Stakeholder Perspectives Report: November 09, 2018 Focus Group Findings on Migrant Legal-Mental Health Intersectionality

Migrants encounter trauma along a continuum of pre-, peri-, and postmigration experiences. This is especially true for migrants forced to leave their home and/or who do so as irregular migrants. The trauma begins with the circumstances that provoked their migration and their rupture from home and family. The trauma continues with the suffering endured in the oft-treacherous journey toward their final destination. The confrontation with legal systems along the way or upon arrival wields new, or exacerbate old traumas, inflicted upon migrants intentionally or accidentally. Trauma is also present in the discomfort and pain associated with settling into new lives where identities and culture must be reshaped for survival. At their new destination, a plethora of legal and social vulnerabilities put migrants at greater risk of becoming victims of crime. Traumatized migrants who manage to arrive to the United States encounter both health and legal professionals, either voluntarily when seeking health services or legal protection, or mandatorily when facing removal, often while in detention. It is likely that health professionals are aware of and even perhaps equipped to address trauma’s effects on the mental and overall health of migrants. It is however, less likely that different types of health professionals are aware of how their work within different healthcare services could be strengthened if they knew more about each other’s research and best practices. Moreover, it is even less likely that these same health professionals understand the ways in which legal systems subject immigrants seeking legal protection to additional trauma, except perhaps in obvious cases of prolonged detentions and other types of ill treatment. Similarly, health professionals likely ignore how their good faith efforts to treat trauma could both harm their patients’ legal proceedings or benefit their legal claims. Legal professionals are usually well aware that forced and irregular migrants, especially refugees and asylum seekers, have experienced trauma. Indeed, the presence of trauma provoking forced flight – the well-founded persecution – is the foundation of a strong legal claim for refugee or asylum protection (Johnson, K., Aldana, R., Hing, B., Saucedo, L., Trucios-Haynes, E., 2019). The same is true human trafficking or crime victims who seek legal protection based on their victimization. Legal advocates are also starting to recognize how efforts to document a client’s story of trauma to prove the legal case can trigger strong emotional responses and re-traumatize clients. However, legal professionals are usually quite unaware of how trauma affects memory or the ability to recall facts and narrate consistent stories. They are also less aware to how their good faith efforts to document in writing their client’s trauma with specificity and chronological logic can end up adversely affecting the adjudicator’s subsequent assessment of the client’s credibility when the client is unable to perform their story as written. They usually lack training; moreover, on how to manage their client’s trauma, or their own vicarious trauma, or on how medical evidence could help them corroborate the veracity of their client’s experiences with trauma. Scientific knowledge about trauma should inform not only how legal and health professionals partner to better serve migrant communities but ultimately also the types of legal reforms needed to help bridge the gap between scientific knowledge and law. The legal community has started to document these gaps, such as recognizing the ways in which credibility assessments in refugee and asylum cases diverge significantly from what science teaches us about how trauma affects memory retrieval and story-telling. Yet, this recognition has yet to make a dent in promoting the urgently needed legal reforms that could actually improve law’s objective: the ability to accurately and humanely identify the petitioners who have a right to protection under the law. This project aims to start this important conversation and partnership between legal and health professionals who serve traumatized migrants. Our aim is to improve our mutual understanding of how trauma affects many migrants, especially refugee and asylum seekers, and how we can best work together not only to ameliorate posttraumatic physical and psychological ill effects, but also to improve the legal systems’ efficiency and ability to fairly adjudicate their claims. We considered it important that these multidisciplinary efforts should be led by research universities with strong programs in science and law, in partnership with practitioners and policy makers in both law and health fields, who are best equipped to inform the issues and the priorities.