Development Articles & Publications

Descriptive, inferential, functional outcome data on 9,025 torture survivors in the United States

A paper authored by 23 centers of the National Consortium of Torture Treatment Programs paints a nuanced portrait of 9,025 torture survivors living in the United States many of whom are refugees or asylum seekers.  This report documents torture in 125 countries, with findings drawn from the largest collection of data compiled and published about torture survivors across a single country. The report emphasizes the high mental and physical health consequences of torture.

Key findings from the report include:

  • The 9,025 individual torture survivors came from 125 different countries around the world.
  • Either Ethiopia or Iraq contributed the most survivors every year of the six-year project. 
  • 10 of the 125 countries account for over half (55.5% / 5,019) of the torture survivors. Those countries are: Ethiopia, Iraq, Somalia, Bosnia, Cameroon, Uganda, Congo DR, Eritrea, Cambodia, and Iran.
  • 9 of the top 10 countries signed the United Nations Convention against Torture. (Iran did not.)
  • 87% (109) of the 125 countries in which torture is documented signed the UN Convention against Torture.  The implications of this are profound for torture prevention.
  • Survivors need both psychiatric and medical treatment. 69% of the survivors, for whom psychiatric diagnoses were submitted, had post-traumatic stress disorder (PTSD); 52.4% had major depressive disorder (MDD). Rape was reported by 32% of female survivors.  Survivors reported experiencing an average of 3.5 types of torture. Hypertension and diabetes documentation is planned for the NCTTP’s next study. 
  • Asylum seekers, as compared to refugees at intake, had statistically higher percentages of both PTSD and MDD at intake.  Demographically, the asylum seekers were younger than refugees (37.1 as compared to 43.4 years old), and also reported more education in their countries of origin (13.8 years of education for asylum seekers vs. 9.75 years reported by refugees). 
  • Refugees showed statistically lower rates of MDD at intake if they accessed treatment one year or less after arriving in the U.S. (versus higher rates if they accessed treatment more than one year after arriving).  
  • At one and two years after beginning treatment, both asylum seekers and refugees reported increased rates of employment and improvements in their immigration status.

The study was authored by 23 of the 34 member centers of the National Consortium of Torture Treatment Programs, and is is published in TORTURE journal, volume 25, nr. 2, 2015

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Developing Competitive SAMHSA Grant Applications

A manual to help grantees acquire the skills and resources needed to plan, write, and prepare a competitive grant.

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Good stewardship

by Michelle Woster, CVT Individual Giving Officer

Good stewardship – which is defined as thanking, informing and engaging donors so they continually renew their support – is a critical piece of a successful development program.  Best stewardship practices are easy to implement, but are often overlooked or undervalued.  Here are three simple strategies for assuring donors that their decision to fund your organization was a smart one:

  1. Timely gift acknowledgments.  Have efficient, consistent procedures in place for processing donations and thanking donors.  Donors have the practical need of knowing that their gift was received either electronically or via USPS.  But they also need to know that the gift is valued, and that is communicated when an organization thanks them quickly and sincerely.  Issue a thank you letter, signed with a pen by a staff person, using appropriate IRS language within one week of receipt.  Donors who make gifts that are considered major by your organization should receive a phone call from leadership, as well. 
  2. Accurate recordkeeping.  If you list donors in your newsletter, website or annual report, make sure that their names are spelled correctly and that they appear in the correct dollar range of gift-giving. 
  3. Communicate outcomes.  Think of easily digestible methods for reporting your outcomes.  Avoid the use of too many acronyms or heady research.   Stories about actual humans served are the most powerful tools for motivating donors to give.   

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Managing and Prioritizing

by Anne Maertz, CVT Manager of Institutional Relations

Let’s say your initial research uncovered 25 foundation prospects, and you also learned about 3 local and state government calls for proposals.  How do you keep track of them all?  Depending on your needs and budget, you could use a Word document, a spreadsheet, a free online data base like CiviCRM,or a sophisticated, expensive program like the Raiser’s Edge.  There are lots of user groups in LinkedIn where you can get advice of the pros and cons of each.  Now, which ones should you approach first?  There are obvious considerations, like: Is there a deadline?  Other things to weigh are:

  • Affinity with your work—do they prioritize funding to mental health or refugee programs?
  • Personal relationships—do any of your trustees know any of their trustees? 
  • Type of funding—will they give you unrestricted support, or do they only want to build buildings?
  • Ability—a foundation with $55 million in assets will make more and larger grants than one with $1 million in assets.  

