Centering torture survivor voices from their experiences

Background: Human rights violations persist globally, with torture routinely utilized as a mechanism to repress democratic expression and silence social movements. The Boston Center for Refugee Health and Human Rights (BCRHHR) is a hospital-based program providing services to refugees, survivors of torture (SOT), and asylum seekers. Emerging evidence suggests that circumstances encountered after resettlement may exert a greater traumatogenic effect than those experienced in the country of origin or along the migration journey. We performed a qualitative needs assessment interviewing 22 randomly selected patients who received BCRHHR services at least twice between January 1, 2021, and December 31, 2021. SOT were asked about their experiences at the BCRHHR and factors influencing treatment-seeking behavior. We analyzed the interview transcripts using thematic analysis guided by the Social Determinants of Health framework for public health research. Thematic analysis revealed seven major themes describing patients' experiences and perspectives as migrant torture survivors: 1) post-immigration stressors, 2) ensuring a supportive, safe space, 3) culturally aligned provider, peer support, 4) the importance of integrated community and compassionate care, 5) the benefits of multidisciplinary services, 6) introduction to mental health services and their benefits, and 7) suggested outreach. Our findings show that migrant torture survivors face significant post-immigration stressors that complicate their access to care, highlighting the need for trauma-informed, multidisciplinary support. The BCRHHR model demonstrates how integrated services—combining legal advocacy, case management, and peer support—can address key social determinants of health while fostering trust and improving outcomes for refugee torture survivors.