(BMC Health Services Research) This study aims to provide guidance to health providers
on assessing and meeting the health needs of trafficked people through a
qualitative analysis of peer reviewed and grey literature. Findings highlight
the importance of interviewing possible victims in private, using professional
interpreters, and building trust. For provision of care, key themes include the
importance of comprehensive needs assessments, adhering to principles of
trauma-informed care, and cultural sensitivity. Further prominent themes are
the necessity of multi-agency working strategies and well-defined referral
pathways.
Background
Human
trafficking, which is estimated to affect 20.9 million people worldwide, is a
serious crime and a violation of human rights.
It involves the recruitment and transportation of people – often by the use of
force, fraud, deception or coercion – for the purposes of exploitation. People may be exploited for forced sex work, domestic servitude, forced labour
in industries such as construction, agriculture, fishing, factory labour, and
in forced criminal activity.
Although
evidence on health and human trafficking is limited, a systematic review found
that human trafficking is associated with high levels of physical and sexual
violence prior to and during trafficking and a range of health problems in the
post-trafficking period.
Studies with survivors identified high prevalence of depression, anxiety and
post-traumatic stress disorder and symptoms such as headache, fatigue,
dizziness, and back and stomach pain. A
number of policy and guidance documents describe assistance measures to respond
to the needs of trafficked persons, which include medical and psychological
care, yet there still appears to be little evidence-based guidance available on how
to plan, assess or provide for the health needs of trafficked adults and
children. Healthcare professionals believe they have insufficient knowledge and
lack confidence about how to respond appropriately to the needs of trafficked
people. Recent research in health organisations in areas with high numbers of
trafficking victims identified by police in England, suggest that 13 % of
health professionals had been in contact with a person that they suspect has
been trafficked.
Such findings underlie the importance of professionals increasing their
preparedness to identify potential cases of human trafficking and make
appropriate referrals.
Care for
survivors of human trafficking
Trafficked
people may present to healthcare services with multiple physical,
psychological, and social care needs. Responding to these needs requires that
healthcare professionals adopt trauma-informed and culturally-sensitive
approaches to working with victims of trafficking, conduct comprehensive health
assessments, and collaborate with a range of agencies, including law
enforcement and voluntary support services. Healthcare professionals’ ability
to provide care and to refer for further support is likely to be affected by
the provision of temporary or permanent legal residency (‘leave to remain’) to
survivors of human trafficking and the availability of stable housing,
financial, and legal support.
Training for healthcare professionals should include information about
in-country referral and support options for trafficked people and national
reporting requirements, if applicable. At the local level, healthcare
professionals should establish clear referral pathways and information-sharing
protocols with relevant agencies.
Studies have
highlighted the high prevalence and enduring nature of mental health problems
among survivors of human trafficking in contact with support services.
It is likely that psychological interventions to promote the recovery of
trafficked people will need to take account of physical and sexual abuse during
- and often prior to – trafficking and to work to stabilise physical and
psychological health and to address social needs before commencing
trauma-focused therapy.
However, no studies were identified that tested the effectiveness of
psychological interventions for trafficked people. The acceptability of
evidence-based treatments for post-traumatic stress disorder (PTSD) and
depression – such as cognitive behavioural therapy, narrative exposure therapy,
and eye movement desensitization and reprocessing – among trafficked people is
uncertain, as is the generalizability of therapies effective for other
traumatised groups such as victims of domestic violence and asylum seekers and
refugees. Research to investigate the efficacy of psychological interventions
for survivors of human trafficking is urgently needed.
Conclusions
Fundamentally,
human trafficking is a criminal form of extreme exploitation and abuse, from
which individuals suffer multiple physical, psychological, and sexual and
reproductive health problems. To foster recovery from this crime, healthcare
professionals must be at the centre of responses for survivors. Responding to
survivors’ needs requires that healthcare professionals adopt trauma-informed
and culturally-sensitive approaches, conduct comprehensive health assessments,
and participate in a reliable referral network, including law enforcement and
voluntary support services. Training for healthcare professionals should
include information about in-country referral and support options for
trafficked people and national reporting requirements, if applicable. At the
local level, healthcare professionals should establish clear referral pathways,
trustworthy points of contact and information-sharing protocols with relevant
agencies. Further health services research is urgently needed to enable health
professionals to fully engage in identifying, referring and caring for victims
of trafficking.
Read all: http://bit.do/cMZHd
No comments:
Post a Comment