Shortly after Elena and her husband were married, he began to beat her. At first, Elena hoped things would get better, but her husband became increasingly violent. He soon controlled Elena’s daily activities, kept her locked inside, deprived her of food, and threatened to kill her and their baby daughter.

Elena was even more terrified when she discovered that her husband held a ranking position in the cartel that controlled their community and many other communities across Honduras. And because two of her husband’s friends were police officers, Elena realized it would never be safe to report his abuse. Even before her marriage, Elena had known that cartels and police were intertwined, and when Elena’s cousin had reported similar abuse, the police threatened to arrest the cousin for making the report.

Eventually, Elena managed to escape with her child and made her way to the home of a relative in a remote village, where she hoped to remain hidden. But her need for employment eventually forced Elena out of hiding. A member of her husband’s cartel identified her, and a few days later, while Elena was away at work, two men entered her relative’s home, beat the relative, and left a threatening message for Elena. It was then Elena realized she could not be safe anywhere in the region, so she took her young daughter and fled for the United States.

At the US border, Elena tried to explain her situation and request protection, but immigration officials turned her away. She found shelter in a donated camping tent, placed among hundreds like it in a community of migrants. Humanitarian groups brought basic food supplies to the tent community, rented portable latrines, and donated water filters. But there was no security, and local police were not available to the stateless tent dwellers. Cartels often kidnapped migrants from the camp, and some who were taken did not return. Here too, Elena lived in fear that a member of her husband’s cartel would identify her.

But humanitarian workers on the ground introduced Elena to a nonprofit immigration attorney, who offered to help her apply for humanitarian parole, a form of emergency, temporary entry to the United States. The attorney reached out to H.O.M.E. and requested that a clinician meet with Elena to document her trauma symptoms and assess her mental health needs. Our clinicians spoke with Elena in a carefully planned clinical interview and then documented her trauma symptoms and emotional needs.

The attorney submitted our clinician’s report as part of Elena’s humanitarian parole petition, and with this combined support, the petition was approved. Elena and her daughter entered the U.S., spent two nights in a border region shelter, and then traveled to the home of a cousin who had lived in the U.S. for many years. Now Elena will begin the process of applying for asylum and creating a life of safety for herself and her child. She is still at risk of deportation, so H.O.M.E. remains available to Elena and others like her.

Ava was alarmed when she learned her government was persecuting indigenous communities and taking their land. She heard about a protest in her city, Nicaragua’s capital, and took a bus downtown with a group of friends to march in the streets, chant, and carry signs. Ava and her friends hoped their voices would be heard. They did not expect their government’s sudden use of violence.

Ava’s close friend, marching near her that day, was killed by a soldier in uniform. The soldier then pointed his gun at Ava and forced her into the back of a windowless truck.

The soldiers drove Ava and other protesters to a remote location and held them in a cold dark room for what felt like days. The protesters were beaten, given no food, and were not told what would happen to them. Finally, Ava and the others were blindfolded, placed in the truck again, and released several miles from the city center.

Ava managed to walk home, where her mother and younger sister nursed her back to health. But she was terrified and no longer able to leave her house.

A few weeks later, when Ava’s mother took a bus to the market, soldiers stopped her and demanded her cell phone. They allowed Ava’s mother to proceed but did not return the phone. “We know you are the mother of a dissident,” they told her. “We will be watching you.”

Fearing for her safety and that of her mother and sister, Ava fled for the United States. But when she approached U.S. border officials to request protection, they detained her in a cold, prison-like facility that held constant reminders of Ava’s captivity by her own government. Ava was afraid to sleep, and when she did, she was awakened by nightmares. The presence of uniformed officers unnerved her, and she was unable to make eye contact or voice her needs.

When a border region nonprofit attorney alerted H.O.M.E. to Ava’s predicament, a member of our team traveled to the detention facility to meet with her for a carefully planned clinical interview. The clinician asked about Ava’s nightmares, fear, and other trauma related symptoms. She also asked about the detention environment and Ava’s ability to function there.

