From Persecution to Prison - Bellevue/NYU Program for Survivors of ...

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TABLE 14:Health-Related Interpreter Services (N=70)ResponseNumber (%)Did you ever need interpreter services while in detention? (n=70 responses)Yes 39 (56)No 31 (44)If you needed an interpreter, (n=39) did you ever utilize aninterpreter while in INS detention?Yes 28 (72)No 11 (28)If you needed an interpreter, (n=39) was there difficulty in obtaining one?(n=35 responses)No difficulty 18 (51)A little difficulty 4 (11)A lot of difficulty 5 (14)Never provided with interpreter when needed one 8 (23)Quality of interpreter services when provided (n=28 responses)Poor 3 (11)Fair 6 (21)Good/Excellent 19 (68)thermore, 35 (56%) of the 62 individuals having serious health problemsreported having at least one serious problem for which they reported a lotor extreme difficulty accessing care. Frequently cited difficulties withaccessing care included difficulty obtaining specialized care (includingdental care), difficulty receiving follow up care, and difficulty getting carefrom a doctor in addition to a nurse (Table 13).Forty-nine percent of detainees reported that they characterized theoverall quality of the medical care they received while in INS detention as“poor.” Similarly, for 50% of all serious health problems noted, detaineesfelt the quality of the care they received was poor. The primary reasonscited for this perception included inadequate evaluation, inadequate treatment(including repeatedly being given the same medication with little orno effect), and dissatisfaction with interactions with health staff (Table 13).Unlike the large discrepancy between those who wanted mental healthcounseling and those who requested it, only ten participants, for a total of12 health problems, reported having serious health problems for whichthey did not request health care. Reasons cited by these individuals for notrequesting health care for a serious health problem included being discouragedeither by their own prior experiences or the experiences of otherPHYSICAL HEALTH, MEDICAL PROBLEMS AND MEDICAL CARE 95
detainees, or because they did not think health services would be availablefor the particular health problem.Most of the individuals (62%)who reported needing interpreter servicesreported little or no difficulty in obtaining such services. (Table 14). However,thirteen (37%) of the individuals who said that they needed an interpreterfor health service reported either having a lot of difficulty or neverbeing provided with an interpreter when they needed one. Detainees weregenerally satisfied with the quality of interpreters when provided (mostcommonly telephonically) as 68% of individuals who needed interpreterscharacterized the quality of these interpreters as “good” or “excellent.”NARRATIVESGeneral HealthAs noted above, detainees often felt that their health had deterioratedwhile in detention.“Since I’m in detention, I’m getting more health problems,” noted onedetainee, who complained of back and chest pain. Another detaineereported;I think my physical health is getting worse. Because here I’m thinking alot about the stuff that happened to me and it is affecting my body.Many of the symptoms were likely manifestations of depression. Forexample, one detained asylum seeker commented:Because I don’t have any exercise. I just sit. I have no interest. I alwaysfeel very tired.Many individuals linked their physical and psychological symptoms.For example, one asylum seeker reported frequently experiencingheadaches after waking up from nightmares of being imprisoned in hiscountry.The headaches are usually at nighttime. Here it is hard to tell what isnight and what is day. I don’t know what the sky looks like.One individual linked severe headaches he was experiencing withsymptoms of depression.Here, when I feel upset or sad, I get very bad headaches, and this happensa lot. I also get shaky when I feel nervous.Positive Aspects of Care Available in INS DetentionSeveral detainees appreciated that they had access to a wide range of services,including services they might not have received in their countries of96 FROM PERSECUTION TO PRISON
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From Persecution to Prison:The Heal
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CONTENTSAcknowledgements . . . . .
