1. Keller, Allen S. MD
  2. Ford, Douglas JD
  3. Sachs, Emily BA
  4. Rosenfeld, Barry PhD
  5. Trinh-Shevrin, Chau MS
  6. Meserve, Chris MD
  7. Leviss, Jonathan A. MD
  8. Singer, Elizabeth MD
  9. Smith, Hawthorne PhD
  10. Wilkinson, John MS
  11. Kim, Glen MD
  12. Allden, Kathleen MD
  13. Rockline, Paul JD


Abstract: Asylum seekers arriving in the United States are often imprisoned for months or years while their asylum claims are processed. Recently, Physicians for Human Rights and the Bellevue/New York University Program for Survivors of Torture released the findings of the first systematic study examining the health of detained asylum seekers. The study found that the mental health of asylum seekers interviewed was extremely poor, including high levels of symptoms for anxiety, depression, and posttraumatic stress disorder, which worsened the longer individuals were in detention. The study also raises concerns about the manner in which asylum seekers are treated upon arrival in the United States and then while in detention. These findings support assertions that detention has a harmful effect on the health and well-being of asylum seekers. Policies regarding the long-term detention of asylum seekers should be reconsidered.


HISTORICALLY, THE UNITED STATES has welcomed refugees fleeing persecution. Inscribed on the Statue of Liberty are the words: "Give me your tired, your poor, your huddled mass yearning to breath free[horizontal ellipsis]." But since a restrictive immigration law was adopted in 1996, asylum seekers arriving in this country are often imprisoned for months or years, while their asylum claims are processed. Such treatment of asylum seekers as criminals is the focus of the report, "From Persecution to Prison: The Health Consequences of Detention for Asylum Seekers," which was recently released by Physicians for Human Rights (PHR) and the Bellevue/NYU Program for Survivors of Torture.


The criminalization of immigrants seeking political asylum reflects a worldwide trend by governments of industrialized nations. This occurs while the number of refugees and asylum seekers fleeing torture and human rights abuses is increasing.


Health professionals and human rights advocates have repeatedly expressed concern about potential detrimental effects of detention on the mental health of asylum seekers. But there is a paucity of research on this, largely due to the difficulties in gaining access to the detention centers. The Bellevue/NYU Program-PHR study is the first systematic effort to examine the health of detained asylum seekers in the United States. Seventy asylum seekers in immigration detention facilities and county jails in New York, New Jersey, and Pennsylvania were interviewed for this study.


The report indicates that imprisonment can have a harmful impact on the health and well-being of asylum seekers, people who have already suffered significant trauma as the result of torture or other persecution in their countries of origin. The study found extremely high symptom levels of depression, anxiety, and post-traumatic stress disorder among asylum seekers; these levels worsened the longer the individuals were detained. Most individuals attributed these symptoms largely to their detention, and many also believed their physical health worsened while in detention.


Many of the asylum seekers in the study described disturbing encounters with U.S. immigration officials upon arrival in the United States, including being subjected to verbal abuse and other indignities. Moreover, many complained that the right to asylum was not adequately explained to them. Once in detention facilities, many asylum seekers also reported experiencing verbal abuse and other indignities, including being placed in or threatened with solitary confinement.


It is revealed in case after case that the U.S. government's practice of imprisoning asylum seekers inflicts further harm on an already traumatized population. For example, a young African asylum seeker who had helplessly watched armed men kill his father and kidnap his sister, said:


When I came I never expected to be put in jail. They don't call it jail; they call it detention. But it is jail. I thought I would be free when I got to America. I came here to find peace and be able to live in peace.


The study found that besides worsening already poor psychological health, in many ways the nature of immigration detention retraumatizes asylum seekers. Confinement and the loss of liberty profoundly disturbed asylum seekers, triggered feelings of isolation and powerlessness, and resurrected disturbing memories of the persecution that the asylum seekers suffered in their native countries. Even when conditions were relatively good, the experience haunted them. Some despaired to the point of contemplating suicide, and even those released were burdened with continued after-effects from their imprisonment.


One study participant who was repeatedly arrested and beaten in his country of origin because of his political and ethnic associations, and who witnessed the beatings and murders of his parents, reported:


This place makes me think a lot about what happened to me in my country. I am not free, and this reminds me of when I was in prison in my country. I think too much, especially of my responsibility. I don't know [my family's] condition. I think too much about whether I am going to be sent back to my country and there I face death[horizontal ellipsis]. I try not to think about what happened, but I can't control it. When I think about what happened, I feel weak and hopeless[horizontal ellipsis]. I'm depressed in here and I feel everything is getting worse.


Access to mental health services in detention facilities was extremely limited. Detained asylum seekers also reported difficulty obtaining specialized medical services, including dental care.


"From Persecution to Prison" recommends several ways in which the U.S. government should change its widespread practice of the long-term detention of asylum seekers, including:


* Restore parole for asylum seekers. While it may be necessary to detain asylum seekers in order to begin the eligibility process, once "credible fear" of persecution has been established the government should parole the majority of these people.


* Ensure adequate safeguards at points of entry to see that the rights of asylum seekers are protected. Officials at the points of entry should be trained to adequately explain the process so that asylum seekers do not suffer retraumatization upon arrival.


* Improve treatment and conditions when detention is necessary.


* Improve access to and the quality of health services (including mental health services) that are available to detained asylum seekers.



To view the full report or to order a copy of "From Persecution to Prison: The Health Consequences of Detention for Asylum Seekers," please visit