United States Department of Justice
Executive Office for Immigration Review
Board of Immigration Appeals

PSYCHOLOGICAL EVALUATION

Name:
Date of birth:
Place of birth:
Gender:
Age at evaluation:
Dates of evaluation:
Total interview time:
Language of interviews:

Mr. Emilio Gutierrez-Soto
June 18, 1963
Nuevo Casas Grandes, Chihuahua, México
Male
54
January 23 & 24, 2018
5 hours
Spanish

Context of the Assessment
On January 23rd and 24th, 2018, Mr. Emilio Gutierrez-Soto participated in two psychological
assessment interviews lasting a total of 5 hours at the El Paso Processing Center, where he is
currently detained. As was requested by Mr. Gutierrez-Soto’s attorney, Mr. Eduardo Beckett,
I travelled from California to Texas in order to meet with Mr. Gutierrez-Soto and conduct these
interviews to assess his current psychological wellbeing as it relates to past experiences in his
country of origin, Mexico, as well as his experiences since arriving in the United States with his
son Oscar.
The forensic psychological evaluation for Mr. Gutierrez-Soto was conducted on a pro bono
basis, and under the umbrella of Partnerships for Trauma Recovery (PTR), a 501(c)(3) nonprofit organization in Berkeley, California. PTR provides psychological and psychosocial care
for international survivors of human rights abuses, including those who have fled persecution
and interpersonal violence in their countries of origin due to their identity, activities or beliefs.
Mr. Gutierrez-Soto was referred to PTR by his attorney Mr. Beckett to assess for any
psychological consequences of the alleged dangerous and threatening experiences he
suffered as a journalist in Mexico, as well as any current psychological difficulties he is
experiencing in immigration detention. The first assessment interview lasted for 3 hours, and
the second one for 2 hours, and were conducted in Spanish, Mr. Gutierrez-Soto’s native
language in which I am also fluent. During our second assessment meeting on January 24th,
2018, I had the opportunity to meet with Mr. Gutierrez-Soto’s son Oscar Gutierrez-Soto, both
individually and in conjunction with his father.

 PTR’s psychological and psychosocial assessments include in-depth structured clinical
interviews exploring the experiences of international survivors of human rights abuses, as well
as the administration of the World Health Organization Quality of Life measure (WHOQOLBREF), the Hopkins Symptom Checklist-25 (HSCL-25) and the Posttraumatic Stress Disorder
Checklist (PCL-5), to evaluate the domains of physical health, psychological health, social
relationships and environment, and assess for symptoms of post-traumatic anxiety and
depression. These measures are commonly used with refugees and asylum seekers both
domestically and internationally. Prior to the evaluation I reviewed Mr. Gutierrez-Soto’s
asylum affidavit, the written decision pertaining to his asylum claim rendered by the
Immigration Judge on July 17, 2017, and other documents shared with me by his attorney.
Upon meeting with Mr. Gutierrez-Soto in the El Paso Processing Center contact room, I
explained to him the evaluation process, and that I would be sharing my findings with his
attorney. Mr. Gutierrez-Soto signed a written consent allowing the evaluation to proceed.
Qualifications
Qualifications allowing me to render a psychological opinion in this case are outlined in the
attached curriculum vitae. I am a licensed clinical psychologist in the state of California
(PSY24660) and a clinical social worker, with specialization in global mental health for refugee
and asylum seeking populations, and in the assessment and treatment of trauma. I received
my Doctorate in Clinical Psychology from the Wright Institute in Berkeley, California, and a
Master of Science in Clinical Social Work from Columbia University, New York. For the past 20
years, I have been providing clinical services for traumatized migrant, refugee and asylum
seeking populations both nationally and internationally. I have worked with local torture
treatment centers in South Africa and Cameroon, where I provided psychosocial care for urban
refugees and asylum seekers, as well as clinical capacity-building for national staff. Between
2002 and 2012, I provided psychological services for survivors of torture, war trauma and
gender-based violence at the San Francisco torture treatment program Survivors International.
At the International Rescue Committee of Northern California, I was the Clinical Manager of
the Center for Wellbeing in Oakland between 2012 and 2016, where I developed a mental health
program for resettled refugees, as well as a clinical training program for graduate students in
psychology and social work.
At present, I am the Clinical & Training Director of Partnerships for Trauma Recovery, which I
co-founded in 2015. In this setting, I oversee our Mosaic Healing Center which serves over 100
refugees and asylum seekers from more than 30 countries per year. Additionally, I lead a
yearlong clinical training program for 10 graduate students in clinical psychology and social
work, and continue to provide direct clinical care for international survivors of human rights
abuses. I have conducted over 50 forensic psychological evaluations for asylum claims, and
testified as an expert witness at the San Francisco Immigration Court. I also train and supervise
our graduate students to conduct psychological evaluations for asylum seeking clients
receiving care at PTR.
2

