U.S. Department of Health and Human Services: Direct Services for Survivors of Torture
The Direct Services for Survivors of Torture (DS SOT) program aims to increase survivors’ access to holistic services using an integrated, strengths-based, and trauma-informed approach to assist them in the healing and recovery process. Holistic services are defined as providing medical, psychological, legal, and social work services to address the biological, psychological, social, and spiritual effects of torture on survivors and their families. Programs must provide all of these services either through direct services or a combination of direct and indirect services provided through partnership(s) and/or affiliation(s). In addition, programs must engage in the required activities listed under the primary and secondary objectives.
The goal of the DS SOT program is to maintain a network of specialized programs that assist torture survivors and their families in the healing and recovery process so they can attend to their health, build effective support networks, become active members of their communities, and lead productive and meaningful lives.
The primary objective is to provide holistic services using an integrated, strengths-based, and trauma-informed approach to assist survivors in managing their health and rebuilding their lives. Required activities include:
- Provide medical, psychological, social, and legal services to address the bio-psycho-social-spiritual effects of torture on survivors and their families
- Strengthen or create partnership(s) within the organization or with local service provider(s) in order to move towards a more integrated approach to service delivery
- Conduct comprehensive assessments and personal wellness planning to help survivors to identify and progress towards client-centered goals for healing and recovery
- Provide strengths-based, trauma-informed case management to coordinate care and connect clients to other services and community resources as needed
- Facilitate support groups and/or provide referrals and linkages to help survivors build a sustainable social support network
- Seek input from clients on services through individual assessments, focus groups, or satisfaction surveys to evaluate program effectiveness and strengthen service delivery
- Program staff and volunteers providing professional services must participate in at least two ORR-sponsored and/or other professional training events each year
- Take steps to triage and provide support to individuals on a waiting list for intake and evaluation, if needed
A secondary objective is to increase awareness of the needs of survivors, build local service capacity, expand access to services, and promote sustainable, quality care for survivors through education, training, strategic partnerships, and client evaluations. Required activities include:
- Provide at least one educational workshop annually to refugee and immigrant communities and/or community members who interact with this population to increase community awareness and support for survivors
- Provide at least one professional training event annually to medical, behavioral health, legal, and/or social service providers on identifying and caring for survivors
- Develop direct linkages with refugee resettlement providers to ensure a well-coordinated referral process
- Partner with state refugee programs and/or ethnic community-based organizations to promote culturally and linguistically appropriate services for survivors
- Provide professional mentoring and/or case consultations to local service providers who are working with survivors of torture in an effort to increase service capacity
- Explore ways to strengthen the program by evaluating and improving processes (e.g., intake) and systems (e.g., data collection) and identifying sustainable sources of funding (e.g., medical billing)
The DS SOT Approach includes:
- Integrated, strengths-based, and trauma-informed service delivery: The program requires that holistic services be available to survivors and eligible family members. These services and the other required activities listed under the primary and secondary objectives are to be culturally and linguistically appropriate for the population being served. Programs are required to move towards a more integrated approach to service delivery by creating partnerships within and outside the organization. An integrated approach involves having a multidisciplinary team provide behavioral health, primary care, and social services in the same location with shared systems and regular communication. The program also uses a strengths-based approach to service delivery that places the survivor at the center of program planning, implementation, and evaluation. Clinicians partner with survivors to help them identify and pursue their goals and priorities. The intake process includes an assessment of the clients’ bio-psycho-social-spiritual and immigration legal needs. Services must be provided either directly by the grantee and/or indirectly through partner organizations and/or affiliate agencies. The lead agency is responsible for providing administrative oversight for both direct and indirect services.
- Increase capacity and sustainability: DS SOT programs engage in activities intended to increase the capacity and sustainability of services to survivors. These activities include evaluating and improving processes and systems (e.g., intake, data collection), identifying sustainable sources of funding (e.g., medical billing), and partnering with organizations already funded to serve the same population (e.g., community health centers, nonprofit or pro bono legal service providers). In addition, DS SOT programs develop direct linkages with refugee resettlement providers to coordinate referrals, and provide professional mentoring and/or case consultations to local service providers working with survivors of torture.
- Increase access and quality of care: DS SOT programs take steps to triage and provide support to individuals on a waiting list in order to give priority to those in urgent need of care, and periodically review the wait time to receive services, if applicable, in order to improve access to client care. To improve the quality of care, DS SOT program staff and volunteers providing professional services engage in professional training each year. There are over 30 torture treatment centers in the U.S.; however, many survivors are not aware of or do not have access to these highly specialized services. Therefore, it is important for mainstream providers who serve refugees and immigrants to be able to identify and provide appropriate care to survivors. Likewise, it is important for refugee and immigrant communities to be aware of and provide community support to survivors. For these reasons, DS SOT programs must sponsor an annual professional training and community education workshop to increase knowledge and skills in serving survivors of torture, raise awareness of survivors in the community, and increase community support. DS SOT programs coordinate with state refugee programs and other Office of Refugee Resettlement (ORR)-funded refugee service providers to assist in the process of identifying and referring survivors.
Amount: A total of $10,000,000 is available to make 34 awards that range from $200,000-$450,000 and average $294,000 per budget period. The project period is for 48 months (four 12 month budget periods).
Eligibility: State governments; county governments; city or township governments; special district governments; independent school districts; public and state controlled institutions of higher education; Native American tribal governments; public housing authorities/Indian housing authorities; Native American tribal organizations; nonprofits with or without 501(c)(3) status; private institutions of higher education; for profit organizations; and small businesses.
Individuals eligible for services under this program are those who have suffered torture in foreign countries and are now present in the U.S., including refugees, asylees, asylum seekers, immigrants, and other displaced persons. U.S. citizens who were tortured abroad are also eligible.
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