By Léonce Byimana, CVT director of U.S. clinical programs

CVT recently helped a group of individuals who had been held as political prisoners in Nicaragua under conditions widely reported to include torture and inhumane treatment. They arrived in the United States and in a short period of time, we took steps to support their mental health needs and help them begin to navigate this enormous transition.

In a matter of days, we worked with partners to set up a welcome for the group of 222 individuals. From touchdown of their plane, we were there to provide help. Then, as they moved out to their next locations, we began destination case management, which is a form of care where a case manager follows a guest wherever they are on their journey to connect them to the services they need. When they arrive to their destination, the case manager continues to provide resources and assist for about six months.

Because of the background information we had about conditions in the prisons, we brought trauma-informed practices into our planning. We knew it would be challenging and stressful for them to be in a new country, speaking Spanish, and being without their families. Because of that, we ensured that all 222 guests had access to a therapist who spoke Spanish and could assist them if needed. And we worked with partners to train all the volunteers who were involved in the welcoming process. In addition, we had a psychiatrist on site for care and help with medications.

We also knew that many of the guests had suffered both physical and psychological torture.”

We also knew that many of the guests had suffered both physical and psychological torture. It had been reported that many had been beaten up, forcibly removed from their homes or kidnapped without knowing where they were going, and then kept away from their families without communication.

We considered these kinds of traumatic experiences and associated impacts when we planned for their arrival. We worked with partners regarding who would greet them, where they would go, and what kinds of needs they would have. For example, we knew they would be met at the airport by U.S. Customs and Border Patrol (CBP) officers as their first contacts. When people have a history of being tortured by police, encounters with uniformed law enforcement can cause further trauma. For this reason, I trained more than 100 CBP officers on effective methods for working with people who have survived torture, focusing on how to be supportive and how to help them without intimidating them.

The first three days, the guests stayed in a hotel and many seemed to be doing well. However, that was only if you looked from the outside. From the quick mental health assessments we did for more than 150 of them, we referred 66 for one-on-one emotional support from a psychologist. We also looked at their immediate, medium- and long-term needs so that we could be their link to other services coordinated at the hotel, including everything from help with housing, work permits, access to food, and access to vaccination and health care, which included physical and mental health.

One person told me that it removed anxiety in a new country without their family to know that we would be there on their journey.”

The support for mental health was especially important because of their past torture experiences. And to make things even harder, when they were released, they were stripped of their citizenship, rendering them stateless. The impact of this is huge. And many of them told me of the stress they already had because during their detention and even after their release, their families were being harassed by government officials and police back in Nicaragua. All of these factors created a very difficult situation for them.

At this time, however, the 222 guests are in new locations, focused on obtaining work permits and finding longer-term housing. The next priority will be related to their separation from their families. Being away from loved ones is a big cause of anxiety, and CVT and partners can provide some mental health support during this time. Several of the guests told me they appreciated knowing that we will follow up with them and call them wherever they are in the country to connect them to services and offer support. One person told me that it removed anxiety in a new country without their family to know that we would be there on their journey.

About The Author

Léonce Byimana

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