Asylum seekers psychological assessments and reports
Dr L has been an expert witness for Foresight for over eight years, and specialises in psychological assessments and reports for the criminal, civil and family courts. In this feature she points to the need for accurate psychosocial assessment and reporting in relation to asylum seekers, and the difficulties their often terrifying experiences bring to the process.
The whole of 2015 and the first quarter of 2016 saw a recorded 40,642 applications for asylum in the United Kingdom. The largest numbers are from Iran, Iraq, Pakistan and Bangladesh (statistics from Refugee Council). The majority of asylum seekers will experience a detailed assessment process to determine their eligibility to stay in the UK, and these include psychological assessments carried out by expert witnesses.
Psychologists and psychiatrists are called upon to provide assessments and reports for asylum seekers who claim to have been persecuted or tortured within their country of origin. More often than not, these individuals have fled for their lives to escape persecution and torture within their country. They have sought sanctuary in the UK, but their struggle does not end when they enter the UK. Life does not return to normal; many have left their families, friends and jobs. Despite many having a good education they are unable to legally work in the UK and immediately enter a life of poverty and isolation. The persecution and torture they have experienced – often in the form of rape, physical torture or imprisonment – leaves them with psychological scars in the form of Post-Traumatic Stress Disorder (PTSD), depression, anxiety and a number of other psychological difficulties.
Many asylum seekers have fled their country of origin using either false documents or with nothing other than the clothes they are wearing, and this causes great difficulty for the Home Office Borders Agency in validating their life stories and experiences.
For most, they enter a long-winded immigration asylum case with legal representation to assist them in their desire to have their life story believed and accepted.
This process of verifying their account often involves a medical examination and report, where a trained doctor will examine any physical injuries and scars, and provide expert opinion on how these may have occurred. In addition, a psychological or psychiatric expert report is often requested in order to provide further evidence of psychological injury and how this may have taken place.
Psychological assessments and reports will detail any PTSD related to mental or physical abuse and torture; provide a diagnosis and future treatment needs and prognosis; and detail the impact of deportation on the asylum seeker. Any time spent in a detention centre is also considered, and short and long term effects of detention, such as any impact on mental health, are detailed in any report.
If there are symptoms to substantiate mistreatment or torture to support an application for asylum, then the expert will state this in the report.
The report will document any details of why the applicant has a well-founded fear of persecution because of their race, religion, nationality, political opinion, or due to their membership of a particular social group. Validated details of this nature can be put forward as acceptable reasons for a waiver to exclusion, deportation and removal.
If the expert is able to report a well-founded fear this can be a valid reason to request that the Home Office grant a waiver for exclusion, deportation and removal, and the asylum seeker may be granted discretionary leave outside of the European Union (EU) rules to remain within the UK.
The European Convention on Human Rights (ECHR) prohibits torture and the extradition of a person to a foreign state if they are likely to be subjected to torture and this is detailed in Article (3) which is used by individuals to apply for asylum in the UK.
The situation for asylum seekers is further complicated in the fact that their torture experiences may have affected their cognitive processing and memory. Discrepancies in their statements and repeat Home Office interviews often lead to the refusal their case on the basis that their torture claims and narrative are fabricated, rather than as a result of cognitive difficulties. Incoherent accounts of events are regarded as a false story in order to gain entry to the UK.
A common assumption is that an experience concerning severe violence or torture will be so important that it will be remembered with clarity in the long term. This is an understandable view but one that’s challenged by the scientific evidence.
Some memories of traumatic experiences are probably qualitatively different from normal autobiographical memories. An autobiographical memory for a normal event is verbal, sequenced (having a beginning, middle and end), recognised as being in the past, and may be recalled voluntarily. Traumatic memories often include incomplete autobiographical accounts. However, they often also include perceptual `snapshots’ (smells, the sound of screams, facial images) which are experienced in the present (reliving experiences) and are often triggered by external or internal cues (the sound of a firework, a feeling of guilt) rather than being subject to conscious recall (Hellawell & Brewin, 2004).
It is understandable that people faced with painful memories like these will adopt strategies to avoid situations likely to trigger them, for example meeting others from their country of origin. They may also adopt less conscious strategies such as amnesia and a number of emotions.
Herlihy et al (2002) twice interviewed refugees granted asylum as a group by the United Nations, and found inconsistency between their accounts on both occasions. They found a relationship between the rate of discrepancies and the nature of the questions asked. Furthermore, individuals with higher levels of PTSD were more inconsistent if there was a longer period of time between interviews.
When people feel shame, they find it difficult to disclose personal information. In an interview with the authorities, however, there are often opposing forces at work. Shame regarding a brutal rape, for example, is likely to inhibit disclosure of the event to an official (Van Velsen et al, 1996), yet disclosure may be essential to gain protection and asylum.
Claimants’ inconsistent accounts of their experiences may also be related to the different triggering of traumatic memories depending on the situation. We do not know enough about the impact of this on the variability of presentation in the high-emotion contexts of the court room, the official interview and clinical assessment.
Some of these questions are being addressed. Steel et al (2004) used case examples to illustrate their arguments that mental health issues have an impact on the fairness of asylum decisions.
Psychiatrists and psychologists that are practicing in this field hold a wealth of clinical knowledge, which may be relevant to the legal process of deciding asylum claims. Legal advisors and immigration judges sometimes look to such experts to help them to make these very difficult decisions. It is important that expert psychiatrists and psychologists are able to describe and detail the impact of memory on the asylum seeker’s narrative, and the impact that trauma has had upon retrieval processes for the individual, and to provide research evidence for this within reports.
If you require asylum seekers psychological assessments and reports contact our team on 0330 088 9000.
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Hellawell, S. J. & Brewin, C. R. (2004) A comparison of flashbacks and ordinary autobiographical memories of trauma: content and language. Behaviour Research and Therapy, 42, 1-12.
Herlihy, J., Scragg, P. & Turner, S. (2002) Discrepancies in autobiographical memories: implications for the assessment of asylum seekers: repeated interviews study. BMJ, 324, 324 -327.
Home Office National Statistics: Immigration Statistics, 2015/6
Masinda, M. T. (2004) Quality of memory: impact on refugee hearing decisions. Traumatology, 10, 131 -139.
Steel, Z., Frommer, N. & Silove, D. (2004) The mental health impacts of migration: the law and its effects. Failing to understand: refugee determination and the traumatized applicant. International Journal of Law and Psychiatry, 27, 511 -528.
Van Velsen, C., Gorst-Unsworth, C. & Turner, S. (1996) Survivors of torture and organized violence: demography and diagnosis. Journal of Traumatic Stress, 9, 181-193.