Asylum seekers and the role of the acute care physician.

There has been a recent influx of migrants and asylum seekers to the United States. They often arrive with poor social support and an inability to access reliable health care. This can lead to overutilization of emergency departments (ED) while awaiting legal proceedings.

The COVID-19 pandemic and its impact on health experiences of asylum seekers to the United States.

Background: The COVID-19 pandemic exacerbated preexisting barriers to accessing healthcare and social services faced by asylum seekers to the United States. This study aimed to uncover the impact of the first year of the COVID-19 pandemic on asylum seekers, including socio-economic stressors and access to medical information, healthcare, and testing.

Method: We conducted 15 semi-structured, in-depth interviews with adult asylum seekers to the U.

Persecution and migration experiences of lesbian, gay, bisexual, transgender, queer/questioning, and other sexual and gender minority asylum seekers.

Lesbian, gay, bisexual, transgender, queer/questioning, and other sexual and gender minority (LGBTQ+) asylum seekers are exposed to high rates of persecution. This study aimed to identify the forms of ill treatment and the impact of these experiences on the mental health of 66 self-identified LGBTQ+ asylum seekers from 24 nations through the analysis of human rights program intakes, sworn declarations, and pro bono forensic psychological evaluation affidavits. The results indicate that participants experienced physical assault (92.

Immigration Judges' Perceptionsof Telephonic and In-Person Forensic Mental Health Evaluations.

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.

The impact of immigration detention on the health of asylum seekers during the COVID-19 pandemic.

COVID-19 disproportionately affects racial and ethnic minority groups as well as people in jails and immigration detention centers in the United States. Between April and August of 2020, the mean monthly COVID-19 case ratio for ICE detainees was 13.4 times that of the general U.

Histories of pervasive gender-based violence in asylum-seeking women who have undergone female genital mutilation or cutting.

Few studies have described the broader experience of survivors of female genital mutilation or cutting (FGM/C) who have sought asylum in the United States. To gain a better understanding of their exposure to gender-based violence (GBV), the study was conducted to help uncover themes and patterns of co-occurring individual and community factors among women asylum seekers who experienced FGM/C before they arrived in the United States. Following a retrospective chart review of FGM/C cases seen in a human rights clinic, 35 women met the inclusion criteria.

Validation of a screening tool for labor and sex trafficking among emergency department patients.

Objective: Patients with labor and sex trafficking experiences seek healthcare while and after being trafficked. Their trafficking experiences are often unrecognized by clinicians who lack a validated tool to systematically screen for trafficking. We aimed to derive and validate a brief, comprehensive trafficking screening tool for use in healthcare settings.

Medical Student Involvement in a Human Rights Program: Impact on Student Development and Career Vision.

Background: There is consensus among many medical school deans that exposure to human rights is a necessary component of physician training [78], however little is known about the impact of engagement in human rights programs on students' personal and professional development [1516171819202122232425262728].

Objective: This study aimed to examine medical students' experiences in the Mount Sinai Human Rights Program (MSHRP), their motivations for involvement, and the possible influence of engagement on their professional identities, personal growth, and career choices.

Methods: Through semi-structured interviews, this qualitative study gathered the experiences of 15 fourth year and recently graduated medical students who participated in the comprehensive training, research, and direct service opportunities provided by the program.

Perspectives on Working with Immigrants Held in Detention Using Photovoice.

Those who work with immigrants in detention centers may be at increased risk of secondary trauma. This study used Photovoice to capture reflections on how the lives of volunteers are affected by their work on behalf of immigrant family detainees. Participants were recruited over a two-month period in 2018 from amongst the volunteers of a non-governmental organization that provides legal services to the detainees at one immigration detention center.

A toolkit for building medical programs for asylum seekers: Resources from the Mount Sinai Human Rights Program.

Forced migration has reached a peak worldwide and healthcare professionals and trainees are increasingly volunteering with medical human rights programs. The Mount Sinai Human Rights Program (MSHRP) provides pro bono forensic medical, gynecological, and psychological evaluations to document evidence of human rights abuses experienced by asylum seekers. From 2015 through 2018, MSHRP refined its workflow and processes to facilitate the coordination of 305 forensic asylum evaluations and 117 continuity care referrals.

Patterns and evidence of human rights violations among US asylum seekers.

Background: Asylum seekers report exposure to human rights violations associated with a range of psychological and medical sequelae. Clinical evaluators can provide forensic evaluations that document evidence associated with their reports of persecution. The aim of this study was to characterize the forms of abuse experienced by asylum seekers, the psychological consequences of abuse, and the frequency with which clinician-evaluators found evidence that corroborated asylum seekers' reports.

Piloting forensic tele-mental health evaluations of asylum seekers.

