Socio-economic, trafficking exposures and mental health symptoms of human trafficking returnees in Ethiopia: using a generalized structural equation modelling

Abstract

BackgroundMental health problems among trafficked persons could be the result of concomitantly interwoven effects of various factors. Analyzing the networked relationships concurrently could be a more substantive approach to better understand the role of risk factors in this population. This study aimed to assess the magnitude of mental health symptoms as well as the association among socio-demographic, trafficking related exposure variables, and mental health problems of Ethiopian returnees from trafficking.MethodsA sample of 1387 returnees who were trafficked via three major human trafficking corridors of Ethiopia were selected consecutively. Data related to socio-economic, trafficking exposure variables, and symptoms of mental illness were collected in personal interviews. Anxiety was measured with a brief measure for generalized anxiety disorder (GAD-7), depression with a patient health questionnaire (PHQ-9), and PTSD with post-traumatic checklist (PCL-C). Generalized structural equation modeling was employed to estimate the relationships among exogenous, mediating, and endogenous variables simultaneously.ResultsThe prevalence of symptoms of anxiety was estimated at 51.9% (95% CI 49.3–54.6%); PTSD was estimated at 34.5% (95% CI 32.1–37.1%) and depression at 58.3% (95% CI 55.6–60.9%). Restricted freedom of movement had a direct positive effect on anxiety (β = 1.24, 95% CI 0.97–1.51), depression (β = 0.94, 95% CI 0.71–1.17) and PTSD (13.00, 95% CI 11.23–14.77). Violence experienced during the trafficking period was a mediator variable and significantly associated with anxiety (β = 0.46; 95% CI 0.26–0.66) and PTSD (β = 4.00; 95% CI 2.06–5.94). History of detention had a positive total effect on GAD (total β = 1.380, 95% CI 1.074–1.687) and PTSD (total β = 15.63, 95% CI 13.708–17.545), and direct positive effect on depression (β = 0.89, 95% CI 0.65–1.13).ConclusionEthiopian trafficked persons were highly likely to return with increased levels of mental health symptoms, namely anxiety, depression, and PTSD. Socio-economic and trafficking related exposures mediated by violence were factors affecting mental health symptoms. Thus, in addition to economic re-integrations of victims, strategies should be designed and implemented to address the prevalent mental health problems.Electronic supplementary materialThe online version of this article (10.1186/s13033-018-0241-z) contains supplementary material, which is available to authorized users.

Mental Health of Human trafficking; A Systematic Review

“…Characteristics of participants in 14 studies were described as follows: characteristics of study participants in Ethiopia were male and female under the age of 18 years old (Gezie et al, 2018). Cambodia, Thailand, Vietnamese were male, female, adolescents and children aged 10-17 years (Iglesias-rios et al, 2018;Aberdein & Zimmerman, 2015), Moldova special for female aged >18 years (Abas et al, 2013), Ghana special for girls and female without mentioning age (Okech et al, 2018), US to keep track of medical records of patients <18 years (Moore, Houck, Hirway, Barron, & Goldberg, 2017).…”

“…The research data was collected in 2006-2012 (Cary et al, 2016), 2006-2012(Okech et al, 2018, 2014 (Rafferty, 2018;Ottisova, Smith, Shetty, Stahl, & Downs, 2018), 2006-2012(Domoney, Howard, Abas, Broadbent, & Oram, 2015, 2016 (Gezie et al, 2018). Four were taken using electronic medical records and databases CRIS years 2007-2012 (Aberdein & Zimmerman, 2015); (Cary et al, 2016); ; (Rafferty, 2018).…”

“…IOM noted Indonesia including the 13 countries with the highest number of cases handled (Kiling-Bunga, 2019). Trafficking problem has occurred for a long time despite the efforts of the government, local and international organizations (Gezie, Yalew, Gete, Azale, & Brand, 2018).…”

“…Victim susceptible to a variety of crimes. It varies depending on socio-demographic characteristics and exposure to the treatment received (time spent during the trade, this kind of exploitation, the level of restriction of liberty and the number of hours worked) (Gezie et al, 2018). Victims are limitations in his life including basic water needs.…”

“…The victim very likely to experience anxiety, depression and PTSD. Exposure related socio-economic factors influencing trade into mental health (Gezie et al, 2018). Mental disorders are continuing according to the condition of victims plus predisposing factors aggravate the situation (Abas et al, 2013) such as differences in experiences of violence on female victims and male.…”