A cruel betrayal: the violation of confidentiality between refugees and doctors in detention centers
Congress will hear legislation to end the administration's cruel practice of using confidential counseling notes against immigrants in their asylum applications.
As the Democratic nomination primaries and the end of President Trump’s impeachment distracted the country, his administration intensified strategies against the immigrant community, especially against asylum seekers on the southern border.
As reported by the Washington Post a couple of weeks ago, a Northern Virginia court saw an ICE attorney use a medical report against the application of Honduran teenage immigrant Kevin Euceda, who has been in custody for more than two years while he appeals his asylum claim.
A therapist at a government shelter for immigrant children, who had assured Kevin that his sessions would be confidential, had given the agency a report that exposed "stories of physical abuse, neglect and gang affiliation in his home country," the Post said.
“Unaccompanied child self-disclosed selling drugs. Unaccompanied child reports being part of witnessing torturing and killing, including dismemberment of body parts,” the report said.
It was at this point that both Kevin and his lawyers realized that his own confidential account to the therapist had followed him from shelter to shelter, making the case against him, and arguing for his detention and deportation.
“This kind of information sharing was part of a Trump administration strategy that is technically legal but which professional therapy associations say is a profound violation of patient confidentiality,” the Post explains. “To bolster its policy of stepped-up enforcement, the administration is requiring that notes were taken during mandatory therapy sessions with immigrant children be passed onto ICE, which can then use those reports against minors in court.”
This includes intimate confessions and personal traumas that immigrants have not authorized to be shared publicly.
The protocol for screening immigration detainees crossing the border was instituted in 1997 by a court agreement that requires "children to meet with counselors within 72 hours of entering custody, and then at least once a week until their release.”
While the intention was to offer advice and support to children in coping with detention, the Office of Refugee Resettlement (ORR), under the direction of Scott Lloyd, implemented in 2017 the separation of children who confessed to their therapists that they had gang ties and thus ensured their detention.
A year later, ORR signed a formal memorandum of agreement with ICE to share the children's details and outline "the weekly counseling sessions where (the children) could self-disclose criminal or gang activity.”
The memorandum included two extra requirements: “one that arriving children be informed that while it was essential to be honest with staff, self-disclosures could affect their release and the other that if a minor mentioned anything having to do with gangs or drug dealing, therapists would file a report within four hours to be passed to ICE within one day.”
Last week, 41 national mental health organizations signed a joint letter delivered to Congress demanding oversight hearings on the practice, described by the American Psychological Association as "a shocking violation of privacy" and "a violation of widely accepted ethical health standards.”
In addition, Senator Ron Wyden (D-Ore.) and Senator Elizabeth Warren (D-Mass) wrote to the Department of Health and Human Services (HHS) and ICE: "vulnerable and traumatized children cannot give meaningful consent.”
In response to the widespread condemnation, shelters like the one in McAllen, Texas, imposed that therapists no longer tell children that their sessions will be confidential, a spokesperson told the Post, and the therapist who signed the report used against Euceda has resigned.
Last Wednesday, a coalition of Democratic representatives introduced legislation to completely suspend the use of confidential information.