Walter Javier Alvarenga Romero v. U.S. Attorney General

Court of Appeals for the Eleventh Circuit·Decided March 15, 2022·No. 20-13187·Unpublished

Opinion

[DO NOT PUBLISH]

In the

United States Court of Appeals For the Eleventh Circuit

No. 20-13187

WALTER JAVIER ALVARENGA ROMERO, Petitioner,

versus U.S. ATTORNEY GENERAL,

Respondent.

Petition for Review of a Decision of the Board of Immigration Appeals Agency No. A212-944-965

2 Opinion of the Court 20-13187

Before JILL PRYOR, LUCK, and BRASHER, Circuit Judges. PER CURIAM:

Walter Alvarenga Romero petitions for review of the Board of Immigration Appeals’s dismissal of his appeal of the immigration judge’s order denying his application for asylum, withholding of removal, and relief under the Convention Against Torture. He argues that the board erred by affirming the denial of his asylum and withholding of removal claims because the evidence compels a finding that, if he were removed to his home country of El Salvador , he would be persecuted on account of his membership in his particular social group—individuals who suffer from a mental illness and behave erratically. After a thorough review of the record and with the benefit of oral argument, we grant Alvarenga’s petition as to his claims for asylum and withholding of removal and remand for further proceedings, but we deny it as to his claim under the Convention Against Torture.

I. FACTUAL BACKGROUND AND PROCEDURAL HISTORY

Alvarenga, a citizen of El Salvador, came to the United States in 2007 when he was sixteen years old. In 2012, he began exhibiting the symptoms of a mental illness. Alvarenga heard voices and experienced paranoia. His family called the police, who hospitalized Alvarenga. He was later diagnosed with schizophrenia.

Following his diagnosis, Alvarenga’s symptoms re-emerged whenever he refused to take his medication, and his family would 20-13187 Opinion of the Court 3

have him hospitalized—often for weeks at a time. Alvarenga was hospitalized four times between 2012 and 2017 because of his schizophrenia .

The Immigration Court Proceedings In 2017, the Department of Homeland Security served Alvarenga with a notice to appear before the Immigration Court. Alvarenga conceded removability and the immigration judge sustained the charge. Alvarenga then requested asylum, withholding of removal, and relief under the Convention Against Torture. The immigration judge denied Alvarenga relief and ordered him removed to El Salvador.

Alvarenga appealed to the board, and the board remanded the case to the immigration judge to determine whether Alvarenga was competent, and, if necessary, to conduct a new hearing with appropriate procedural safeguards. On remand, the immigration judge determined that Alvarenga wasn’t competent to litigate his own case and appointed counsel.

Alvarenga, now represented, then filed a second application for asylum, withholding of removal, and relief under the Convention Against Torture. Alvarenga argued that he had a well-founded fear of future persecution if he were removed to El Salvador on account of his particular social group: individuals from El Salvador who suffer from a mental illness and behave erratically. 1 He

1 Alvarenga also proposed several alternate social groups as a basis for relief: “Individuals in El Salvador who suffer from schizophrenia; Schizophrenic 4 Opinion of the Court 20-13187

contended that El Salvador had a “horrific record” in dealing with people suffering from severe mental illness and stigmatized mental illness. This stigma rose to the level of persecution, Alvarenga maintained, because he would be harmed by government officials (the police, the military, and the staff in El Salvador’s mental health institutions), and by gangs that the government was “unable and unwilling to control.” Alvarenga also argued that he was likely to be “singled out” for persecution because he wouldn’t receive adequate treatment for his schizophrenia, he would end up homeless because he had no family in El Salvador, and he would exhibit erratic behavior attributable to his mental illness, which in turn would cause gang members to notice and persecute him.

Alvarenga submitted reports from the United Nations and other organizations describing the poor state of El Salvador’s mental health facilities, the overuse of institutionalization, and the societal stigma against individuals with mental illnesses. Alvarenga also submitted an affidavit from Dr. Samuel Nickels, an expert on social conditions in El Salvador, describing the state of El Salvador’s mental health facilities, the poor treatment of individuals who

individuals in El Salvador; Individuals in El Salvador diagnosed with paranoid schizophrenia; Individuals from El Salvador who suffer from paranoid schizophrenia and display erratic behavior; Individuals from El Salvador who suffer from severe mental disabilities; Individuals from El Salvador who suffer [from] paranoid schizophrenia without family support, such as schizophrenia [sic]; [and] Schizophrenic individuals in El Salvador without family support.”

20-13187 Opinion of the Court 5

suffer from mental illnesses, and the heightened risks they face from gang members and the police.

The immigration judge held a hearing on Alvarenga’s application . Alvarenga testified about his mental illness, his history of hospitalizations, his lack of family support in El Salvador, and his fear of returning.

Dr. Nickels also testified in support of Alvarenga’s application . He explained that if Alvarenga were to be hospitalized in El Salvador’s primary mental health institution, he would likely be subjected to involuntary electroconvulsive therapy. 2 Dr. Nickels explained that there were widespread instances of overcrowding and medical neglect in the mental health institution: a common sight included patients “behind bars,” wearing “no clothing,” or just lying “on the cement floor in catatonic positions.”

Dr. Nickels explained that he believed Alvarenga would end up homeless in El Salvador, which would make him particularly susceptible to abuse by gang members and the police who would interpret his erratic behavior as resistance or disrespect. Dr. Nickels testified that gang members were “known to get irritated with these folks and just deal with them by stabbing or beating them up,” and that “there is real physical abuse and, sometimes, death and killings that result from the [mental] illnesses that these folks

2 Electroconvulsive therapy is a psychiatric treatment where a patient is anesthetized , fitted with an electric helmet, and then jolted with a pulse of electricity running through the frontal lobe of the patient’s brain.

6 Opinion of the Court 20-13187

have.” Dr. Nickels explained that although there are laws in El Salvador prohibiting discrimination against the mentally ill, gang members operate with impunity and the risk of violence was further exacerbated by the ongoing gang wars.

When he was asked how people in El Salvador would know that Alvarenga suffered from a mental illness, Dr. Nickels explained that:

[T]hey may or may not know that the person has a mental illness depending on whether they have any education and understanding about what a mental illness is. What they will certainly be able to observe and understand [is] that this person has bizarre behaviors . . . that would sort of stigmatize this person as being loco, crazy or violent and so in that sense, they would certainly be identifiable, what you and I would call somebody with mental illness but people across society might not use that term. They might just simply say, “Yeah, he’s a crazy guy. Watch out for him . . . .”

Dr. Nickels testified that this stigma put Alvarenga at a higher risk of harm relative to someone who didn’t suffer from a mental illness .

The immigration judge again denied Alvarenga’s application for asylum, withholding of removal, and relief under the Convention Against Torture. The immigration judge assumed that 20-13187 Opinion of the Court 7

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