Based on this interview, the H.O.M.E. clinician prepared a detailed report that explained how detention triggered Ava’s trauma memories and worsened her debilitating symptoms. The clinician recommended extensive trauma therapy for Ava, as well as a nurturing, stable environment, rather than detention. Based on this document, Ava’s attorney filed a petition for Ava’s release.

A short time later, H.O.M.E. received word that Ava’s petition for release would be granted. Two relatives in another US state drove to meet her and welcomed her into their home. Ava still faces the long challenge of applying for asylum, but she can now do so in a safe environment with caring family members.

When Adamma, a young woman in Nigeria, found a job in a local factory, she was hopeful. The salary would help support her, her chronically ill mother, and her younger brother. But Adamma was also burdened by a secret fear: She was dating a coworker, another woman, and the two maintained a hidden relationship.

The women feared discovery, not only because same sex relationships were socially stigmatized, but because they were punishable by imprisonment and death. Adamma and her girlfriend were careful to hide the nature of their relationship, but this proved more and more difficult over time.

One day, as Adamma walked home from work, a group of men in police uniforms grabbed her and forced her into their vehicle. The officers tied and blindfolded Adamma, then took her to a locked, dark room, where one of them raped her. The men told Adamma she must “learn to be with a man” or they would return to imprison her. They forced her back into their vehicle, drove for about an hour, then removed her blindfold and released her.

Adamma struggled back to her mother’s home but found she was unable to talk about what had happened to her. She feared the men would keep their promise to return, so two days later, Adamma purchased a bus ticket and fled to her grandmother’s home in a remote town. But even there, she suffered panic attacks at the sight of police officers, and she feared she would never be safe. Adamma’s grandmother told her about a relative in the United States, and Adamma decided to make the arduous journey there.

By the time H.O.M.E. connected with Adamma, she had been staying with her relative in the US Midwest for several months. A pro bono attorney had filed an asylum petition for her, but Adamma knew that most asylum cases are denied. She feared she would be forced to return to a country where her life was under threat and her very identity was criminalized.

Adamma met with her H.O.M.E. clinician, a trauma specialist, for a total of four hours across two extended sessions. Adamma began to feel safe with her evaluator and acknowledged the rape for the first time.

The evaluator asked questions about Adamma’s mental health and day-to-day functioning, then prepared a comprehensive report that described Adamma’s trauma history and explained the nightmares, social avoidance, fear, and depression she experienced as a result.

When Adamma appeared in immigration court, the judge granted her asylum petition, citing the mental health report as a key piece of evidence. Adamma is now safe, in treatment for her symptoms, and free to pursue new goals.

Aapo was a community health educator in the rural indigenous region of Nicaragua where he had grown up. He divided his time among five villages, teaching community health practices and providing first aid when medical professionals could not be reached. Aapo even put together a health guidebook and saved enough money to print copies for community leaders.

Community members came to trust Aapo and consulted with him on a variety of topics. This included asking for explanations about events reported from national news sources.

During Aapo’s fourth year of service, his nation’s president was removed from office. Military presence increased rapidly in rural areas, and soldiers were alerted to remove anyone known to be a member of the previously ruling political party. Community members were fearful, and their questions for Aapo became more pointed and more secretive.

One night, Aapo was awakened when five soldiers burst through the door of his home and held him at gunpoint. The soldiers shouted that Aapo was a political dissident, teaching subversive propaganda. They held up a copy of his guidebook, declaring that it contained coded language intended to overthrow the new government. They beat Aapo with the butts of their riles and told him they would kill him unless he left the country.

Aapo gathered a few belongings and left home the same night, fleeing first to the home of a trusted friend, then boarding a bus for a neighboring country. In that country, and later in another, he attempted to find safe community. But as a foreigner and ethnic minority, he was harassed and threatened each time. Aapo decided the United States was his only hope for finding safety.

