Monitoring and evaluation of remote medico-legal report assessments when documenting evidence of torture for asylum seekers detained on Diego Garcia.

INTRODUCTION: Between 2022 and 2023, Freedom from Torture (FfT) produced remote medico-legal reports for 19 asylum seekers unlawfully detained on Diego Garcia (DG), an island in the Chagos Archipelago. To ascertain clinical challenges and the effectiveness of remote assessment of evidence of torture for individuals held in quasi-detention on DG, as compared to non-detained UK-based individuals. In early 2020, FfT audited telephone assessments of individuals in the UK to assess the extent to which they can safely evaluate evidence of torture. Results were published in the Torture Journal (Cohen et al., 2021). METHODS: Between 2020 and 2021, we conducted a further audit of appointments with individuals in the UK by (i) video assessment only, (ii) a combination of video and face-to-face assessments, and (iii) face-to-face assessment only. We collected structured feedback from doctors following video assessments with individuals on DG. We compared this with the feedback from previous audits. RESULTS: Doctors carrying out DG video assessments felt less able to make a full assessment of the impact of torture or to complete a full psychological assessment, compared with assessments of UK-based individuals. They were less able to obtain as full an account and establish rapport. Substantially more challenges and safeguarding concerns were reported. CONCLUSION: Remote medico-legal assessments of asylum-seekers held in detention-like circumstances are less likely to be able to fully document and evaluate evidence of torture than remote assessments of asylum-seekers not in conditions of detention. Our study had several limitations; however, we set out principles we believe may be of use to others conducting remote assessments.