Abstract Background Asylum applicants can benefit from psychiatric evaluation which can explain how culture and mental health symptoms relate to perceived deficits in credibility. Case presentation Ms. B presented for psychiatric evaluation, seeking asylum in the USA after multiple threats on her life in Honduras. At initial evaluation, she was diagnosed with depression. On reevaluation, she was found to have panic attacks and post-traumatic stress disorder. Recommendations included an anxiolytic medication and the use of pre-written statements upon interview. However, Ms. B was sent back to her country of origin despite her severe mental symptoms. Conclusion Post-traumatic disorder scales should be used by mental health professionals especially with patients who are not forthcoming about past trauma history to avoid missing this diagnosis. There is a need to inform immigration officials and lawyers about the necessity of accommodating clients’ needs to appropriately present themselves in asylum interviews.