BUSPH News: ‘This Is the Worst That I’ve Seen in My 20-Year Career’

Posted on: July 3, 2019

Among the many policies, actions, and threats leveraged against asylum seekers in recent years, the mass detention and separation of families on the southern border is receiving the most attention. But working with asylum seekers in the Immigrant & Refugee Health Program at Boston Medical Center, Sondra Crosby is seeing first-hand how a different action by the Trump administration is making it harder to be granted asylum.

Crosby, associate professor of health law, ethics & human rights at the School of Public Health, is a physician who conducts forensic medical examinations. For asylum seekers, this means providing medical evidence—physical or psychological—to corroborate their cases, showing that they face significant harm, persecution, or torture in their home countries. “We’ll take however long it takes—sometimes two or three hours, but I’ve had people I’ve literally spent 40 hours with because they’re so traumatized that they can’t talk about it,” she says. “It’s an incredibly adversarial process to begin with, and it’s become more stressful with the harmful policies and the current anti-immigrant rhetoric and atmosphere.”

In June 2018, a decision by then-Attorney General Jeff Sessions (and a subsequent federal court ruling against it) led to confusion within immigrant communities about whether people seeking safety from domestic and gang violence and other forms of what Sessions called “private violence” were eligible for asylum. “Lawyers tell us that such claims remain viable, but the multilayered misunderstandings emanating from social and formal media related to this new decision has caused the immigrants we serve additional, and unnecessary, mental anguish,” Crosby says.

That confusion is just one factor making the asylum system more and more difficult to navigate. Oona Wallace, who works with Crosby as the citizenship & immigration rights navigator in the Immigrant & Refugee Health Program (and has lectured in two of Crosby’s SPH classes), says there has been a “steady and stark” increase in the proportion of asylum denials in the US. “In 2018, the asylum denial rate was 65 percent” in immigration court, she says, compared to the two-decade low of 42 percent in 2012.

Crosby and Wallace talked with SPH about the legacy of the Sessions ruling, the growing injustices of the immigration system, and what individuals can do to help.

How have you seen recent policies, threats, and actions affect asylum-seeking patients?

Crosby: I have been doing forensic medical examinations for 20 years. In the last few years I’ve seen a demonstrable increase in the number of asylum seekers requesting services, and also an increase in anxiety and fear over the asylum process. Immigration detention and deportations have increased in the last year. The stakes are high—an asylum seeker could risk torture or death if deported.

It’s easy to see why people are fearful. This is a horrible time in our country for immigrants. We’re locking up asylum seekers who are coming over the southwest border right now, people fleeing persecution who have not committed any crimes. We’re detaining them in deplorable conditions, and we’re separating families.

This is the worst that I’ve seen, by far, in my 20-year career. It’s frustrating, it’s sad, and it makes me angry. These are not the values we hold as a nation.

What have been the repercussions of the change in asylum criteria, despite it being blocked last year?

Crosby: After Jeff Sessions overruled the case of ‘A-B,’ who was a domestic-violence asylum-seeker, it signaled that the administration was pushing back on being in a ‘particular social group’ (PSG) as grounds for asylum. That’s raised anxiety and fear among these very important groups of people who have been persecuted, including women who have experienced severe domestic violence and have not been protected by their countries, people who are survivors of gang violence, and sexual-minority cases of persecution, which we have seen many of.

I recently cared for a woman who experienced severe domestic violence in her country and was not protected by her government—in fact the government repeatedly returned her to the perpetrator. She was so distraught at rumors circulating around her community that her asylum claim was not valid that she was reluctant to see a lawyer, and suffered severe PTSD and depression. Her symptoms were exacerbated by her fears of deportation.

The reality is, there has been an increase in asylum denials. This information is obviously known in these communities, and it puts pressure on people to bolster their stories to try to reduce the chances of having their asylum claims denied. That’s very dangerous.

What other barriers to asylum are these patients facing?

Crosby: A major issue is the backlog in cases. People are fearful of being deported while waiting for their asylum process to go on—because the courts are also backed up, with approximately 15,000 cases just in Boston.