 Psychological Assessment
Behavioral Observations & Mental Status Exam
When Mr. Gutierrez-Soto entered the El Paso Processing Center contact room, he was dressed
casually in his detention facility clothing. He was slender and of medium stature, and greeted
me with a friendly handshake and a cautious smile. His hair was wispy and grey, and seemed
to not have been cut for some time. His face wore a sad and tired expression, and he appeared
slightly older than his stated age of 54. Mr. Gutierrez-Soto respectfully waited to sit down until
I welcomed him to do so. He was courteous, soft-spoken and cooperative throughout the
assessment process, and expressed much appreciation for the opportunity to speak with a
mental health professional about his experiences, his current psychological and emotional
state, and his health concerns.
Mr. Gutierrez-Soto described his mood as chronically worried, as well as sad, discouraged and
frustrated. He reported being continuously fearful for his own safety and wellbeing and that
of his son, and of being terrified of being sent back to Mexico where he believes he would
encounter life threatening danger. During our two interviews, Mr. Gutierrez-Soto’s affect was
depressed, and he became tearful on several occasions. He became especially distraught when
speaking of his son Oscar, and the harm he believes he has caused him because of his work as
a journalist. He expressed intense feelings of guilt about the difficulties they have both
encountered over the course of many years as a result of his professional activities in Mexico.
Mr. Gutierrez-Soto expressed deep concern for the wellbeing of his son, who has experienced
long-term insecurity and instability related to Mr. Gutierrez-Soto’s reporting activities, and
since their flight to the United States in search of safety.
Throughout the assessment Mr. Gutierrez-Soto was personable, open, gracious and able to
relate with ease. He was fully oriented, his thought processes were clear and logical, and he
denied any thoughts of harming himself or anyone else. Mr. Gutierrez-Soto interacted with
respect and thoughtfulness, demonstrating sound judgement and capacity for reflection.
Traumatic Life Experiences
Threats by Mexican Military Related to Reporting Activities
Mr. Gutierrez-Soto was born in Nuevo Casas Grandes, in the state of Chihuahua in Northern
Mexico. He grew up in a modest family and small town environment, where he completed his
upper secondary education. Over the following several decades, he developed his professional
life as a journalist and reporter with a number of local newspapers. Mr. Gutierrez-Soto stated
that he was initially drawn to journalism through photography, and gradually became involved
in writing and reporting about local news and events. He described a deep passion for and
commitment towards his career, and a profound sense of loss that he has no longer been able
to engage in this work since fleeing Mexico a decade ago.
3