After a long journey northward, Aapo presented himself to U.S. Border Patrol, hoping to explain his situation and request asylum. He was held for three days in an ice cold room with inadequate food or sanitation.

Aapo was then transferred to an ICE detention center. Here, he had a bunk in a crowded cell, where lights were left on day and night. Aapo developed a fever and cough but did not receive medical care. He had no contact with the outside world and no information about what would happen to him. Aapo began to feel hopeless but found the courage to tell an officer he was having thoughts of suicide.

In response to Aapo’s depression and suicidal thoughts, the detention facility moved him to solitary confinement, where officers removed his clothing and replaced it with a thin hospital gown that was open on both sides. Despite the cold, Aapo’s bed was a concrete platform with no bedding, and his meals were limited to raw vegetables.

Desperate to be released from solitary, Aapo told detention staff he was feeling better and no longer having suicidal thoughts. After his return to the main holding cells, a fellow detainee helped Aapo connect with an attorney from a nonprofit legal organization. The attorney accepted Aapo as a client and contacted H.O.M.E. to request a mental health assessment.

The H.O.M.E. clinician travelled to the remote facility and met with Aapo for an extended clinical interview. She documented his depression, his trauma symptoms, and the harmful psychological effects of solitary confinement. Aapo’s attorney used this expert documentation as the basis of a petition for Aapo’s release, and the petition was granted. Aapo must still navigate the challenges of the asylum process, but for now, he can do so from the safety of a friend’s apartment.

Josue and Sonia were frightened when local gang leaders demanded increased “tax” on the small produce store they managed in northern El Salvador. The young parents already struggled to meet the gang’s monetary demands and still provide for their two children. But the gangs were powerful in their city, and not long ago, they had killed a near neighbor for refusing to join them. Josue and Sonia were careful to meet the gang’s demands despite the financial hardships this caused, but the new amount was simply impossible.

Soon after their failure to make the full payment, Josue and Sonia received a frantic call from their daughter Lucía’s school. Gang members had taken Lucía at gunpoint, then released her with the message that their actions were her parents’ fault. If her parents did not pay, they told the child, they would return to kill her next time, and they would find her baby brother too.

Terrified for their children’s safety, Josue and Lucía packed a few belongings and purchased bus tickets. The family headed north as far they could, crossing two borders to escape the regions in which the gangs might still track them. But when they reached northern Mexico, U.S. policies did not permit them to approach a border official with their request for protection.

Josue and Sonia found shelter in a makeshift encampment, not far from the U.S. port of entry, where other families were already waiting. A humanitarian aid group provided a small camping tent, and Josue and Sonia did their best to create a safe space for their children and to comfort Lucía when she awakened from her frequent nightmares. Josue and Sonia’s biggest fear was the cartel presence near the encampment.

The family had been waiting nearly two months when they were awakened by nearby screams. Josue and Lucía warned their children to be still until the danger had passed. They were distraught to learn the next morning that a family in a neighboring tent had been kidnapped.

From that day forward, Lucía refused to leave the tent for any reason. Her appetite was diminished, and her nightmares increased. Josue and Sonia asked for help from a humanitarian worker who connected them with H.O.M.E. and with an attorney.

A H.O.M.E. evaluator with expertise in childhood trauma met with Lucía and then with her parents to ask questions about Lucía’s psychological health and to observe her behavior. The evaluator wrote a clinical analysis and a recommendation for urgent intervention from a therapist with appropriate expertise. In her report, the evaluator also explained the need for a safe, stable environment in which Lucía could hope to recover.

The attorney prepared a petition for emergency humanitarian parole, which would allow Lucía to enter the U.S. for mental health care. He presented the mental health report as supporting evidence for this petition. Based on this petition, Border Patrol granted Lucía, her parents, and her baby brother permission to enter. Shortly after crossing through the port of entry, the family travelled to the home of a family friend, where they could safely begin the asylum process and find appropriate care for Lucía.