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The Bellevue/NYU Program for Surviv
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don, Miranda Ip, and Meriam Alrashi
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Significant symptoms of depression
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Detained asylum seekers participati
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persecution, yet most emphasized ho
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In many facilities, the response to
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years in detention, she finally got
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abuse For example, while being take
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They didn’t let me use the phone
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intensely personal events they had
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Limitations of this study include t
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Non-governmental organizations serv
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22 FROM PERSECUTION TO PRISON
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the late 1990s ranging from 10 to 7
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Historical BackgroundFor most of th
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international standards with the 19
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apply for asylum make up the majori
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tion judge. 57 Yet in many parts of
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York and Newark, New Jersey has had
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trict began denying parole to them
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Correctional Facility in 2000. “[
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men of which 750 were detained on i
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from that same country from seeking
Page 53 and 54: Detention Facilities in this StudyF
Page 55 and 56: high reliability in numerous langua
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Page 59 and 60: York County Prison in York Pennsylv
Page 61 and 62: TABLE 2:Demographic Characteristics
Page 63 and 64: TABLE 4:Prevalence of Pre-Migration
Page 65 and 66: on a part time basis, researchers w
Page 67 and 68: Case #1(DK): “Loneliness and Fear
Page 69 and 70: TABLE 6:Hopkins Symptom Checklist-2
Page 71 and 72: TABLE 8:Harvard Trauma Questionnair
Page 73 and 74: think such services were available.
Page 75 and 76: When I am talking to you now it is
Page 77 and 78: After being granted asylum and rele
Page 79 and 80: “Being here is like going through
Page 81 and 82: In my country even though I became
Page 83 and 84: how long they were there - six mont
Page 85 and 86: Thoughts of SuicideSeveral asylum s
Page 87 and 88: here?’ I told the doctor, they br
Page 89 and 90: Another subject reported a positive
Page 91 and 92: substantial distance from their att
Page 93 and 94: eported that her experience in dete
Page 97 and 98: e somatic manifestations of the psy
Page 99 and 100: Case #2 (JG): “Health Care in Cha
Page 101 and 102: TABLE 11:Detainee Perceptions of He
Page 103: TABLE 13:Availability and Quality o
Page 107 and 108: Difficulty Obtaining Specialized Ca
Page 109 and 110: Another detained asylum seeker repo
Page 111 and 112: One detainee who speaks French and
Page 115 and 116: Detention Facilities in this StudyS
Page 117 and 118: even though many reported having ex
Page 119 and 120: CASE #3 (HN): “SOLITARY CONFINEME
Page 121 and 122: Here, I’m scared. In [the detenti
Page 123 and 124: emote control and watch what he wan
Page 125 and 126: Whenever someone misbehaves, they t
Page 127 and 128: This subject was himself threatened
Page 129 and 130: One detainee reported several incid
Page 131 and 132: Some Process Exists to Respond to R
Page 133 and 134: There were no witnesses other than
Page 135 and 136: tion. An INS officer said they put
Page 137 and 138: There is an Anglican minister who c
Page 139 and 140: The dentists didn’t explain anyth
Page 141 and 142: tion between dental age and chronol
Page 143 and 144: Case #4 (LK): “Fifteen-Year-Old G
Page 147 and 148: TABLE 16:Treatment/Abuses Reported
Page 149 and 150: “There is no political asylum her
Page 151 and 152: I was crying. I was so afraid with
Page 153 and 154: save her life, but was not able to
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Case #5 (CR): “Begging for Mercy
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ehind and told me to sign. He physi
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days and it is now 2 years and four
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viewers asked for additional inform
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y study participants. In evaluating
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trast, under US law, detention of s
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nation for an asylum determination
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very negative effects of detention
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authority to grant asylum and with
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absconding.” 250 Since the passag
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said “[F]reedom from imprisonment
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Standards relevant to this study ar
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“detained person” generally as
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which they are charged and a fair h
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esponse to substantial public press
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specified procedures, provided they
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PunishmentThe Detention Standard on
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any time the detainee complains.”
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while in detention, thus adding to
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Establish a Uniform National Parole
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that effect. These officers should
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Besides their inaccuracy, these exa
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friends so asylum seekers can maint
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appropriate staffing of such groups
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efugees and asylum seekers who win
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of thorough documentation. However,
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Human development is complex and di
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18. Country from which fleeing pers
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9. Being close to death.10. Forced
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Complete for each health problem:5.
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Explain:(Interviewer: Write brief n
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2. Depression SymptomsA How much we
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B. You said that you have experienc
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Explain:13. How was your physical h
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Yes ...........1No............22. W
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Explain:20. At the time of your arr
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