 With regard to his family, Mr. Gutierrez-Soto explained that the relationship between himself
and his son’s mother had unfortunately not lasted, and he had become his son’s sole guardian
since Oscar was a toddler. During the early years, Mr. Gutierrez-Soto’s mother helped him take
care of Oscar. Mr. Gutierrez-Soto recounted with sadness however that his mother passed
away when Oscar was still a young boy, and Mr. Gutierrez-Soto became entirely responsible
for his son after this time. Being a single father was not easy, as Mr. Gutierrez-Soto managed
his full-time reporting responsibilities. It was evident during our interviews that Mr. GutierrezSoto is a deeply committed and loving father, who has done everything in his power to provide
a caring and protective environment for his son.
Before his first encounter with the Mexican military in February of 2005, Mr. Gutierrez-Soto
reported that he had been living a contented and secure life despite increasing violence in
Northern Mexico. He loved his growing son, enjoyed his profession and daily work, had a
partner and friends in his small community, and was satisfied with his life. He stated that he
had no interest in moving or making any significant changes in his life. He explained that he’d
never had a desire or intention to live outside Mexico, and had not wished to leave his life and
community behind, as he was eventually obligated to do.
When I asked Mr. Gutierrez-Soto to tell me about his experiences with the Mexican military, he
drew a sketch in pencil of his encounter with them at the Miami Hotel in Ascension, where they
had summoned him soon after he wrote an article describing their illicit activities. He explained
in detail how soldiers had been positioned in formation along the intersection near the hotel,
and how a military commander flanked by a group of armed soldiers had insulted, humiliated
and verbally threatened him during this confrontation, telling Mr. Gutierrez-Soto he had better
never write another word denouncing the military, or they would silence him for good. Mr.
Gutierrez-Soto reported immense fear for his safety and life during this encounter, and
expressed gratitude that he had not been physically harmed.
During this exchange, Mr. Gutierrez-Soto’s young son had remained inside his truck as he
waited. Mr. Gutierrez-Soto stated that he had not told his son anything either before or after
this encounter at the Miami Hotel, in an effort to protect and not frighten him. When I spoke
to Oscar about his memories of this experience, he stated that his father had seemed very
distraught and frightened when he returned to the truck. His face was ashen and he started
to cry, but did not explain anything to Oscar until much later, when they had to flee the country.
Oscar knew that something was very wrong as his father was unusually distressed, but he was
just a young boy, and did not understand what was happening. He stated that he was unaware
of the danger his father faced until they left for the United States several years later.
When I asked Mr. Gutierrez-Soto what had influenced his decision to keep doing his work,
despite the challenges and dangers he encountered, he responded “I cannot see injustice and
remain silent. Since I was a child, I witnessed so many injustices around me. People were treated
so badly, and I wanted to tell the truth. I cannot be silent when I know something is wrong”.

4

 Intrusion into Family’s Home
After his first encounter with the military in Ascension, Mr. Gutierrez-Soto filed a complaint
with the Human Rights Commission, but continued to fear for his safety, worrying that the
military could threaten or harm him at any moment. His second direct encounter with the
military occurred in May of 2008, when a large group of soldiers came to his home late one
night and forced their way inside, stating that they were searching for evidence of criminal
activity. Mr. Gutierrez-Soto described the men as heavily armed, and explained that they
pointed their weapons at him and forcefully searched his home. Both Mr. Gutierrez-Soto and
his son were terrified by this violent intrusion into their privacy, and Mr. Gutierrez-Soto believes
this was another effort on the military’s part to frighten and intimidate him. After this incident,
Mr. Gutierrez-Soto alerted the police, and then filed another complaint with the Human Rights
Commission. The police never responded to Mr. Gutierrez-Soto’s request for assistance.
During subsequent weeks, Mr. Gutierrez-Soto noticed that people in civilian clothing seemed
to be observing him from outside both his home and his office. He suspected that they were
plain clothed military personnel keeping watch over him, and felt increasingly anxious and
unsafe. Due to his fears, Mr. Gutierrez-Soto began spending some nights sleeping at a friend’s
house with his son. Soon thereafter he received a phone call from a friend who asked to speak
with him urgently. This friend warned Mr. Gutierrez-Soto that there was a potential threat
against his life, and that the military was planning to kill him. At this time Mr. Gutierrez-Soto
felt he could wait no longer. The friend who warned him took him to the home of another
friend on a ranch outside of town. Mr. Gutierrez-Soto and his son hid there for some time until
they left for the United States’ border to request political asylum. Fearing for his life and the
safety of his son, Mr. Gutierrez-Soto believed he could no longer safely remain in Mexico.
Request for Asylum and Experiences in Immigration Detention
Mr. Gutierrez-Soto and his son arrived at the Antelope Wells border crossing between
Chihuahua and New Mexico in June of 2008, requesting asylum. Upon entry to the United
States, Mr. Gutierrez-Soto was held in immigration detention for approximately seven months,
and his son Oscar for a shorter period of time. Mr. Gutierrez-Soto’s first immigration court
hearing took place in November of 2016 - 8 years and 5 months after his arrival and his request
for political asylum. This was a considerable amount of time for Mr. Gutierrez-Soto to await
adjudication of his case, which caused him significant distress as he lived with the uncertainty
of his legal status in this country, not knowing if he would be obliged to return to Mexico where
he feared death. In July of 2017, his application for asylum was denied, and is now being
appealed by his attorney Mr. Eduardo Beckett.
Mr. Gutierrez-Soto recounted that in early December of 2017, he and his son were apprehended
and taken into custody. Mr. Gutierrez-Soto described with considerable anxiety how he and
Oscar were taken to a border station. Here, they were told by officers accompanying them
that they would be imminently deported and handed over to Mexican officials on the other
side. Mr. Gutierrez-Soto reported that he was in a state of terror at that moment, imagining
5

