For many immigrants, crossing oceans, deserts and mountains is only part of the journey, there are numerous challenges ahead. A complex immigration system is one of the most critical challenges that many immigrants must overcome. In a system that is not trauma-informed and lacks due process protections, a misremembered time, place, or sequence of events by an asylum-seeker could be interpreted by the judge as lacking credibility and resulting in a denial.

Over the years, HILSC has engaged in ongoing communication with our partners, which helps guide our work and our effort to support the immigrant community. One of the things we heard from our partners is the growing importance and increased need for forensic mental health evaluations. Such evaluations serve a vital purpose in immigration cases, especially for clients who have experienced complex trauma. Forensic evaluations can help bolster a client’s legal case. Specifically, the forensic evaluation can provide additional evidence, corroborate the client’s story, and support their credibility. In addition, clinical expert testimony can provide an objective expert opinion as well as psychosocial education regarding the impact of trauma on a person’s psychological and emotional well-being.

Immigration attorneys have noted the vital role of forensic mental health evaluations. The synergistic collaboration between attorneys and mental health providers often leads to successful outcomes for our clients. A high-quality evaluation can sometimes be the difference between a case getting approved or not. Unfortunately, these specialized services are not easily accessible due to limited financial resources and specialized training needs for clinicians.

In 2019, HILSC launched the forensic evaluations program funded by the Robert Wood Johnson Foundation to support our legal services partners and their clients. This capacity building project has helped to connect attorneys with local clinicians and most importantly, it has helped immigration clients gain access to forensic mental health evaluations. The project has focused on expanding the capacity of high-quality mental health evaluations by including various program initiatives including network development, case coordination, financial assistance, and training. We began by developing a network of Houston-based clinicians who have training in trauma-informed psychotherapy. Today, our clinical network comprises evaluators of various clinical backgrounds, including licensed clinical social workers, licensed professional counselors, licensed marriage and family therapists, psychologists, and psychiatrists. Although their therapeutic approach and training might vary, all clinicians are trained to assess, treat, and diagnose mental health. The next step was to collaborate with our legal partners to offer specialized training focused on forensic evaluations.

Our forensic evaluation webinar series offers interdisciplinary instruction aimed to train clinicians and attorneys on best practices for conducting and incorporating mental health evaluations. Although attorneys and clinicians have different approaches and operate in different frameworks, the goal to support the immigrant community is the same. The webinar series incorporates cross training for both disciplines to give clients the best chance for a successful outcome.

After building a clinical network, HILSC focused on providing case coordination to connect trained forensic evaluators with immigration attorneys in our legal network. Case coordination consists of connecting attorneys with clinicians based on a range of factors including the client’s needs, the legal needs of the case and the evaluator’s clinical expertise. Once connected to the attorney, the clinician meets with the client, conducts the forensic interview, documents the psychological impact through a written report and provides oral testimony during the hearing. This multi-step process is often the key to successful outcomes for our clients seeking asylum.

Our commitment to program evaluation and quality improvement led us to establish critical training opportunities including our forensic evaluation mentorship program. The mentorship model is a collaborative training system which amplifies and enhances the work of our clinical network. Seasoned mentors share their knowledge, skills, and expertise in performing mental health evaluations in the immigration context. The mentorship model not only expanded our clinical network, but it has also helped set high standards of practice for clinicians who are doing this important work.

One of the challenges in accessing forensic evaluations is the cost associated with the specialized service. To minimize the access barrier, HILSC developed a stipend program focused on building capacity and defraying the cost of mental health evaluations. HILSC provides low bono stipends for forensic evaluators whose service is requested by HILSC’s legal partners. Since 2019, our forensic evaluations program has offered case coordination to pair attorneys and clinicians in 136 cases, provided more than $76,000 in stipends for mental health evaluations, with 21 cases pending. We have also developed a clinical network with clinicians of diverse backgrounds, provided interdisciplinary training on how to conduct and incorporate forensic evaluations, and finally, we have provided mentorship and technical assistance.

The pandemic has led to closure of the Immigration Courts for sixteen months, many hearings have been postponed. To ensure that clinicians are prepared to provide compelling testimony to support the clients’ cases, HILSC will offer another round of mentorship focusing on preparing clinicians for court testimony. The crux of these testimonies is to provide psychosocial education to the judge, to provide an expert opinion to explain the client’s behavior, to corroborate the client’s story and to bolster the client’s credibility. Clinicians in our mentorship program have shared that “it’s important to have support and continued growth for best practices and improvement for completing sound [forensic] evaluations.”

The second mentorship cycle will offer opportunities to support clinicians with varying levels of experience. New forensic evaluators will receive the necessary support to begin engaging in this work and experienced clinicians will have opportunities to further their professional development and get guidance from seasoned clinicians in preparing for court testimony. We will also offer a continued education curriculum with specific learning objectives and additional resources. The curriculum will emphasize integrating clinical and legal work to adopt an interdisciplinary approach in working with clients. We plan to roll out the curriculum through an on-line classroom platform that carries CEU credits for clinicians.

The forensic evaluations program has accomplished many things in the last three years. But perhaps, the most important accomplishment is to normalize mental health services and open the door for immigration clients to engage in counseling. Complex trauma can have long-lasting, detrimental effects. But mental health services can help minimize the impact and encourage clients to embark on a journey to begin healing.

~ by Zenobia Lai & Thalia Flores Werner

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