Category: Mental Incompetence in Court

 

http://jaapl.org/content/early/2022/04/20/JAAPL.210075-21

Immigration Judges’ Perceptions of Telephonic and In-Person Forensic Mental Health Evaluations

Aliza S. Green, Samuel G. Ruchman, Beselot Birhanu, Stephanie Wu, Craig L. Katz, Elizabeth K. Singer and Kim A. Baranowski

Journal of the American Academy of Psychiatry and the Law Online April 2022, JAAPL.210075-21; DOI: https://doi.org/10.29158/JAAPL.210075-21

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Abstract

Clinicians affiliated with medical human rights programs throughout the United States perform forensic evaluations of asylum seekers. Much of the best practice literature reflects the perspectives of clinicians and attorneys, rather than the viewpoints of immigration judges who incorporate forensic reports into their decision-making. The purpose of this study was to assess former immigration judges’ perspectives on forensic mental health evaluations of asylum seekers. We examined the factors that immigration judges use to assess the affidavits resulting from mental health evaluations and explored their attitudes toward telehealth evaluations. We conducted semistructured interviews in April and May 2020 with nine former judges and systematically analyzed them using consensual qualitative research methodology. Our findings were grouped in five domains: general preferences for affidavits; roles of affidavits in current legal climate; appraisal and comparison of sample affidavits; attitudes toward telephonic evaluations; and recommendations for telephonic evaluations. Forensic evaluators should consider the practice recommendations of judges, both for telephonic and in-person evaluations, which can bolster the usefulness of their evaluations in the adjudication process. To our knowledge, this is the first published study to incorporate immigration judges’ perceptions of forensic mental health evaluations, and the first to assess judges’ attitudes toward telephonic evaluations.

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Across the United States, clinicians working in collaboration with medical asylum clinics and torture treatment programs conduct forensic evaluations of asylum seekers.1,–,5 In such evaluations, clinicians investigate the physical and psychiatric sequelae of human rights abuses and document their findings in medico-legal affidavits that are submitted to the immigration judge as part of an individual’s application for immigration relief.1,6,7 The affidavits provide the evaluators’ written testimony explaining to a judge the relevance of their findings (e.g., the impact of trauma on memory). Medical providers experienced in conducting forensic evaluations have worked in consultation with attorneys to establish and disseminate best-practice guidelines for evaluations.6,–,10 Much of the best-practice literature reflects the perspectives of clinicians and attorneys, rather than the viewpoints of immigration judges who apply forensic reports in their decision-making. (One notable exception was a presentation of suggestions for writing medico-legal affidavits based on a qualitative study of a sample that included immigration judges, clinicians, and attorneys.11) As a result, forensic medical evaluators have limited insight into how immigration judges view the content of affidavits or how the documentation of forensic evaluations affects asylum cases.

In the context of the COVID-19 pandemic, medical human rights programs have transitioned to conducting forensic evaluations by telephone or video.12,13 Forensic clinicians have also been using telehealth modalities to evaluate asylum seekers who have poor access to forensic services because they live in geographically remote areas of the United States, immigration detention centers, or Mexico border cities.14 Mental health practitioners have reported both comfort with and concerns about the limitations of telehealth forensic evaluations.15 Most literature on telehealth forensic evaluations has focused on evaluators’ perceptions of video-teleconference, applied across multiple dimensions of forensic mental health.16,–,20 Assessing the acceptability of remote evaluations to adjudicators of immigration claims and incorporating their perspectives into broader practice recommendations is particularly critical at this time, given that telehealth visits and telephonic interviews of asylum seekers have become standard as a result of both the COVID-19 pandemic and the increased number of asylum seekers in immigration detention facilities.

This study was to explore former immigration judges’ perspectives on forensic mental health evaluations of asylum seekers. We examined the factors that immigration judges use to assess the medico-legal documents resulting from mental health evaluations. We also specifically identified participants’ attitudes and perceptions toward telehealth evaluations. This study adds to existing literature by incorporating immigration judges’ perceptions of forensic mental health evaluations and by assessing judges’ attitudes toward telephonic evaluations. We specifically investigated telephonic rather than video-based evaluations because asylum seekers may have limited access to the internet, and immigration detention centers often restrict access to video conferencing platforms.14 This study was approved by the Mount Sinai Institutional Review Board.

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Full article at the above link.

This should be great information for practitioners, judges, ICE counsel, and administrators seeking a fairer, better functioning Immigration Court system.

This illustrates one of many “under-appreciated” aspects of modern immigration and human rights “practical scholarship:” Its virtually unmatched interdisciplinary usefulness and its “right off the shelf” ability to advance knowledge, fairness, 21st century efficiency, and best practices!

While EOIR might actually be “worse than your father’s and mother’s Immigration Courts,” not so the private bar, NGOs, and the academic (particularly the clinical) sectors! It’s where the action, upcoming talent, and quality is right now!

It’s a shame that more of those in charge of the Immigration Courts, the stumbling immigration bureaucracy, and the often behind the times “improperly above the fray” Article IIIs aren’t paying attention to both the types of individuals they should be hiring and the methods they should be using to improve the delivery of justice. 

If change has to come from below, so be it! But, change and progress will eventually come to the broken and dysfunctional Immigration Courts and the bumbling bureaucracy surrounding and enabling this disgraceful systemic failure that is dragging down both our legal system and our democracy!

🇺🇸Due Process Forever!

PWS

04-25-22