A toolkit for building medical programs for asylum seekers: Resources from the Mount Sinai Human Rights Program

Ruchman, Samuel G.; Green, Aliza S.; Schonholz, Stephanie; Hersh, Eliza H.; Sikka, Neha; Baranowski, Kim A.; Singer, Elizabeth

doi:10.1016/j.jflm.2020.102037

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…The HRC experience presents early insight into the integration of follow-up services into the FME process. Other SRACs have previously described follow-up programs (Ruchman et al, 2020). By documenting the most requested referral services, we demonstrate the health and social needs of asylum seekers.…”

Section: Discussionmentioning

confidence: 77%

“…Translating findings into HRC policies and practices HRC leaders enacted real-time interventions and adaptations to its clinic structure and functions in response to the complexity of client trauma and the trauma impact on clients, students, and clinicians (Table 6). HRC learned from the experiences of other SRACs in the U.S as well as from case series in similar settings across the world (Gu et al, 2021;Ruchman et al, 2020;Sharp et al, 2019). Prior studies on SRAC structure and format have focused on the challenges of optimizing logistics, retaining clinicians, building sustainable leadership, improving handoffs between student leaders, and increasing caseloads.…”

Section: Discussionmentioning

confidence: 99%

“…We compare characteristics of asylum seekers with and without histories of sexual violence, investigate the relationship between the number of past traumas and mental health outcomes, and demonstrate an unmet need for mental health treatment. We also build on studies aimed at improving SRAC sustainability by reporting strategic trauma-centric practices that reduce client barriers to FMEs and the impact of trauma exposure on clinicians and students (Gu et al, 2021;Ruchman et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Asylum seeker trauma in a student-run clinic: reducing barriers to forensic medical evaluations

Gallagher

Steiner

Michel

et al. 2022

torture

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Introduction: The number of forcibly displaced immigrants entering the United States continues to rapidly increase. Movement from Latin America across the southern border of the United States was the third-largest migration worldwide in 2017; the U.S. now serves as home to one-fifth of the world’s migrants (Budiman, 2020; Leyva-Flores et al., 2019). Reporting on the first two years of clients receiving forensic medical evaluations (FMEs) conducted by clinicians trained at University of California, San Francisco (UCSF), this descriptive study demonstrates the multiple layers and types of trauma in asylum seekers presenting to a student-run asylum clinic (SRAC) at an academic medical center. Methods: A retrospective review of the first 102 asylum seekers presenting to a university-affiliated SRAC for forensic medical and psychological evaluations is summarized. Demographics, immigration history, medical and mental health histories, descriptions of extensive trauma and referral patterns are reported. Multivariate statistics were employed to investigate the relationship between past trauma and current mental health status. Results: Clients reported extensive trauma histories, with an average of 4.4 different types of ill-treatment per person, including physical, psychological, and sexual violence. The current mental health burden was extensive with 86.9 percent of clients reporting symptoms of PTSD and/or depression. Clients were evaluated within a clinic structure that intentionally aligns with SAMHSA’s implementation domains of trauma-informed care using a continuous improvement model to reduce barriers to FMEs and promote longitudinal follow-up and referral access. Discussion: This study demonstrates the profound trauma exposure reported by asylum seekers, as well as the adaptation of a SRAC to better respond to complex trauma through intentional structural and leadership decisions. The HRC experience provides a blueprint for other asylum clinics to implement systematic trauma-centered services.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Asylum seeker trauma in a student-run clinic: reducing barriers to forensic medical evaluations

Gallagher

Steiner

Michel

et al. 2022

torture

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“…The unique student-faculty hybrid nature of the MSHRP's leadership was also cited by students as a factor which made the clear delineation of roles and responsibilities more challenging at times. Yet, the successes of the MSHRP in its ability to serve an increasing number of clients each year and to educate an expanding segment of the medical school and community [33] demonstrates that success is achievable, a fact that may encourage students at other institutions who are seeking opportunities to start a human rights program.…”

Section: Discussionmentioning

confidence: 99%

Medical Student Involvement in a Human Rights Program: Impact on Student Development and Career Vision

Schonholz

Edens

Epié

et al. 2020

Annals of Global Health

Self Cite

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Background: There is consensus among many medical school deans that exposure to human rights is a necessary component of physician training [7, 8], however little is known about the impact of engagement in human rights programs on students' personal and professional development [15-28]. Objective: This study aimed to examine medical students' experiences in the Mount Sinai Human Rights Program (MSHRP), their motivations for involvement, and the possible influence of engagement on their professional identities, personal growth, and career choices. Methods: Through semi-structured interviews, this qualitative study gathered the experiences of 15 fourth year and recently graduated medical students who participated in the comprehensive training, research, and direct service opportunities provided by the program. Responses were coded using a content analysis approach. Findings: The results of this research highlight the motivations behind students' involvement in a medical human rights program, as well as the challenges they experienced engaging with this work. The study captured students' perceptions of the role of the program on their personal growth, clinical skills, and career vision. Nearly all the students interviewed indicated they developed important, clinically applicable skills that enhanced their traditional medical education. Students indicated that their participation directly influenced their professional identities and future career directions by reinforcing previous interests in human rights and social justice work, impacting medical specialty and residency program selections and fostering commitment to working with immigrant populations. Conclusions: The results of this study indicate that longitudinal involvement with the MSHRP contributed to the acquisition of important clinical skills that were not otherwise attained in students' early medical education. Findings suggest that there is significant opportunity for clinical and leadership development outside the traditional preclinical and clinical setting, and that exposure to human rights education shapes students' professional identities and career paths. Finally, the findings highlight the essential role of human rights and social justice in medical education.

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“…This issue is not limited to only this province of Pakistan but worldwide annually 18 million people die because of lack of health facilities (Ma et al, 2020). The forced migration also created health related issues and lack of access to this basic human right (Ruchman, 2020). The forced migration took place in many areas of Khyber Pakhtunkhwa due to rise of terrorism, war of terror and natural disasters which created a lot of health problems to the displaced people.…”

Section: Factors Affecting Human Rightsmentioning

confidence: 99%

Factors Affecting Human Rights in Khyber Pakhtunkhwa, Pakistan

Khan¹,

Yan²,

Naeem³

2021

Grassroots

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In Khyber Pakhtunkhwa the situation of human rights is comparatively worse. Factors affecting human rightsin thisprovinceincludefailure to guarantee good governance,growingpoverty, illiteracy, violence, terrorism, worseningsecurity, social injustice, political instability, and economic turmoil. These factors have been affecting adversely the human rights.To ensure human rights in the province, theexecutionof international human rights laws needs to be implemented.It is required to ensure good governance, peace and stability to ensure viable environment, provision of sustainable and quality education and reduce poverty. Unless the favourable environment beprovided to the people at large, human rights violations may be continued. This paper attempts to know about the factors affecting human rights in the province and present some solid recommendations and policy options.

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A toolkit for building medical programs for asylum seekers: Resources from the Mount Sinai Human Rights Program

Cited by 9 publications

References 21 publications

Asylum seeker trauma in a student-run clinic: reducing barriers to forensic medical evaluations

Asylum seeker trauma in a student-run clinic: reducing barriers to forensic medical evaluations

Medical Student Involvement in a Human Rights Program: Impact on Student Development and Career Vision

Factors Affecting Human Rights in Khyber Pakhtunkhwa, Pakistan

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