Severe post-traumatic disorder leading to failure of passing asylum interview\u2014a case report

Regina Baronia,Ashish Sarangi,Sabrina Deleon,Yasin Ibrahim,Rosalinda Jimenez

doi:10.1186/s43045-021-00098-5

Regina Baronia, Ashish Sarangi + Show 3 more

Open Access

https://doi.org/10.1186/s43045-021-00098-5

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Abstract

BackgroundAsylum applicants can benefit from psychiatric evaluation which can explain how culture and mental health symptoms relate to perceived deficits in credibility.Case presentationMs. B presented for psychiatric evaluation, seeking asylum in the USA after multiple threats on her life in Honduras. At initial evaluation, she was diagnosed with depression. On reevaluation, she was found to have panic attacks and post-traumatic stress disorder. Recommendations included an anxiolytic medication and the use of pre-written statements upon interview. However, Ms. B was sent back to her country of origin despite her severe mental symptoms.ConclusionPost-traumatic disorder scales should be used by mental health professionals especially with patients who are not forthcoming about past trauma history to avoid missing this diagnosis. There is a need to inform immigration officials and lawyers about the necessity of accommodating clients’ needs to appropriately present themselves in asylum interviews.

Highlights

Asylum applicants can benefit from psychiatric evaluation which can explain how culture and mental health symptoms relate to perceived deficits in credibility.Case presentation: Ms B presented for psychiatric evaluation, seeking asylum in the USA after multiple threats on her life in Honduras
After the initial psychiatric evaluation, the patient was interviewed by an asylum officer and was unable to respond to questions regarding her trauma
After re-evaluation by the psychiatrist, Ms B was diagnosed with panic attacks secondary to post-traumatic disorder (PTSD) and recommended to receive an anxiolytic prior to the asylum interview as well as accommodations to read pre-written statements and to respond to questions in writing if unable to speak

Summary

Conclusion

Post-Traumatic Stress Disorder is one of the psychiatric disorders that persons seeking asylum often present with to the USA. The source of this trauma is often gangrelated violence and riots in the patient’s country of origin. Patients with PTSD often have comorbid panic attacks which leads to avoiding reminders of their trauma due to a fear of repeated panic attacks. The avoidance symptoms of PTSD in this population can pose a challenge in obtaining accurate history of trauma and hinder their ability to gain asylum rightfully. Asylum officials should be reminded and encouraged to offer the appropriate accommodations to asylum seekers with mental health disorders

Background

Discussion