The global movement against torture depends on accurate identification of torture survivors. At the organisational level, accurate counts of survivors are often crucial to funding. At the individual level, accurate identification is essential to providing survivors with the resources to which they are legally entitled. However, due to factors such as the complex and varying legal definitions of torture and the risk of retraumatisation, the systematic and valid identification of torture survivors remains challenging. Past research has shown that both false positives and false negatives are common and that results differ depending upon how torture is assessed.
Participants in Healing Hearts, a randomised control trial focused on integrated care that is run by the Center for Victims of Torture, are asked about their torture history when they are screened for the study. Because being a torture survivor is not an eligibility requirement for the study, this process is intentionally relatively brief. However, dependent upon treatment status, there are later time points, within varying contexts, at which disclosure of torture experiences could occur—such as in appointments noted in a client’s chart or at an semi-structured qualitative interview offered upon exit from the study. Our analysis compares the rate of torture disclosure at different points through the clinical and research pathway of the study for exited participants (approximate n = 120). Our objective is to identify best practices in assessment for torture survivor identification that balance the well-being of the client with gathering accurate data. Healing Hearts has been approved by the Institutional Review Boards of the University of Minnesota, HealthEast, and the Minnesota Department of Human Services.
We found that a significant percentage of study participants were incorrectly classified with respect to torture history based only on the brief screening and that some participants disclosed torture at later points, within varying clinical and research contexts. A closer analysis of this group revealed common patterns in torture disclosure that are linked to particular contextual and methodological variables. We will also describe cases in which a survivor of torture was not identified as such at certain points. Based on these cases, we offer recommendations for good practice in identifying torture survivors from an evaluation perspective.
Funding & No Conflicts Declaration
We are not aware of any conflicts of interest between local funders of the study, the authors, and sponsors of the IRCT Scientific Symposium.