Piloting Forensic Tele-Mental Health Evaluations of Asylum Seekers

Green, A. S.; Ruchman, S. G.; Katz, C. L.; Singer, E. K.

Problem Forensic mental health evaluations can provide critical evidence in the legal cases of individuals seeking asylum and other forms of protected immigration status. While the number of academically affiliated medical human rights programs has increased in recent years, there is still substantial unmet need for pro bono evaluations throughout the United States, especially for individuals in detention. Approach The Mount Sinai Human Rights Program launched its pilot Remote Evaluation Network in September 2019, with the aim to coordinate forensic mental health evaluations by telephone or video call for individuals who are unable to access in-person services. The authors recruited mental health clinicians from across the country, trained them in best practices in conducting forensic evaluations using telehealth platforms, and coordinated pro bono mental health evaluations of individuals seeking immigration relief. Remote forensic services have been a particularly relevant solution in the context of the COVID-19 pandemic. Outcomes The Remote Evaluation Network consists of seventeen active evaluators. From December 2019 to April 2020, the pilot program has coordinated fifteen forensic evaluations of individuals seeking asylum and other forms of protected immigration status in six different states. All clinicians participated in a training module on best practices in conducting forensic evaluations by telephone; respondents to optional pre-and-post-module surveys reported an increase in comfort level with conducting telephonic evaluations after participating in the module. Next Steps We will formally evaluate this pilot program's services by assessing the quality of medico-legal affidavits from telephonic evaluations, tracking legal outcomes and qualitative feedback from attorneys, and investigating the acceptability of telephonic mental health evaluations among legal professionals. Future directions include expansion to new geographies, including individuals affected by the Migrant Protection Protocols or "Remain in Mexico" program.