Psychological examinations within asylum procedures 35 Psychological examinations within asylum procedures Many asylum seekers suffer from health problems arising from their flight and the violence that preceded it. Most often these are physical problems related to pain and experiences of violence and mental problems such as depression, anxiety and post-traumatic stress disorder (PTSD). Research on Iraqi asylum seekers, for example, showed a high incidence of psychiatric illness (42%) among asylum seekers that recently arrived in the Netherlands.1 Of this group, one quarter suffered from depression and approximately another third from PTSD. Also, in some cases, asylum seekers will remain silent about what happened in order to protect themselves against painful memories, or they may find it indecent to talk about the events because it is culturally inappropriate to do so. It is clear that most of these problems existed during the asylum interviews and that they interfere with the outcomes of those hearings, resulting often in a questionable rejection of the application for asylum. Medical and psychological research in the field of traumatisation indicates that trauma can cause interference with memory and incapacity to recall events. As a consequence, some asylum seekers are unable to give a complete and coherent account of their flight. The story the asylum seeker tells to the immigration authorities during the interview is pivotal, frequently making the difference between a residence permit and expulsion. The accelerated asylum procedure (“fast track”) in The Netherlands has been criticised (i.e. by Human Rights Watch, the UN High Commissioner for Refugees and Committee against Torture) because of the lack of adequate guarantees for a fair consideration of asylum claims of vulnerable individuals, including asylum seekers with mental health problems. But also in the “regular” (non-accelerated) procedure, physical scars, medical and psychological complaints as well as accompanying behavioural and socio-cultural problems are not By Erick Vloeberghs MSc, international affairs, Pharos; Evert Bloemen MD, senior advisor/trainer, Pharos; and Riëtte Mellink MA, psychologist/psychotherapist and one of the initiators of the MAPP project