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心理健康是寻求庇护者医法合作的基石:Terra Firma 模式。

Mental health as the cornerstone of effective medical-legal partnerships for asylum-seekers: The terra firma model.

机构信息

Terra Firma at Montefiore Bronx Health Collective.

出版信息

Psychol Trauma. 2024 Aug;16(Suppl 2):S417-S425. doi: 10.1037/tra0001343. Epub 2022 Jul 21.

Abstract

OBJECTIVE

Challenges and traumas faced by asylum-seekers before, during, and after migration are compounded by the stressors of the asylum-seeking process, potentially compromising mental health (MH). Poor MH outcomes, in turn, complicate asylum-seekers' capacity to navigate the asylum-seeking legal process (e.g., hindering an individual's ability to provide an organized statement of their premigration experiences). Medical-legal partnerships are models of care that address legal problems as social determinants of health. However, when implementing medical-legal partnerships for asylum-seekers, standard definitions focusing on physical health do not appropriately capture the crucial role of MH services. Since 2013, the Terra Firma Program has provided services for asylum-seekers in the South Bronx, New York, by integrating MH, medical, and legal services along with enrichment activities, and concrete services. The present paper describes the benefits of this approach to working with asylum-seekers; highlights the importance of the MH component, including MH staff's dual therapist-evaluator role as a trauma-informed and ethical vehicle to support clients' asylum cases; and advocates for these partnerships to be recognized as MH-medical-legal partnerships.

METHOD

Drawing from Terra Firma's experience with over 800 asylum-seekers, the authors provide a framework for addressing asylum-seekers' needs through MH-medical-legal partnerships.

RESULTS

Terra Firma's work with asylum-seeking children and families provides evidence in support of the establishment of MH-medical-legal partnerships and highlights the importance of the MH component in addressing asylum-seekers' legal needs.

CONCLUSIONS

MH-medical-legal partnerships are proposed as effective models for working with asylum-seekers, with potential benefits to MH, physical health, and legal outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

目的

寻求庇护者在移民前后所面临的挑战和创伤因寻求庇护过程中的压力因素而更加复杂,这可能会损害心理健康(MH)。反过来,较差的 MH 结果会使寻求庇护者在寻求庇护法律程序中更加困难(例如,阻碍个人有条理地陈述其移民前经历的能力)。医疗法律伙伴关系是一种关注健康问题的社会决定因素的护理模式。然而,在为寻求庇护者实施医疗法律伙伴关系时,专注于身体健康的标准定义并不适当地捕捉到 MH 服务的关键作用。自 2013 年以来,Terra Firma 项目在纽约南布朗克斯为寻求庇护者提供服务,方法是整合 MH、医疗和法律服务以及充实活动和具体服务。本文描述了这种与寻求庇护者合作的方法的好处;强调了 MH 部分的重要性,包括 MH 工作人员作为创伤知情和符合伦理的工具的双重治疗师-评估员角色,以支持客户的庇护案件;并主张将这些伙伴关系确认为 MH-医疗法律伙伴关系。

方法

利用 Terra Firma 与 800 多名寻求庇护者的经验,作者提供了一个通过 MH-医疗法律伙伴关系解决寻求庇护者需求的框架。

结果

Terra Firma 为寻求庇护的儿童和家庭所做的工作为建立 MH-医疗法律伙伴关系提供了证据,并强调了 MH 部分在解决寻求庇护者法律需求方面的重要性。

结论

MH-医疗法律伙伴关系被提议作为与寻求庇护者合作的有效模式,对 MH、身体健康和法律结果都有潜在的好处。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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