 himself being apprehended by the Mexican military very soon after crossing back into Mexico,
and being killed shortly thereafter. He described trembling and shaking with intense fear and
dread, imagining that his life would be short lived, and terrified of what would become of his
son. Mr. Gutierrez-Soto and his son were not deported however, as their emergency stay of
removal was granted while they were at the border station. They were subsequently taken
into immigration detention, where they remain.
Mr. Gutierrez-Soto and his son Oscar are thus being held in immigration detention for the
second time since arriving in this country and seeking asylum almost a decade ago. Both father
and son recounted during our assessment interviews how difficult their current situation in
detention has been, and how much emotional, mental and physical distress it is causing them.
Mr. Gutierrez-Soto reported that he did not commit any crimes or break any laws since arriving
in the United States. He complied with immigration requirements, and followed the laws and
rules of this country. Mr. Gutierrez-Soto was able to make a living by selling food and doing
different kinds of work in his small New Mexican community of Las Cruces. Oscar went to
school and was attending college until the family was taken into custody. Father and son made
friends and developed close community ties in Las Cruces, despite the psychologically insecure
conditions under which they were living.
Based on their descriptions, my impression is that they were adapting as best could be
expected for a family in their circumstances, while demonstrating significant resilience,
responsibility and courage. It appears that they are highly respected and appreciated by
community members in Las Cruces, who continue to provide support and encouragement
through weekly visits to the El Paso Processing Center. Mr. Gutierrez-Soto spoke of how
meaningful and helpful these weekly visits are for him as he struggles to maintain hope, and a
sense of connection to the world outside the detention facility. He became tearful as he spoke
of feeling grateful and cared for by these friends and supporters who feel like family.
In 2012, the United Nations High Commissioner for Refugees (UNHCR) published their
“Guidelines on the Applicable Criteria and Standards Relating to the Detention of AsylumSeekers and Alternatives to Detention”. This United Nations international document states
that “Detention can only be exceptionally resorted to for a legitimate purpose… In the context
of the detention of asylum-seekers, there are three purposes for which detention may be
necessary in an individual case, and which are generally in line with international law, namely
public order, public health or national security.”1 Based upon my evaluation of Mr. GutierrezSoto’s psychological health, and in my professional opinion as a psychologist, he does not
appear to present a threat to public order or public health.

1 United Nations High Commissioner for Refugees (UNHCR), “Guidelines on the Applicable Criteria and Standards relating to the Detention of
Asylum-Seekers and Alternatives to Detention,” 16-17 (2012), available at http://www.unhcr.org/refworld/ docid/503489533b8
6

 Post-Traumatic Symptoms & Diagnostic Impressions
It was evident throughout the evaluation process that the threats and intimidation Mr.
Gutierrez-Soto encountered from the Mexican military in association with his work as a
reporter, as well as his experiences of near-deportation and immigration detention have
considerably impacted his emotional health and psychological wellbeing. During both our
assessment meetings, Mr. Gutierrez-Soto reported and demonstrated considerable distress,
including being tearful and struggling to hold back tears, and showing symptoms of anxiety
and depression. Mr. Gutierrez-Soto’s demeanor during the interviews and his report of
symptoms were consistent with diagnoses of Posttraumatic Stress Disorder and Major
Depressive Disorder, as defined by the DSM-5 (Diagnostic and Statistical Manual of Mental
Disorders, American Psychiatric Association).
Throughout the assessment process, Mr. Gutierrez-Soto’s report of traumatic experiences, as
well as his description of his emotional state, remained consistent. His report of symptoms
was congruent with what I observed during our meetings, as well as with what is common for
the international survivors of human rights abuses with whom I have worked during the past
two decades. In addition, his reports were consistent with what I have read in the
documentation provided by his attorney.
DSM-5 Diagnostic Assessment
Diagnoses:

Posttraumatic Stress Disorder, chronic (Principal Diagnosis)
Major Depressive Disorder, recurrent, moderate

309.81
296.32

Health Concerns:

Fluctuating high and low blood pressure; chronic and severe headaches/
migraines; high cholesterol; dental pain; allergy to clothing detergent.

