Wheelchair User Denied U.S. Entry Because of a History of Depression

Kermit Cole
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A U.S. border agent, citing Immigration and Nationality Act Section 212, which denies entry to people who have a physical or mental disorder that may pose a threat, denied entry to a paraplegic woman who had been hospitalized for depression in 2012 following the breakup of a relationship.  Ellen Richardson, who  is paraplegic, was so shocked and devastated by the event, she said, that she wasn’t thinking about how U.S. authorities had accessed her private medical information.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

13 COMMENTS

  1. This is one of those “unintended consequences” that “helpers” cause to innocent people. Today people with what the INA calls “dangerous mental diseases” can be denied entry in the US the same way HIV positive people were until 2009. Even though my commitment and diagnosis happened when I was already a US citizen, I checked the USCIS guide that deals with these things. It is very technical but basically anybody diagnosed with bipolar or schizophrenia is going to have a hard time getting a greencard lawfully (and lying about it in an application is even more problematic). Further, the N-400, the form one needs to fill out to apply for US citizenship, explicitly asks whether the applicant has been civilly committed as a problematic area. This is an extra area of my life that could have been derailed by psychiatry had my ordeal happened while I was not yet a US citizen.

    • To supplement that, this is the document that instructs medical examiners how to screen immigrants for so called “mental health issues”. As I said, it is very technical,

      http://www.cdc.gov/immigrantrefugeehealth/pdf/mental-health-cs-ti.pdf

      And this is the N-400 form,

      http://www.uscis.gov/sites/default/files/files/form/n-400.pdf

      The question about civil commitment is in Part 10/A, question 7. While answering yes will not automatically disqualify anybody from US citizenship, the immigration officer has the discretion to give you a hard time, even deny your application if you don’t make a convincing case about why you should be admitted. In addition, saying yes there will forever put that info in the hands of the US government. If you lie, since this issue is “material”, you’d be getting your citizenship through fraud, which is even a worse offense for which there is no statute of limitations.

      What makes the above case even more strange is that from the article, it seems somebody in Canada put the info in a database to which the US government has access. Scary!

  2. Frightening, to say the least.

    Now that millions have lost their private health insurance policies, with tens of millions soon to lose their employer-provided group health plans… the “answer” will be the exchanges – a place where the government will be privy to whatever private health information they want; including mental health records, to be used for whatever purpose they wish… after all, who will stop them? Nobody is topping them now.

    … “Free” health care… Be careful what you ask for.

    Duane

    • The government has thrown billions at getting all physicians to enter all their patients’ private medical details into universal “electronic medical records”, which are non-alterable and will follow (or precede) all of us around forever.

      All it takes is for one doctor or “physician extender” to slap a label on you, and it will affect how any other person who sees that record treats you, for the rest of your life.

      A perfectly sane and well adjusted 30-year-old mother of two whose husband is a hunter but who herself received inpatient treatment for an eating disorder as a 14-year-old might see law enforcement agents breaking down their door in the middle of the night in order to confiscate any hunting rifles on the premises.

      A nurse practitioner or physician’s assistant who’s having a bad day and doesn’t like being questioned might put a note in a patient’s permanent, universal medical record that they suffer anxiety or are argumentative.

      A patient who was inappropriately prescribed Seroquel or some other strong antipsychotic for anxiety or insomnia will always carry with them the stigma of having been on antipsychotics.

      And of course any psychiatric diagnosis, whether accurate or not, will always be tied to the patient it was applied to. It can’t be taken off, so “once biploar, always bipolar”. When the patient presents at an ER for abdominal pain 10 years down the line, she’ll be “the mental case in cubicle 3” and her complaints probably won’t be taken as seriously as those of a woman with a “clean” EMR.

      I see a huge market for doctors who will promise to try to keep their patients’ private medical records “off the grid”. I’m not rich, but I’d sure try to find a way to pay someone extra for that “service”.

      • This is very true, but at the same time, there are things that one can do to minimize the probability that your medical information is misused thanks to HIPAA like protections that exist both at the federal and state level.

        While no protection is absolute, you can at the very minimum ask that your providers to NOT share your medical information with other providers. Providers are required to comply except in circumstances such as emergencies. And “emergency” is not some doctor saying “this is an emergency” but it has to be something like you are taken to the ER or something. There are penalties for breaches of privacy and, more importantly, loss of reputation. Nothing mollifies a provider more than the threat of a medical malpractice lawsuit.

        After gaining “awareness” of the negative consequences of my past psychiatric history, I decided to never go back to the medical center where my American psychiatrist worked and protect that record from unauthorized access. I worked with their privacy officer to revoke each and every single release authorization that I had previously signed and wrote a letter to be put in my medical record with them that I was the only person I explicitly authorized to access my medical data. While HIPAA regulations allow medical providers to access the data without your consent in a specific circumstances, like emergency care or in response to a court order, putting such a letter in your record makes it clear that they would be violating the law if they decided to share that information for uses not authorized by the HIPAA regulations, which would increase their legal liability in case of an unauthorized sharing.

        Your new provider cannot force you to share your old data with them for regular, non emergency service, no matter how much they scream or how much they tell you otherwise. The law, is the law.

