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For the refugees in the New York City metropolitan area, the seventh floor of Bellevue Hospital in Manhattan was more than a place to heal. It felt, in Tré Kayumba’s words, like going to “your auntie’s house.”
“It was a place where I went to for comfort and to get support,” said Kayumba, whose family was displaced amid armed conflict in the Democratic Republic of the Congo and eventually became clients at the Bellevue Program for Survivors of Torture (PSOT). “Up to that point, we were just dealing with survival, and all of a sudden, these guys wanted us to be in touch with emotions that, I think, we suppressed for years.”
Founded in 1995 and funded chiefly by $1.1 million in federal grants from the Office of Refugee Resettlement, the treatment center offered a holistic, interdisciplinary assortment of free medical, mental health, legal, and social support services tailored to victims of torture. Last year, it served as many as 700 people: men targeted and beaten for their political beliefs or sexual orientation; women fleeing rape, sex trafficking, or genital cutting; their children and family members who were forced to watch a murder.
But on Feb. 12, Bellevue administrators met with program co-founder Dr. Allen Keller to inform him that the program would be closing, staff told Prism.
In the weeks since, competing narratives have developed. Staff and previous reporting describe a closure slated for mid-May, with staff saying they were offered little rationale as to why and minimal communication from hospital administrators. NYC Health + Hospitals, which oversees Bellevue, contends that nothing is changing but the program’s name and source of funding.
That funding, authorized by the federal Torture Victims Relief Act of 1998, is not at risk. The program’s two grants last through the end of 2027, according to an Office of Refugee Resettlement representative and PSOT Director Dr. Hawthorne Smith.
The risk, and reason for the closure, according to his understanding, is twofold: perceived threats of increased scrutiny of federal funding for the entire NYC Health + Hospitals system by a government that is broadly hostile toward immigration, and of U.S. Immigration and Customs Enforcement gaining access to identifying patient information.
“There was no transparency in terms of who made the decision, how the decision was made, based on what,” said Dr. Asher Aladjem, a program co-founder and chief psychiatrist, whose termination was set to go into effect May 15. “Nobody from the hospital administration has met with us as a group to kind of explain the mechanics of how this is happening.”
Smith said that NYC Health + Hospitals administrators have not met with him regarding the closure, but that he has been asked to triage clients into groups based on high, moderate, or stable needs.
“Those who are in the moderate-need [group], a lot of them are now ratcheting up towards high need,” Smith said, after “having this rug pulled out from under them.” His position will be eliminated as of May 15.
NYC Health + Hospitals maintained that a structured, warm client handoff is underway. But program staff assert that the allotted time was insufficient to wind down services, to clear the wait list, to transition legal files and stewardship of approximately 250 active asylum applications, and to ensure continuity of care for this high-need population.
“The safety, health, and wellbeing of our patients in the PSOT program, and throughout the public health care system, are paramount,” said Adam Shrier, press secretary for NYC Health + Hospitals, in an emailed response. “All existing patients of the PSOT will continue to receive the same high level of care and uninterrupted access through a new Primary Care Human Rights Clinic (PCHR) at Bellevue Hospital.”
Scheduled to open May 15, the PCHR clinic will make primary care the first point of contact for new clients, prioritizing their medical needs before referring them for behavioral health, legal, and social services, according to NYC Health + Hospitals.
‘My heart is dipped in tar’
Over in St. Paul, Minnesota, the Center for Victims of Torture has provided services in both standalone and primary care clinics, and staff understand how challenging it can be to provide nuanced care to survivors of torture in a general medical setting. Alison Beckman, senior clinician for external relations, described being co-located at two primary care clinics for a research project involving Karen refugees from Myanmar, who used culturally specific idioms to describe distress.
“They had these beautiful metaphors: ‘I feel like my heart is dipped in tar’ or ‘my heart is soaking in alcohol,’” she said. “When we looked in their medical chart? Everybody’s on Prilosec for heartburn.”
Uncertainty ahead
PSOT’s culturally sensitive care at Bellevue Hospital has included robust legal services for a majority of its clients.
“We have a very high success rate of clients of the program being granted asylum,” said John Wilkinson, the program’s recently retired director of legal services—“around 94%.”
Whether the medical-first model of the new PCHR clinic can provide comparable results, meet torture survivors’ complex needs, and foster the same sense of familial comfort, remains to be seen.
“Unlike any other immigrant organization which I’ve been a part of, this one,” said Kayumba, “has a certain kind of fire, fervor about it that is unmatched. I cannot stress that enough.”
Aladjem said, “We still have people that are calling for intakes.” The PSOT referral form is still available online. It is unclear who will be reviewing submissions.
Editorial Team:
Sahar Fatima, Lead Editor
Lara Witt, Top Editor
Stephanie Harris, Copy Editor
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