Psychosocial
Stressors:

History of trauma involving death threats, surveillance and harassment
by the military; exile and displacement from country of origin; separation
from family, community and social supports; inability to adequately
protect son; loss of career and professional identity; loss of home and
belongings; limited ability to learn English and communicate in country
of resettlement; prolonged stress of immigration procedures; fear of
deportation and death; impact of repeated and indefinite detention;
current stress of conditions in detention.

Post-Traumatic Stress Disorder
On the Hopkins Symptom Checklist-25 (HSCL-25), Mr. Gutierrez-Soto scored 3.1 for Anxiety,
when scores above 1.75 are considered symptomatic. With regard to anxiety, Mr. GutierrezSoto reported feelings of fearfulness and nervousness; intense physiological reactions such as
a pounding and racing heart, and cold hands; chronic and severe headaches/migraines; feelings
of panic, especially related to being separated from his son; feelings of restlessness; fear for
his safety, specifically related to the threats he received from the Mexican military; and terror
at the possibility of being forced to return to Mexico where he fears death.
7

 Posttraumatic Stress Disorder (PTSD) is both a physiological and a psychological stress
response which can occur after a person has experienced or witnessed overwhelmingly
frightening or life-threatening events. PTSD can occur after a single event, or after multiple
traumatic events during which a person has felt intense fear, helplessness or horror. The
intensity of posttraumatic responses is highly individual. Patterns of PTSD symptoms fall into
the three main categories of a) persistent reexperiencing of events; b) avoidance and
emotional numbing; and c) physiological hyperarousal and vigilance. On the PTSD Checklist
(PCL-5), Mr. Gutierrez-Soto scored a total of 48 points, when a score above 33 with adequate
symptom spread indicates a diagnosis of Posttraumatic Stress Disorder. Mr. Gutierrez-Soto
gave clear and detailed examples of the symptoms he endorsed.
Mr. Gutierrez-Soto reported the following symptoms of Posttraumatic Stress Disorder:
1) Repeated disturbing and unwanted memories of his trauma, particularly of the death
threats he received from the Mexican military when he met with them at the Miami
Hotel in Ascension. Mr. Gutierrez-Soto recalls the officer berating and insulting him,
letting him know that any further criticism of the military would lead to a fate similar to
that of drug traffickers whom the military apprehend and take to isolated areas in the
mountains to murder. Mr. Gutierrez-Soto also remembers the night when the large
group of soldiers violently forced entry into his home, and he and his young son were
terrorized by their assault weapons and aggressive manner, not knowing if they were
going to be harmed. In addition, Mr. Gutierrez-Soto recalls an instance when the
military performed an ‘operation’ in a nearby town, during which a close friend of Mr.
Gutierrez-Soto’s was murdered. Approximately 9 people were killed during this night
of terror.
2) Repeated disturbing dreams related to his trauma. Mr. Gutierrez-Soto described
upsetting dreams he frequently has of being pursued, and hiding in isolated places to
avoid violence and death.
3) Recurring fear and feelings of vulnerability. Mr. Gutierrez-Soto described a constant
sense of fear and insecurity, not knowing if he will be allowed to remain in the United
States, and feeling terrified of returning to Mexico where he is certain he would face
further persecution and harm. He said “each time I hear of another Mexican journalist
who was killed, I think of their families. Then I imagine my son, helpless, if that happened
to me”.
4) Sustained efforts to avoid situations, activities, places, objects or people which could
remind him of the trauma. Mr. Gutierrez-Soto does not maintain contact with his
extended family, friends or community members in Mexico. This is in part due to fears
for their safety, as he is aware that their having any contact with him could put them in
danger. His lack of communication is also due to avoidance of any reminders of what
happened, and everything he lost from his former life.
8

