persecuted avoid deportation and, possibly, death. 

Asylum applications with physical or psychological evaluations from professionals have an extraordinarily high rate of approval — 89 percent, according to one study, far higher than the normal rate.

Ricardo, a gay man who said he was violently assaulted twice in Colombia due to his homosexuality, is one of those recently approved for asylum. He asked that his last name be withheld due to protect his privacy. 

On a trip to the United States last year, Ricardo couldn't bear the thought of returning home to Colombia, where he said law enforcement does not properly investigate crimes against gay people. So he walked into African Services Committee in Harlem, which provides legal aid to immigrants, and met attorney Deirdre Stradone. 

"He was persecuted because of his homosexuality and he could not rely on the government for protection — they were unable or willing to protect him," Stradone said. "A big part of asylum is proving that you're persecuted because of a protected group and you can't rely on the government to help you."

Stradone believed Ricardo's story of persecution, but she saw a hurdle in his case. She had to prove that Ricardo continued to feel unsafe as a gay man in Colombia even though the last violent incident was back in 2011. That’s where the psychological evaluation came in. 

Dr. Kim Baranowski, a counseling psychologist and the associate director of the Mount Sinai Human Rights Program, volunteers her time interviewing asylum seekers. She said many of those she evaluates are fleeing gang-related violence from the northern triangle of Central America. "The violence takes the form of extortion, sexual assaults, threatened kidnapping, kidnappings, rapes, witnessing people being shot and killed in front of them, death threats," Baranowski said.

While those with physical evidence of their abuse are referred to medical doctors for evaluations to prove that they suffered injuries related to torture or abuse, others, like Ricardo, bear no physical scars. Baranowski is there to find those wounds that aren't visible to the naked eye.  

"It's bewildering how resourceful and resilient people can be in light of such horrible horrible violations of their human rights," Baranowski said. "And I think that's the part that sits with me more than the actual impact of the violence."

Given the trauma, which may be compounded by the experience crossing dangerous terrain into the United States, Baranowski takes care not to further traumatize the client in her questioning. She meets with clients for as long as five hours at a time, and starts with the beginning of their stories. 

"Childhood is not always the easiest place to begin for a lot of folks, so I usually say, 'Tell me about growing up,'" she said. "I want to be able to talk about what their life looked like before that experience." From there, she can probe how the abuse or torture that the asylum seeker faced had emotional and psychological ramifications: Mood changes, eating disruptions and loss of connection to community, family and church. 

"Certain forms of torture do leave very kind of characteristic scars," Baranowski said. "But in many cases torture is designed to not have physical evidence."

For many asylum seekers, this is their first experience with mental health practitioners. The fact that translators are often present for these very personal conversations can make it more difficult. "It was hard, because it was remembering things that I suppressed, from when I was little and when I was growing up," Ricardo said. 

Ricardo told Baranowski about a series of sexual and physical abuses he faced as a child, at the hands of relatives and neighbors. He later detailed the most recent attack, in which he was stabbed by a known gang member after being seen in public kissing a man.

"I never filed [a police report] because I knew my life was in danger," Ricardo said.

But Baranowski did write a report — 10 pages about Ricardo's mental health, with a conclusion that he suffered PTSD and showed symptoms of anxiety and depression. Stradone shared parts of that evaluation with WNYC.

Stradone submitted it to the government along with a mountain of other documents: Hospital records from Colombia, statements from witnesses and an analysis of conditions for gay people in Colombia. A 2½-hour interview with an asylum officer in Newark followed. A few weeks later, this past spring, Stradone called Ricardo with the result of his asylum request.

"He didn't understand what I said," Stradone said, referring to Ricardo's limited English, "but he could tell by my emotion that [asylum] had been granted."

Ricardo now has a job working at a kitchen supply store. He lives in Washington Heights and he's taking English classes. "For me it's the capital of the world," Ricardo said of New York. "A lot of culture. It's very friendly. I love New York."

The group Physicians for Human Rights has more than 1,100 health professionals across the country who do medical and psychological evaluations of asylum seekers. In New York, the Mount Sinai Human Rights Program said it needs more volunteers to handle the demand -- particularly the psychological evaluations, which make up half the work load. The clinic expects to evaluate about 200 asylum seekers this year. 

"We are in desperate need for more mental health professionals to do this work," Baranowski said. "As a professional, one of my motivations in terms of talking about this work is trying to excite and inspire other psychologists, psychiatrists, licensed social workers, mental counselors to get trained and to dedicate pro bono hours to doing this work."

The need coincides with a more difficult path to asylum, as the Trump Administration tightens criteria for who qualifies. An international refugee agreement from 1951, signed by the United States, says immigrants may claim asylum based on "a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion." But now Attorney General Jeff Sessions says women beaten by their partners and others tormented by gangs are not necessarily victims of violence perpetuated by government actors, and therefore should not be eligible to stay in the country. 

With Spanish translation support from Jose Olivares.