Creating a Collaborative Trauma-Informed Interdisciplinary Citywide Victim Services Model Focused on Health Care for Survivors of Human Trafficking

Abstract

Although human trafficking is recognized as a public health issue, research on the health effects of human trafficking and best intervention practices is limited. We describe 2 citywide collaborative victim services models, the THRIVE (Trafficking, Healthcare, Resources, and Interdisciplinary Victim Services and Education) Clinic at the University of Miami and Jackson Health System in Miami, Florida, and the Greater Houston Area Pathways for Advocacy-based, Trauma-Informed Healthcare (PATH) Collaborative at Baylor College of Medicine, CommonSpirit Health, and San Jose Clinic in Houston, Texas, funded in part by the Office for Victims of Crime, which focus on trauma-informed health care delivery for victims of human trafficking. From June 2015 through September 2021, the THRIVE Clinic served 214 patients with an average age of 28.7 years at the time of their first visit. From October 2017 through September 2021, the PATH Collaborative received 560 suspected trafficking referrals, 400 of which screened positive for labor or sex trafficking. These models serve as a framework for replication of interdisciplinary practices to provide health care for this unique population and preliminary information about the strategies put in place to assist victims during their recovery. Key lessons include the importance of a citywide needs assessment, patient navigators, interdisciplinary care, and building community partnerships to ensure safe housing, transportation, identification, health insurance, vocation services, input from survivors, peer-to-peer mentorship, and medical–legal services. Further research is needed to understand the detrimental health effects of trafficking and the health care needs of victims. In addition, a need exists to develop optimal models of care for recovery and reintegration for this patient population and to address public health, legal, and medical policies to ensure access to and sustainability of comprehensive, trauma-informed, interdisciplinary victim services.

Argument-based Ethics and Mandatory Reporting Laws for Trafficked Persons

“…The clinical applications described in the reviewed articles include the need to have educational efforts accompanying any mandatory reporting laws. Education for health care professionals on human trafficking is increasingly available, 27 but simply the existence of education is the bare minimum standard 11,28 . Trainings must be held to a standard that provides mandatory reporters with a nuanced understanding of both labor and sex trafficking and an understanding of how bias and intersecting structural vulnerabilities may impact the identification of already marginalized groups 29 .…”

“…Education for health care professionals on human trafficking is increasingly available, 27 but simply the existence of education is the bare minimum standard. 11,28 Trainings must be held to a standard that provides mandatory reporters with a nuanced understanding of both labor and sex trafficking and an understanding of how bias and intersecting structural vulnerabilities may impact the identification of already marginalized groups. 29 Furthermore, we must consider the intersections of human trafficking and special populations.…”

“…6,8 There are both patient-centric and provider-centric barriers to disclosure and identification. 9,10 Emerging work describes best practices in how to work with patients once they have been trafficked, 11 but with one contentious issue concerning whether there should be mandatory reporting by health care professionals of trafficked adults with capacity. There is more consensus regarding mandatory reporting of vulnerable populations being trafficked, including children and incapacitated adults.…”

Human trafficking prevention: Using a socioecological framework to moderate risk and promote protective factors.

“…Feelings of disenfranchisement are common and impede health care access behaviors and health services engagement (Price et al, 2021). Individual-level supports, such as trauma-informed case management and advocacy, can increase accessibility to resources described under community protective factors above, including community connectedness and safety, economic stability, educational opportunities, and social services and quality health care (Jain et al, 2022;Pesso, 2014).…”

Saúde: Aspectos Gerais

“…Em resumo, várias diretrizes são identificadas ao longo do capítulo do documento 4, incluindo confidencialidade, escuta ativa, confiança e atendimento diferenciado. Essas diretrizes visam garantir a segurança e integridade das vítimas, promover um ambiente acolhedor e atender às necessidades específicas de cada caso(MOUSAVI-RAMEZANZADE et al, 2020;JAIN et al, 2022;HEMMINGS et al, 2016;ORAM et al, 2012;GREENBAUM, 2020). Embora o documento 4 não apresente discussões específicas para as vítimas de exploração sexual, menciona o modelo europeu de Plano de Assistência Individual (PAI), que consiste em um plano individualizado elaborado por uma equipe multidisciplinar, com ações de curto, médio e longo prazo de acordo com a realidade de cada indivíduo(MJSP, 2013).…”