Wallace: With regard to affirmative asylum filings, there is a newly adopted ‘first in, last out’ policy at the asylum office, where they’re trying to schedule applicants within three weeks of the date their application is received. About half of cases get scheduled for this fast initial interview. But people often wait two to five years for the initial interview, and recently I’ve met two different people who’ve been waiting more than 10 years.

I do know that the asylum office in Boston is trying to hire more asylum officers to take more cases in this backlog, but I also know that the number of cases that are referred to immigration court is increasing. When someone applies affirmatively for asylum, they file first at the Asylum Office, and if the Asylum Office decides that they’re not sure about the case, they refer the person to immigration court. For many years, the immigration courts have been severely underfunded, and wait times for a hearing in the immigration courts have increased.

While this wait prolongs someone’s experience in the immigration process, it’s also important to allow an asylum applicant sufficient time to explain her case to the immigration judge. Some of the cases we are now seeing are incredibly complex.

What other factors affect someone’s chances of being granted asylum?

Wallace: One of the largest factors in whether someone’s asylum case is accepted or denied is the discretion of the judge. In some places the difference between judges’ asylum rates can be 80 percent—so one judge will grant 10 percent of cases, whereas another will grant 90 percent of cases. Your odds of being granted asylum are much more dependent on the judge you’re assigned than the claim that you have.

It also relies on getting an attorney. Someone is five times more likely to be granted asylum if they have an attorney.

How is this immigration environment affecting public health?

Wallace:  Outside of the asylum cases, so many people are worried about the proposed ‘public charge’ rule, which would make it harder for people who are applying for green cards to enlist in public benefits, including things like healthcare and food assistance. That’s the piece that the people I work with are identifying as the most discouraging: The distance between the rights that people with citizen status and people with other immigration statuses have is widening dramatically. It’s enraging.

Crosby: This is a major public health issue, with residents potentially not accessing services—not bringing their kids in to be vaccinated, not going to a food pantry, not accessing a domestic violence centers.

There’s also a new proposal to evict people from public housing if any member of the family in the household is undocumented. We have so many mixed-status households, where Mom and/or Dad is undocumented and their children are citizens, so the whole family would be out of housing. We need to rally around this and try to block it.

What can individuals do to help?

Crosby: We’ve seen pro bono lawyers and clinicians stepping up—but, clearly, the demand for help is much bigger than the supply.

You can join and/or donate money to a grassroots organization: MIRA Coalition, Irish International Immigration Center, Project Citizenship, Greater Boston Legal Services, and PAIR Project.

Wallace: MIRA and Project Citizenship both hold citizenship clinics regularly, where volunteers help immigrants fill out citizenship applications.

The Boston Immigration Justice Accompaniment Network (BIJAN/BEYOND) matches volunteers with people going to ICE check-ins and court appointments. Those are two really anxiety-inducing experiences for people who don’t have attorneys, and having someone there to witness and support can be a huge help and alleviate a lot of anxiety. BIJAN also does a lot of work to help raise money to post bond for people in immigration detention, which is a good donation opportunity.

There are a lot of ways that time and money can be utilized to make a direct impact for people at all stages of the immigration process.

Crosby: Also, talk to your legislators. Express your disgust with the way immigrants are being treated through government policies, from the detention of asylum seekers to the public charge proposal to the ICE presence here in Massachusetts.

Massachusetts is a relatively friendly place for immigrants compared to a lot of other states, but there should not be ICE agents in courtrooms, on the T, in parking lots, and they should not be targeting families who are just going about their daily lives. Massachusetts is the immigration detention hub for the Northeast; we have four detention centers, detentions have increased, and ICE presence has increased around Boston.

Wallace: It’s especially important to talk to legislators about the proposal to give undocumented people driver’s licenses. That would be a huge step forward for people.

Crosby: The one positive thing in all of this is that there has been so much public response to these policies. We’ve had students come forward and want to volunteer, people are offering churches to let immigrants stay in safe places… There has been a lot of outrage, including here in Massachusetts, and it’s been heartwarming to see people stand up and support immigrants.

Michelle Samuels


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