 5) Heightened distress when remembering his traumatic experiences.
6) Physiological arousal including pounding and rapidly beating heart, as well as cold
hands, when remembering his traumatic experiences.
7) Strong negative beliefs about oneself, others and/or the world. Mr. Gutierrez-Soto
described in particular a lack of trust in others, and difficulty trusting in the future, or
maintaining hope that his life will improve.
8) Blaming himself for the trauma, or what happened as a result of trauma. Mr.
Gutierrez-Soto experiences debilitating feelings of guilt for having caused so much
distress to his son Oscar, and disruption in his life since childhood. Though Mr.
Gutierrez-Soto believes he did the right thing by denouncing the Mexican military’s
illegal activities, and has a strong sense of purpose in relation to his former professional
work, his feelings of guilt about his impact on his son’s life remain overwhelming. Mr.
Gutierrez-Soto was most tearful and his emotional pain was evident whenever he spoke
about his son Oscar, and the impact his work as a journalist has had on his only child.
9) Experiencing strong negative feelings such as fear, anger and guilt. Mr. Gutierrez-Soto
experiences the full range of these painful affective states.
10) Having difficulty falling and staying asleep. Mr. Gutierrez-Soto described persistent
trouble with severe insomnia and constant fatigue. He reported that he is only able to
sleep about 4 hours each night, and wakes every hour during this time. He stated that
the guards in detention make noise at night, and his sleep is so light that he wakes up
with the slightest sound. Mr. Gutierrez-Soto cannot find rest or respite for his mind or
body during the night.
11) Feeling easily angry and irritable. Mr. Gutierrez-Soto reported significant feelings of
frustration and anger, including in relation to what he described as disrespectful
behavior on the part of detention facility guards. He spoke of insulting and
racist/xenophobic language such as ‘you stupid Mexican’ directed at him by some of the
detention personnel. Mr. Gutierrez-Soto also described crowded communal cell
conditions; a lack of activities except for one hour of time outside the cell each day; and
terrible tasting and non-nutritious food in detention. The detention conditions are
contributing to Mr. Gutierrez-Soto’s feelings of frustration and anger.
12) Being on guard, watchful and alert to potential danger.
13) Feeling jumpy and easily startled.

9

 Major Depressive Disorder
Mr. Gutierrez-Soto also meets criteria for a diagnosis of Major Depressive Disorder, recurrent
and moderate without psychotic features. On the Hopkins Symptom Checklist-25 (HSCL-25),
Mr. Gutierrez-Soto scored 2.6 for Depression, with scores above 1.75 considered to be
significant. Related to Major Depressive Disorder, Mr. Gutierrez-Soto reported and clearly
described the following symptoms with accompanying examples and behavioral evidence:
1) Fatigue and lack of energy. Mr. Gutierrez-Soto reported being constantly tired and
lethargic, and appeared fatigued during our meetings, with dark circles under his eyes.
2) feelings of guilt and self-blame. Mr. Gutierrez-Soto feels tremendously guilty about the
impact his professional activities have had no his son, and how disrupted Oscar’s family
life, schooling and peer relationships have been from childhood, through adolescence
and into his current young adulthood.
3) Being tearful and crying easily. Mr. Gutierrez-Soto reported frequent crying, and
became tearful on several occasions during our two assessment meetings.
4) Poor appetite and weight loss. Mr. Gutierrez-Soto stated that he is unable to eat much
in detention, and reported that he has lost a significant amount of weight. He looked
lean and slight, and his face seemed wearied.
5) Difficulty sleeping and insomnia. Mr. Gutierrez-Soto reported constant waking and
only managing to sleep about 4 hours per night.
6) Feelings of hopelessness. Mr. Gutierrez-Soto expressed a lack of hope for his future.
He stated that the longer his situation remained so highly stressful and insecure, the
more difficulties he experienced, and the harder he believed it would be for him to
rebuild a ‘normal life’. He stated that he had had a romantic partner in Mexico before
he fled, but did not believe he would be able to share life with a partner again due to
his circumstances and state of mind. He expressed the feeling that he has lost
everything, and that due to his emotional difficulties, he would be unable to recover.
7) Persistent sadness. Mr. Gutierrez-Soto described chronic sadness and feelings of loss
for his country, his profession, and his past life in Mexico. He stated that he had never
wanted to come to the United States, but is now trapped here, uncertain if he will be
able to remain, yet unable to return to Mexico due to the danger he faces there. He
also expressed tremendous sadness at witnessing and feeling powerless about his
son’s suffering.
8) Feelings of loneliness. Despite never being alone, and being in detention with his son,
Mr. Gutierrez-Soto spoke of feeling lonely and isolated from the world. He spoke of
how vital it is for him to maintain contact with people outside of the detention facility.
9) A sense of being trapped. Mr. Gutierrez-Soto feels stuck in limbo, uncertain of his
future. He feels trapped in the detention facility as well as in his legal proceedings, and
does not know if, how or when he might regain his freedom. Mr. Gutierrez-Soto does
not understand how or why he and his son are being held in detention.
10) Extensive worrying. Mr. Gutierrez-Soto reported chronic worry and anxiety about his
current and future life, and about the wellbeing and future of his son Oscar.
10

