Dr. 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.
J Am Acad Psychiatry Law. 2022 Jun;50(2):240-251. doi: 10.29158/JAAPL.210075-21. Epub 2022 Apr 20.
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.
美国各地的医疗人权项目的临床医生对寻求庇护者进行法医评估。许多最佳实践文献反映了临床医生和律师的观点，而不是将法医报告纳入决策过程的移民法官的观点。本研究旨在评估前移民法官对寻求庇护者的法医心理健康评估的看法。我们考察了移民法官用来评估心理健康评估产生的宣誓书的因素，并探讨了他们对远程医疗评估的态度。我们于 2020 年 4 月和 5 月对 9 名前法官进行了半结构化访谈，并使用共识定性研究方法对其进行了系统分析。我们的研究结果分为五个领域：对宣誓书的一般偏好；宣誓书在当前法律环境中的作用；对样本宣誓书的评价和比较；对电话评估的态度；以及对电话评估的建议。法医评估人员应考虑法官的实践建议，包括电话评估和面对面评估，这可以提高他们在裁决过程中评估的有用性。据我们所知，这是第一项纳入移民法官对法医心理健康评估的看法的已发表研究，也是第一项评估法官对电话评估的态度的研究。
