Abstract
Background: Asylum evaluations are highly specialized medico-legal encounters which collect physical or mental health evidence, or both, and used in immigration proceedings. Although the field of asylum medicine is growing, access to these evaluations is still inadequate, particularly for asylum seekers in immigration detention or other forms of custody, such as under the Migrant Protection Protocols or “Remain in Mexico” policy. Given advances in telemedicine in recent years and growing evidence of similar outcomes with in-person treatment, it seems prudent to examine whether remote modalities may also be effective for conducting mental health asylum evaluations in hard-to-reach populations. Methods: We analyzed the comments of 12 clinicians who conducted a total of 25 cross-border remote mental health evaluations and completed a post-evaluation survey regarding their impressions and experiences. Results: Clinicians encountered a number of challenges including technical difficulties and a decreased ability to establish rapport. Nearly uniformly, however, clinicians noted that despite difficulties, they were able achieve the goals of the evaluation, including rapport building and diagnosis. Conclusion: remote evaluations appear to be non-inferior to in-person encounters and may be useful in expanding legal options for hard-to-reach asylum seekers.
Cross-border ties and Arab American mental health