 Quality of Life and Level of Distress
On the World Health Organization Quality of Life measure (WHOQOL-BREF), Mr. GutierrezSoto received the following scores, out of a maximum score of 20 in each domain:
Domain 1:
Physical Health
score of 8.0
Domain 2:
Psychological Health
score of 7.3
Domain 3:
Social Relationships
score of 9.3
Domain 4:
Environment
score of 5.5
Higher scores on the WHOQOL-BREF correspond to a better reported quality of life, with 20
points representing the highest possible score in each domain. Mr. Gutierrez-Soto’s four
domain scores are below 10 points, indicating that he evaluates his quality of life as poor.
Mr. Gutierrez-Soto reported that he is currently in the worst health he has ever been in, stating
“I am like a cadaver of my former self”. He recounted that when he sees his reflection in the
mirror he does not recognize himself. He sees a depressed, sunken and depleted man. Mr.
Gutierrez-Soto no longer finds meaning or enjoyment in life, and rated his total level of distress
as a 9.5 out of a possible 10 on the Refugee Health Screener-15 (RHS-15), indicating significant
emotional and psychological distress.
Mental Health Impacts of Detention on Asylum Seekers
In a 2013 report, the Center for Victims of Torture (CVT) asserted that indefinite immigration
related detention can lead to significant and persistent emotional and psychological distress
among asylum seekers, including feelings of powerlessness, despair, hopelessness and
suicidality. CVT described how detainees’ lack of understanding about why they are being held;
lack of knowledge about when they will be released; and lack of control over their
circumstances combine to create a subjective experience of detention as being indefinite. In
addition, isolation from their previous lives, lack of information about the legal process, and
limited communication with the outside world are frequently compounded by a perception of
disrespect from detention personnel, which can lead to the experience among detainees of
being chronically unsafe and under constant threat. 2
Immigration detainees often experience severe anxiety and chronic feelings of dread;
overwhelming levels of stress which can have deleterious effects on health (including on the
immune, cardiovascular and central nervous systems); clinical depression; and the aggravation
of post-traumatic stress disorder for those with prior histories of trauma. Several studies
evaluating detained asylum seekers in countries of resettlement have shown that in addition
to exacerbating previous mental health difficulties related to past trauma and persecution,
indefinite immigration detention can be independently traumatizing and detrimental to mental
health. Research has found that these negative mental health impacts are often long-term. 3
2 “Tortured and Detained: Survivor Stories of U.S Immigration Detention”, Center for Victims of Torture, (2013).
3 Ward, Tony. “Long-term health costs of extended mandatory detention of asylum seekers,” Yarra Institute for Religion and Social Policy (October
2011), available at www.yarrainstitute.org.au (finding that “in addition to the high costs of maintaining detention facilities, there are significant
additional costs as a result of prolonged detention for the long-term healthcare of former asylum seekers once they are released into the
community.”).
11