While the number of medical human rights programs has increased, there is substantial unmet need for forensic evaluations among asylum seekers throughout the United States. From September 2019 through May 2020, the Mount Sinai Human Rights Program has coordinated pro bono forensic mental health evaluations by telephone or video for individuals seeking protected immigration status who are unable to access in-person services. The national network clinicians conducted 32 forensic evaluations of individuals in eight U.

Addressing the need for forensic psychological evaluations of asylum seekers: The potential role of the general practitioner.

Asylum seekers who have survived torture and other abuses may experience a wide range of psychological symptoms associated with depression, anxiety, and posttraumatic stress disorder. During the asylum process, attorneys might refer their clients to clinicians who document these psychological sequelae of human rights violations. However, the need for forensic psychological evaluations exceeds the number of mental health clinicians available to provide these assessments.

Experiences of gender-based violence in women asylum seekers from Honduras, El Salvador and Guatemala.

Introduction: Every year, thousands of women flee gender-based violence in Honduras, El Salvador, and Guatemala (sometimes collectively referred to as the Northern Triangle) in an attempt to seek asylum in the United States. Once in the United States, their legal teams may refer them for a psychological evaluation as part of their application for asylum. Licensed clinicians conduct in-depth interviews in order to document the psychological impact of the reported human rights violations.

Building RAFT: Trafficking Screening Tool Derivation and Validation Methods.

Background: Labor and sex trafficking have long impacted the patients who seek care in emergency departments (ED) across the United States. Increasing social and legislative pressures have led to multiple calls for screening for trafficking in the clinical care setting, but adoption of unvalidated screening tools for trafficking recognition is unwise for individual patient care and population-level data. Development of a valid screening tool for a social malady that is largely "invisible" to most clinicians requires significant investments.

Characterization of the mental health of immigrant children separated from their mothers at the U.S.-Mexico border.

Immigrant children who faced forced separation from their parents may be at heightened risk of developing mental health disorders, including depression, post-traumatic stress disorder (PTSD), and anxiety disorders. This cross-sectional study assessed the mental health of children being held in U.S.

Time-Dependent Measurement of Nrf2-Regulated Antioxidant Response to Ionizing Radiation Toward Identifying Potential Protein Biomarkers for Acute Radiation Injury.

Purpose: Potential acute exposure to ionizing radiation in nuclear or radiological accidents presents complex mass casualty scenarios that demand prompt triage and treatment decisions. Due to delayed symptoms and varied response of radiation victims, there is an urgent need to develop robust biomarkers to assess the extent of injuries in individuals.

Experimental Design: The transcription factor Nrf2 is the master of redox homeostasis and there is transcriptional evidence of Nrf2-dependent antioxidant response activation upon radiation.

Forensic psychiatry evaluation in a U. S. immigration detention center in southwest Texas.

Immigration and asylum-seeking are issues that have recently. warranted increased attention and significance. In the aftermath of terrorist attacks, people are more wary of asylum seekers who are usually held in detention centers after fleeing persecution and not for criminal or immigration charges.

Mental health of children held at a United States immigration detention center.

Rationale; Children held in immigration detention may be at risk for mental health disorders due to the impacts of pre-migration factors, including exposure to violence, their displacement from their home countries, their journey between countries, and the conditions of their detention. Limited research has demonstrated high rates of clinical depression, post-traumatic stress disorder (PTSD), and anxiety disorders among detained immigrant children. Objective; In this cross-sectional study, we assessed the mental health of children held at a US immigration detention center over two months in mid-2018.

Depression, Anxiety, Post-traumatic Stress Disorder and a History of Pervasive Gender-Based Violence Among Women Asylum Seekers Who Have Undergone Female Genital Mutilation/Cutting: A Retrospective Case Review.

We sought to evaluate the frequency of anxiety, depression, PTSD, and any experiences of violence in women who had undergone Female Genital Mutilation/Cutting (FGM/C) and were seeking asylum in the United States. We undertook a retrospective qualitative descriptive study of FGM/C cases seen in an asylum clinic over a 2-year period. Standardized questionnaires provided quantitative scores for anxiety, depression and PTSD.

Living with parents or grandparents increases social capital and survival: 2014 General Social Survey-National Death Index.

Introduction: After nearly a century-long trend toward single-family living arrangements, people in wealthy nations are increasingly living in multi-generational households. Multi-generational living arrangements can, in theory, increase psychological, social, and financial capital-factors associated with improvements in health and longevity.

Methods: We conducted a survival analysis using the 2014 General Social Survey-National Death Index, a prospective multi-year survey.

Managing Opioid Withdrawal for Hospital Patients in Custody.

Dr. Brown, a hospitalist, admits Mark, a patient transferred from a local jail for management of cellulitis. The patient, who was taken into custody two days prior to hospital admission, has a history of intravenous heroin use.

Social Capital and the Paradox of Poor but Healthy Groups in the United States.

Increased income strongly correlates with improved health and lower mortality risk. Yet in spite of having a lower mean and median income, both Hispanics and the foreign-born living within the U.S.