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Immigration Judges' Perceptionsof Telephonic and In-Person Forensic Mental Health Evaluations
Aliza S Green1, Samuel G Ruchman2, Beselot Birhanu1
1Dr. Green is a first-year resident in the Internal Medicine Program, Brigham and Women's Hospital, Boston, MA. Dr. Ruchman is a first-year resident in the Internal Medicine-Pediatrics Program, University of Colorado, Aurora, CO. Ms. Birhanu and Ms. Wu are third-year medical students at the Icahn School of Medicine at Mount Sinai, New York, NY. Dr. Katz is Clinical Professor in the Departments of Psychiatry, Medical Education, and Health System Design & Global Health and Faculty Director of the Mount Sinai Human Rights Program's Remote Evaluation Network, Icahn School of Medicine at Mount Sinai, New York, NY. Dr. Singer is Director of the Mount Sinai Human Rights Program and Associate Professor in the Departments of Emergency Medicine and Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY. Dr. Baranowski is Associate Director of the Mount Sinai Human Rights Program and Faculty Director of Research, Icahn School of Medicine at Mount Sinai, New York, NY.
Abstract:
Clinicians affiliated with medical human rights programs throughout the United States perform forensic evaluations of asylum seekers. Much of the best practice literature reflects the perspectives of clinicians and attorneys, rather than the viewpoints of immigration judges who incorporate forensic reports into their decision-making. The purpose of this study was to assess former immigration judges' perspectives on forensic mental health evaluations of asylum seekers. We examined the factors that immigration judges use to assess the affidavits resulting from mental health evaluations and explored their attitudes toward telehealth evaluations. We conducted semistructured interviews in April and May 2020 with nine former judges and systematically analyzed them using consensual qualitative research methodology. Our findings were grouped in five domains: general preferences for affidavits; roles of affidavits in current legal climate; appraisal and comparison of sample affidavits; attitudes toward telephonic evaluations; and recommendations for telephonic evaluations. Forensic evaluators should consider the practice recommendations of judges, both for telephonic and in-person evaluations, which can bolster the usefulness of their evaluations in the adjudication process. To our knowledge, this is the first published study to incorporate immigration judges' perceptions of forensic mental health evaluations, and the first to assess judges' attitudes toward telephonic evaluations.
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