Translating horror into justice: Stanford mental health physician advocates for human rights

IMG_9409
Photo taken in Fiji courtesy of Daryn Reicherter

It may seem obvious that the trauma of genocide, mass killings, rape and torture will cause mental health issues in the victims. But courts require evidence. So the Human Rights in Trauma Mental Health Program at Stanford provides the evidence needed in such judicial processes.

The program is an interdisciplinary collaboration between the WSD Handa Center for Human Rights and International Justice, Stanford Law School and Stanford University School of Medicine. I recently spoke with Daryn Reicherter, MD, a Stanford psychiatrist and the director of the program.

How did you become a human rights advocate?

“I was clinically treating survivors of human rights violations at refugee clinics and the center for survivors of torture. So I became familiar with treating issues like depression and post-traumatic stress disorder. And the very obvious cause of the mental health issues I was seeing was political trauma and torture — basically human rights violations.

Another major catalyst was working with the bigger network that supports these patients, particularly human rights attorneys. I’ve remained involved with the clinical part, the rehabilitation of victims of human rights violations. As doctors, my colleagues and I are starting with patients who already have terrible outcomes because of what happened to them. The attorneys are starting with how to get people access to mental health resources, or how to stop a crime from ever happening or how to hold a human rights violator accountable in a court. I started recognizing that the person in front of me has a larger problem that affects more people. So I started collaborating on how to use the science of psychology to make changes in human rights.

What kinds of traumas does the program handle?

“Our program has worked on a whole bunch of different projects, spanning from mass rapes in the Central African Republic to torture in Somalia. We’ve even worked on preventing California from putting men in solitary confinement for longer than 10 years.”

What is your role?

“We consult with attorneys who are trying to use the science of mental health to demonstrate a point about human rights violations. Our final product is usually a written report about an individual or situation, which is used by the attorneys in court. And we’re often asked to testify to clarify things in the report.

For instance, we write expert reports demonstrating that individuals have post-traumatic stress disorder from torture, which is likely to help them win asylum in immigration courts around the world.  And if there are many asylum claims that outline human rights violations happening in a country, we put together a report that is delivered to programs concerned with human rights violations and that ultimately may help create sanctions against the country that’s committing the violations.”

What is it like to work in international courts?

“I’ve testified at the  International Criminal Court on two occasions. In U.S. courts, lawyers argue in front of judges. In international courts, it’s really a dialogue between attorneys, judges and experts. And that’s very exciting.

Being an expert witness for something that’s so clear cut is actually quite simple. For instance, I testified in an egregious child rape case in the Fiji High Court. I presented evidence showing the man that raped his daughter over 300 times caused a lot of damage to her psychology, including the likelihood of her suffering from PTSD, depression, regular nightmares and other mental issues. The man got a life sentence, which had never happened before. And the attorney also used our report and my testimony in the Fiji Supreme Court, which extended the possible sentence for child rape. That’s exactly how our program hopes to work with attorneys and courts, in the U.S. and internationally.”

How do you personally cope with this work?

“I’m passionate about doing clinical treatment, but I actually find it to be more emotionally challenging than my advocacy work. It’s more difficult to work with somebody who’s been through this kind of human rights violations than to write a detailed report, go into a court of law and present the facts.

And in court, I sometimes see justice. I see reparations given for mental health. I see someone winning asylum because they really ought to, and now they have access to mental health treatments. So for me the program is the morale booster.

Of course, I still need self-care. I can recall five or 10 stories that in an instant can bring tears to my eyes. And I’ve heard some stories I wish I could un-hear, but that’s the reality. If I’m able to translate that pain and grief into something that’s advantageous for that person or situation, wow, that’s power. And overall, I find our program to be very light, not dark.”

What are your future goals?

“We don’t want to be limited to cases with data published in psychiatry journals, but our program doesn’t have the manpower to collect all the data needed for court cases. So we’re developing validated screening tools from the Diagnostics and Statistical Manual of Mental Disorders that shouldn’t require an expert for data collection.

For example, if our attorney colleagues can ask a five-point questionnaire to see if someone has the hallmark symptoms of PTSD, then we can interpret the data. I think that’s the next big thing for our program, in addition to continuing and expanding our cases.”

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.

Advertisements