        When my new provider insisted that I share with them all my past medical data, since I have to go to the doctor at least once a year to make sure that my metabolic indicators are within normal range, I told them that they had two choices: either accept my request that they will not know my past medical history or that I would take my business somewhere else. They complied :D.

        Of course, this assumes that you have the choice to switch providers, which is the case for a lot of people. If you have an HMO type of plan or a plan with a limited network of providers, then, yes, it is a problem.

  3. CANADA would not let me in there country because I had a DUI/DWI years before but before turning me around they searched my truck and messed up all my belongings and were very rude to me and ruined my vacation.

    In the USA they give a DUI for drinking 2 beers in an hour, .08% , what a money generating scam. No grown man is “intoxicated” from 2 beers.

    I suspect there is an information sharing agreement between the USA and Canada cause the USA ratted me out to Canada somehow.

  4. This appears to be an example of how people who have been treated for or diagnosed with any mental illness are apparently not allowed to heal. The label, the history, the stigma becomes a ‘self-fulfilling prophecy’ capable of generating more depression via ostracization such as depicted in this woman’s story. It’s a very broken state of affairs. I haven’t seen a doctor in many years. I was looking forward to an ‘objective’ review and when I responded to a letter indicating the review was due and I explained that I am better, I don’t Rx meds, I don’t have a doctor, the Social Security review committee sent me a letter back saying “we said we were going to review you, but we aren’t going to review you right now.” Well, you’d think they’d want to get an objective professional opinion since I was deemed mentally disabled and now claim that I am not. But, here is the catch: I had filed numerous complaints against a few doctors and my psychiatrist with the state licensing board. There were so many contradicting diagnoses, and documented incidents of them giving me Rx that I’ve documented adverse reactions to, any non-biased review would certainly bring these medical treatment questions to light. There may also be, a non-acknowledged disability (or potential discriminatory factor) that would have to be addressed. You see, after many years, in the “system” one can become “employment disabled” simply by being out of the market place for so long…untrained, no resume history, stigmatization, not to mention, … Aging, also, presents stigmas and dilemmas if one is afflicted with the common illness that may accompany getting older such as arthritis. I spent my whole life it seems (over 20 yrs.) dealing within that broken system. It hasn’t gotten any better. I have, even though, I am now like the “tinman” and rusty in just about all aspects of living and have arthritis. My mind is as fine as those who diagnosed the long lists of mental afflictions over the years. There is no redemption. Recovering the mind is evidently not permitted and if by the grace of some God, luck, or, in my case, completely abandoning the Rx meds and doctors that made me sicker~ there are no parades, no recognition…just silent poetry. Oh, and the SSDI checks that just keep coming (even though I told them “I AM Mentally well now” because as broken as the system is, I believe they recognize what it has done. So sad. No place to return the shoes that no longer fit. This woman’s story made me think of these things. I am sorry if you don’t think it is pertinent to the topic at hand; it just felt like a good time and place to share it. I wish this lovely lady all the best. Have a lovely day. Ohio

    • The short answer is no.

      I am going to get a bit technical here. Under US law, Ellen was a foreign national trying to travel to the US. US immigration law, as written, has a set of “inadmissible” categories, related to health issues but also to other things like criminal records. An immigrant who is deemed “inadmissible” can only be admitted in some cases if a waiver is requested. For some categories of inadmissibility, like the most serious crimes, there is no waiver relief possible. For Class A medical conditions, which is the pretext used against Ellen, there is, but the process is long and bureaucratic.

      This “inadmissibility” thing goes beyond traveling to the US, it also applies to immigrants applying legally for work visas and permanent residency aka “greencard”. Once you are admitted as permanent resident, inadmissibility due to medical reasons no longer applies. For instance, when HIV infection rendered immigrants inadmissible, HIV positive people were ineligible for the greencard. But, those who got their greencard and became infected AFTER their greencards and while maintaining legal status, were allowed to stay in the US and apply for US citizenship. In other words, there is a difference between “inadmissibility” and “deportability”. Certain types of crimes make immigrants both inadmissible and deportable. Class A medical conditions, including mental health issues that result or can result in harmful behavior, makes the immigrant inadmissible but not deportable unless the immigrant engages in criminal behavior that makes him/her deportable.

      All this is very technical, as US immigration is. Only an immigrant, like yours truly, is aware of these things :D.

      In my own case, one of the potential damaging effects that my commitment could have brought to my life would have been immigration problems. Although my commitment happened under a “need for treatment” standard and I could prove that I was not engaging in dangerous behavior, the fact that I was committed and diagnosed after I was already a US citizen inoculated me from problems with US immigration. But this is yet an other area in which psychiatry does more damage than good. If you take a look at the guide above, although it says that no DSM label by itself renders anybody inadmissible, the instruction is to be particularly picky with anybody diagnosed of “bipolar”, “schizophrenia”, “depression” and, excuse me for word, I am just copy/pasting, “mental retardation”.

      Given the lack of validity of DSM labels, and the lack of ability of psychiatrists to predict who and when is likely to become violent, needless to say, that having one of those labels before getting your greencard can severely impact your life if you want to stay in the US.