 The British Journal of Psychiatry conducted a review of worldwide research, and established
that “All studies found high levels of emotional distress among individuals who were in
detention or who had been previously detained… [There is] evidence that the findings relate
in part to pre-detention trauma experiences, in addition to detention itself having an
independent adverse effect on mental health.”4 Additionally, a 2003 report from Physicians
for Human Rights regarding the health consequences of detention for asylum seekers
concludes the following:
“The testimonies of the detained asylum seekers in this study powerfully articulate
how detention harmed their mental health and highlight several dimensions of this
harm. Confinement and the loss of liberty profoundly disturbed asylum seekers and
triggered feelings of isolation, powerlessness and disturbing memories of persecution
that asylum seekers suffered in their countries of origin. Asylum seekers were treated
as criminals, a demeaning status, even though they were not convicted of any crime.
The length of time in jail and uncertainty of its duration contributed to the deterioration
of mental health. Even when conditions were relatively good, the experience haunted
them. Approximately one quarter of the study participants reported suicidal thoughts
while in detention. Two individuals reported having attempted suicide. Even those
who won release were burdened with continued symptoms from their INS
imprisonment.” (p.14) 5
Conclusions
Mr. Gutierrez-Soto was cooperative and non-defensive in all aspects of the assessment
process. His description of his experiences in Mexico was consistent with his documentation;
his report of symptoms and psychological state was congruent with my observations of him
during our interviews; and his psychological profile was consistent with that of other
international survivors of human rights abuses I have seen during my two decades of work with
this population. Mr. Gutierrez-Soto answered questions in a clear and concise manner, with
accompanying examples and behavioral activation which substantiated his claims. His
responses to test items and his description of posttraumatic depression and anxiety symptoms
were discriminating and detailed. There was no evidence of exaggeration or deception on Mr.
Gutierrez-Soto’s part, and it is my professional opinion that he is an honest and genuine
reporter. During the course of our meetings, I observed the impact of Mr. Gutierrez-Soto’s
symptoms of Post-Traumatic Stress Disorder and Major Depressive Disorder, and witnessed his
vulnerability to ongoing uncertainty and insecurity in the context of detention. Mr. GutierrezSoto expressed intense fear at the possibility of being returned to Mexico, where he believes
he would experience further persecution and harm perpetrated by the Mexican military.
4 Katy Robjant, Rita Hassan and Cornelius Katona “Mental health implications of detaining asylum seekers: systematic review” British Journal
of Psychiatry, 194: 306-312 (2009).
5 “From Persecution to Prison,” Physicians for Human Rights, (2003) available at https://s3.amazonaws.com/PHR_Reports/ persecution-toprison-US-2003.pdf (finding, “Clinically significant symptoms of depression were present in 86% of detainees, anxiety was present in 77%, and
PTSD in 50%. Further, study doctors documented that these levels of psychological distress worsened as the length of detention increased.
While more than half (58%) of the asylum seekers interviewed reported having poor psychological health at the time that they fled their
country, 70% stated that overall their mental health had worsened substantially while in detention.”)

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 Due to Mr. Gutierrez-Soto’s experiences of persecution and trauma in Mexico, and the
exacerbation of his post-traumatic symptoms of anxiety and depression since being held in
immigration detention for the second time, his current psychological state remains fragile. It
is my professional opinion that it would be detrimental to his mental health and emotional
wellbeing to have to return to Mexico, where he would not feel protected from further
persecution and harm. It is also my professional opinion that it is deleterious to his current
psychological, mental and physical health to remain in immigration detention, which is causing
an increase in his levels of distress, and a worsening of his post-traumatic symptomatology.
I have observed Mr. Gutierrez-Soto to be a respectful, thoughtful and resourceful man, as well
as a caring father dedicated to the wellbeing of his son. I am confident that he would make
meaningful contributions to this society should he be permitted to safely remain in the United
States. The safety and security which would be afforded to Mr. Gutierrez-Soto were he
granted political asylum in this country would be significant in allowing him to begin healing
from his trauma, and start building stability as he adjusts to life in this environment.
Mr. Gutierrez-Soto expressed interest in receiving psychological support, and it is my
recommendation that this be made available to him as soon as possible. He was fully engaged
in the assessment process, and would be able to benefit from continued psychological care.
Mr. Gutierrez-Soto would also benefit from an evaluation by a psychiatrist for medication to
treat his symptoms of Post-Traumatic Stress Disorder and Major Depressive Disorder. With
ongoing support, and once he is released from detention and experiences a greater sense of
stability and safety, Mr. Gutierrez-Soto’s prognosis for recovery is good, and his psychological
and physical wellbeing will likely begin to improve.
I hope these findings will be helpful in considering Mr. Gutierrez-Soto’s application for
political asylum, and please contact me at asridharan@traumapartners.org or
(510) 334-5757 if further information is needed.
Respectfully submitted,

_______________________________
Annika Sridharan, MSW, Psy.D
Clinical & Training Director
Licensed Clinical Psychologist PSY24660
Partnerships for Trauma Recovery
1936 University Avenue, suite 191
Berkeley, CA, 94704

Healing the psychological impacts of human rights abuses for a more peaceful tomorrow
www.traumapartners.org
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