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

nature and severity of these problems unanswered. As noted in the healthsection of this report, there is the possibility that at least some, if not manyof the medical problems reported by our sample may have reflected psychosomaticconditions (which are common among trauma survivors)rather than organic conditions. Thus, the “failure” to provide medicaltreatment perceived by some detainees may in some cases actually reflectan appropriate response, at least with regards to medical care, to thenature of the symptoms reported. The lack of availability for appropriatemental health services, however, still is a matter of concern in how suchsomatic symptoms could be addressed. Unfortunately, such differentiationsare not necessarily possible given the data. The Bellevue/NYU-PHRresearchers did attempt to distinguish “medical” problems that wereovertly psychological in nature (e.g., insomnia) but many other symptoms(pain, headaches, gastrointestinal discomfort) may have reflected psychologicalstress rather than organic etiology. How often such complaintswere somatic rather than organic in nature is not known.The geographic region in which the study was conducted is anotherlimitation pertaining to the study sample. This study was limited to detentioncenters in the northeastern United States and included only 70detainees. Detainees in other regions of the US may be from different partsof the world, having experienced different forms of torture and abuse, andmay be treated quite differently by customs and detention center staff.Nevertheless, given the absence of data on detained asylum seekers nationwideand internationally, the present study provides the first attempt toobtain systematic data on the general health, psychological functioningand experiences while in detention of this group.Finally, the reliance on self-report data to assess symptom severity,access to medical care, and treatment by Customs and INS staff is anotherlimitation to consider. Despite informing the study participants that surveyresponses (or even participation) would not influence either their asylumclaims or their status in detention, and there would be no material or othergain by participating in the survey, the severity of psychological symptoms,and experiences/number of abuses reported in the study may havebeen over or under reported if detainees judged that it was in their interestto exaggerate or conceal symptoms or claims of mistreatment. For example,despite the fact that interviews were conducted in private and assurancesof confidentiality were provided, individuals may have been fearfulof reporting occurrences. Also, there is a subjective component to whatconstitutes verbal/physical abuse, and individuals may have under or overreported such incidents as well because of this. The narrative informationpresented in this study provides a useful context in which to understandthe survey response data.This study was a survey of individuals’ experiences, and it was notwithin the scope of the study to corroborate accounts of events describedSTUDY LIMITATIONS 153