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Proposal writing

by Anne Maertz, CVT Manager of Institutional Relations
 
Through good research, you’ve found a funder whose interests match the work of your organization. You invited them to visit your program, they liked what they saw, and they’ve invited a proposal.  That’s great!  
 
There are many different proposal formats.  The two most common are: 1) a cover letter and narrative; and 2) an online form.  Briefly, the key elements of most general operating proposals are:
  • Organizational background (mission, history, programs, accomplishments and awards)
  • Needs statement (not your organization’s needs: torture survivors’ needs)
  • Organizational capability (qualifications of board, leadership, and staff; financial stability, experience managing grants, which other funders support you—will they be one of the “cool kids” named in your annual report donor list?)  
  • Monitoring and evaluation (what are your goals and objectives, how do you measure success, and what are your results?)
  • Attachments (typically your 501(c)3, audited financial statements, annual report, board roster, and annual budget)
Even general operating proposals should be tailored for each funder.  One foundation may be interested in your local program, another in your national or international work. One may care passionately about direct services and the next one will “get” the need for advocacy or training. Finally, writing proposals takes focus, which can be challenging, so consider how best to create time and space to zero in on it.  It may seem obvious, but make sure you get every proposal submitted on time if there’s a deadline, complete, and with no typos.  If any of your board members have connections with a foundation, send them a copy of the proposal and ask them to put in a good word for it if appropriate.  Then move on to the next proposal!     
 

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Relationship Building

by Anne Maertz, CVT Manager of Institutional Relations

There is an old saying in fundraising, “people give to people.”  Of course, a foundation will want to know that your organization’s programs are effective and your finances are in good shape.  However, if you can meet face to face with funder representatives and—even better—if you can introduce them to individuals who have been helped by your organization, those interactions will reinforce the case for support you have presented on paper.  It can be intimidating to pick up the phone or send an email to a foundation contact.  However, keep in mind that it is their job to give away money.  Most of them want to hear from potential grantees.  They will say “no” if they don’t think your organization is a good fit for their programs; don’t take it personally.  If they say “yes”, set up a meeting at your office for a tour and to meet several beneficiaries and/or direct service staff members.  Think through your messages ahead of time and rehearse the meeting.  Have a list of questions to ask them, and leave plenty of time for them to ask questions.  It’s okay to ask at the end of the meeting, “May we submit a proposal?”  Either way, thank the funder for visiting.  Then, try to maintain regular contact through email updates, invitations to events, or phone calls.  Don’t just call or write when you want something!      

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Researching Foundations

by Anne Maertz, CVT Manager of Institutional Relations

The first step to raising funds from foundations is to research them.  Look for foundations that have an interest in your organization’s type of work.  Try using the Foundation Center’s keyword search website.  Try terms like “mental health” or “refugees.”  Then check out any that are in your geographic area.  Also, review funder lists in the annual reports of organizations that carry out similar work.  Most foundations will expand their support to additional organizations if they really care about a cause.   You can look up individual foundations on the Foundation Center’s 990 finder.  A 990 is a foundation tax return that can give you a wealth of information, especially on smaller foundations that do not have websites.  For instance, who is on the board?  How large are they in terms of assets?  Have their assets risen or fallen (which has implications for their grant making)?  Who did they make grants to last year, and what is their typical grant size?   You may want to make a “rough cut” list to start.  Next month: How to prioritize and manage foundation prospects.       

