Mental health expertise in refugee status decision-making: judging or caring?

Therapeutic and legal methodologies address credibility assessment in crucially different ways. These differences can generate mistrust and antipathy between refugee decision-makers and mental health professionals whose expert assessment reports are offered to assist decision-making. The anthropologist Good, quoted above, provides a graphic expression of one aspect of this discipline rift, highlighting the contrast of focus between the decision-maker's perspective and the therapeutic lens in the highly sensitive legal environment of refugee determinations. Here a high percentage of applicants exhibit psychological sequelae of trauma. In addition, cultural and linguistic differences add to the challenge. These elements are particularly pertinent where, as is often the case, the applicant's story is the pivot of his or her claim for protection. This article draws upon an Australian cross-disciplinary empirical study (known as the Tales study) in which the authors and psychology and psychiatry colleagues explored the propensity for psychologists and refugee decision-makers to misunderstand each other's perspectives. The authors discuss the reasons why such misunderstandings arise, and the consequences for the decision-making process, and conclude with reference to guidelines developed from the Tales study which are intended to assist those providing expert opinions, decision-makers, and representatives.