UNIVERSITY OF CALIFORNIA DAVIS ARAB REGION CONSORTIUM
UC Davis Refugee Law-Mental Health Intersection Forum
PI: Raquel E Aldana and Patrick Marius Koga
Thanks to a generous seed grant from UC Davis Global Affairs, Associate Vice Chancellor for Academic Affairs and Professor of Law Raquel Aldana, and Director of Refugee Health Research and Assistant Professor of Public Health, Dr. Patrick Marius Koga, hosted the first UC Davis Refugee Law-Mental Health interdisciplinary gathering at the medical school on November 9, 2018. Fifty two professionals from twenty countries that included lawyers, mental health providers, refugee resettlement practitioners, researchers and academics, and leaders of medical associations or non-profits, came together to share experiences, discuss issues, and start to identify policy recommendations in the spaces where science about trauma could inform the treatment and adjudication of trauma association with forced migration at all stages of their journey, from the push factors provoking flight, the treacherous migration journey, the harsh treatment in the legal system, and through the challenges of resettlement.
All of the participants came with vast experience in working with forced migrant communities and nearly all were connected based on previous collaborations or interactions with AVC Aldana, with Dr. Koga’s Ulysses Refugee Project, and with Professor Suad Joseph’s Transforming Refugee Mental Health (TRMH) Project. In her welcome remarks, AVC Aldana acknowledged that the most important success of the day had been to gather in one room and to recognize each other in their work and begin to feel less isolated and even more hopeful in the knowing that their work is widely shared by a community of dedicated and exceptional professionals. In a social media posting that day, Professor Holly Cooper, co-Director of the UC Davis Immigration Law Clinic commented: “Mind blown by the UC-Davis Law-Mental Health Intersection Forum. A room full of lawyers, doctors, and nurses from Haiti, Congo, Iraq, Mexico, Iran, Afghanistan, India, Lebanon, Palestine—with one clear goal: to make this world a better place of all people regardless of race.”
The day began with welcome remarks from Law School Dean Kevin R. Johnson who celebrated the amazing diversity of the participants and also expressed his sense of urgency and importance of the gathering at a time when the vulnerability of forced migrants has been worsened even more by the current anti-immigrant climate and responses they experience not just in the United States but in many parts of the world. After heartfelt introductions expressing excitement and gratitude, eight inter-disciplinary focus groups came together to discuss for an hour and a half five questions that ranged from sharing their experiences with trauma as part of their work or even personally to the identification of policy prescriptions and best practices informed by evidence based science on trauma. Associate Dean and Department Chair for Public Health Sciences Dr. Brad Pollock spoke during lunch to congratulate the organizers and participants for the fertile cross-collaboration between law and medicine to improve the lives of refugees. Following lunch, six experts offered their unique vantage point reflections. Dr. Sergio Aguilar-Gaxiola, Director of the UC Davis Center for Reducing Health Disparities and Professor of Clinical Internal Medicine, spoke about the acculturation impacts on mental health of Latino men who migrate to the U.S. emphasizing the protective effect of retaining one’s native roots (“la cultura cura”). Dr. Fahim Pirzada spoke about the Afghan refugee resettlement experience emphasizing how premigration war traumas are exacerbated by postresettlement disorientation, disillusionment, and everyday life difficulties. Dr. Caroline Giroux, UC Davis Associate Clinical Professor of Psychiatry and Behavioral Sciences, spoke about RESTART, a novel approach in psychiatry to trauma treatment. Co-piloted by Drs. Giroux and Andres Sciolla, RESTART is anchored in trauma-centered psychotherapy, ACEs Overcomers Program, mindfulness-based stress reduction, resilience support, and social justice. UC Davis Clinical Law Professor Holly Cooper, one of lawyers in the case that led to the Flores settlement establishing minimum standards the treatment of children in immigration detention, focused on the retraumatizing of children by the U.S. legal system and highlighting the unfortunate return of pre-Flores practices and worse in recent years. Attorney Katie Fleming, removal defense lawyer for the F.U.E.L. project at the California Rural Legal Assistance Foundation, focused on the trauma experienced by adults in immigration detention and her work with immigrants with mental illness in immigration custody. Finally, Dr. Fatima Karaki, Assistant Professor of Medicine and Director of UCSF Refugee and Asylum seeker Health Initiative (RAHI) discussed the commitment to develop sustainable, evidence-based clinical interventions for refugees and asylees, and to foster high-quality research in order to improve the quality of refugee healthcare treatments and outcomes. Dr. Koga closed the day with a discussion of the next steps. This will include the publication of the results of the focus groups and a reconvening in March 2019 of the group with many more guests, including neuroscientists from the UC Davis Mind Institute, policy makers, legislators, researchers and practitioners who wish to convert the wealth of knowledge generated through this inter-disciplinary dialogue into policy recommendations to improve the lives not only of forced migrants but of all persons who have experienced trauma.