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Sample Donor Profile Sheet

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Sample Fundraising Letter to Law Firms

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Sample Time Line for Annual Benefit

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Sample Time Line for Fundraising Letter to Law Firms

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Sharing client stories - ethical, professional, and legal considerations

Sharing client stories must be done within a framework of ethical, professional, and legal considerations. While the experience can prove beneficial for some individuals, programs must establish boundaries for interviews and speaking engagements, and empower clients to decline the opportunity if they choose. Some considerations might urge extreme caution:

  • Client welfare
  • Risks of danger to family/friends back home
  • Client capacity to say no 

Some, on the other hand, might lead us to encourage clients to speak:

  • Speaking out as healing, especially within treatment/recovery context (empowering)
  • Staff collusion with collective silence/denial, a primary goal of the torturers (our own discomfort)
  • Client self-determination

Other concerns might include:

  • Dual relationships with the organization
  • Ambiguity inherent in “de-identifying” a client story
  • Client concerns about impartiality of our justice system and impact on ongoing immigration case
  • HIPAA and state laws (including privacy, informed consent, and fundraising disclosure)

The process of having clients share self-chosen aspects of their story might include: 

  • Mindfully selecting a pool of clients to approach (pre)
  • Inviting those selected clients with a carefully worded letter (pre)
  • Informing clients of specific media opportunities (pre)
  • Preparing clients for interviews (pre)
  • Accompanying clients during the interview (during)
  • Debriefing with the client after the interview (post)
  • Setting limits for future involvement with the interviewer (post)

The above is just a summary of the considerations for sharing client stories. Soon, we'll be sharing a video with a full presentation on this topic here.

For examples of client stories shared appropriately and effectively, see CVT's recent report on Syrian survivors and the earlier Tortured and Detained.

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Targeted Case Management

Background:  In 2010, CVT launched an effort to expand billing income, and in particular to fund services provided by social workers/case managers, and explored the possibility of securing contracts for Adult Mental Health Targeted Case Management.  Targeted Case Management (TCM) is a federal program that aims to help people with serious mental health problems stay out of the hospital and function independently.  TCM is managed by states, with individual counties either providing case management services through their own social workers or contracting with third party vendors for specialized and challenging populations such as torture survivors.  TCM services must be provided by a licensed clinician (social worker) and cannot involve psychotherapy.

Eligibility: Eligibility may vary from state to state.  In Minnesota, persons are eligible for TCM if they are eligible for Medicaid, have a mental illness and meet at least one of the criteria listed below.  CVT has found that 70-75% of clients are eligible by virtue of a diagnosis of major depressive disorder.

  1. Two or more episodes of inpatient care for a mental illness within the preceding 24 months;
  2. Continuous psychiatric hospitalization or residential treatment exceeding six months duration within the preceding 12 months;
  3. Has been treated by a crisis team two or more times within the preceding 24 months;
  4. Has a diagnosis of schizophrenia, bipolar disorder, major depression or borderline personality disorder; indicates a significant impairment in functioning; and has a written opinion from a mental health professional, in the last three years, stating that the adult is reasonably likely to have future episodes requiring inpatient or residential treatment, of a frequency described in clause (1) or (2) above, unless ongoing case management or community support services are provided;
  5. Has, in the last three years, been committed by a court as a person who is mentally ill under chapter 253B, or the adult’s commitment has been stayed or continued; or
  6. Was eligible under clauses (1) to (5), but the specified time period had expired or the adult was eligible as a child; and has a written opinion from a mental health professional, in the last three years, stating that the adult is reasonably likely to have future episodes requiring inpatient or residential treatment, of a frequency described in clause (1) or (2), unless ongoing case management or community support services are provided.

Reimbursement details: Contracts are issued by counties, and the reimbursement rate is negotiated between the county and the third party vendor.  CVT’s rate is $530 per client per month, and reimbursements are made by the state Department of Human Services.  For example, if 10 clients are TCM-eligible, the monthly reimbursement for those clients would be $5,300 and the annual reimbursement would be $63,600.

There are several parts to the process of launching TCM: a political process that involves relationship-building with county commissioners and professional health and human services staff, to help secure a contract with the county; an internal clinical process of altering the social services/case management function to conform to TCM requirements and then training case managers on the new requirements;  and a financial/administrative process to facilitate billing if that capability doesn’t already exist and to align with TCM billing requirements.

To begin the contracting process, it is vital to establish relationships with the county officials, mentioned above, who represent the district where your torture rehabilitation program is located. 

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Who is My Neighbor?

Tool Pamela Barnes developed specifically to raise money from local Christian churches. Available in MS Publisher format and PDF - if you have Publisher, you can modify this tool to suit your needs; if not, you can view the PDF and use it as a model or as inspiration.

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