Telepsychiatry for Asylum Seekers May be Effective, Improve Access

Psychiatric evaluations of asylum seekers exhibit similar efficacy as those conducted in person, according to retrospective study results published in Psychiatry Research.

To be granted asylum in the United States, applicants must demonstrate proof of persecution or credible fear. As part of the asylum process, mental health professionals frequently provide supporting evidence and information. However, access to professionals may be limited, with some asylum seekers residing in remote areas or detention centers.

Researchers at the Icahn School of Medicine at Mount Sinai in New York City compared in-person with telephonic psychiatry evaluations by examining evaluation affidavits and performing voluntary interviews with providers. Data were provided by The Mount Sinai Human Rights Program; qualitative and quantitative statistical analyses were conducted.

Affidavits were gathered for 20 in-person and 10 telephonic interviews. The majority of the affidavits corresponded to asylum seekers originating from Central America.

Researchers found a minor, statistically insignificant difference in affidavit quality between the 2 evaluation modalities, which were both comparable and effective for 26 clinically relevant areas. Telephonic evaluations were lacking in a few metrics, including notes on cognitive complaints and motor activity. According to the analysis of provider interviews, both formats allowed for proper diagnosis and evaluation of asylum seekers.

Overall, the study replicated favorable findings for the ability of telepsychiatry to improve accessibility for certain populations, including veterans.

The study was limited by the low number of mental health providers willing to conduct telephonic evaluations.

“Further research could explore teleconference (video) interviews as a potential new avenue to allow interviews to be conducted remotely while allowing the interviewer to observe the client,” the researchers concluded.

Reference

Bayne M, Sokoloff L, Rinehart R, Epie A, Hirt L, Katz C. Assessing the efficacy and experience of in-person versus telephonic psychiatric evaluations for asylum seekers in the U.S. Psychiatry Res. 2019;282:112612.