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New U.S. guidelines aim to improve the health sector's response to human trafficking and better support survivors
Hanni Stoklosa is the Executive Director of HEAL Trafficking. Her co-authors are Laura Murphy, Jessica L. Peck, Rachel Robitz, Jordan Greenbaum, Ashley Garrett, Elizabeth Hopper, and Katherine Chon.
Last year, the U.S. National Human Trafficking Hotline received reports of more than 19,000 potential victims of human trafficking. In one challenging case, a hospital worker identified trafficking of a patient with a baby in need of immediate services and housing. The healthcare provider acted quickly to safely separate the patient from the trafficker, contact the hotline, and request emergency assistance from the U.S. Department of Health and Human Services.
While individuals experiencing forced labor or sex trafficking may be physically and socially isolated, research suggests that the majority of trafficking survivors have come into contact with a healthcare professional. Healthcare is a point of access for those experiencing trafficking, as indicated by more than 1,600 medical and behavioral health providers who called into the hotline last year. Yet not every healthcare provider may know what to do to spot and respond to human trafficking.
Trafficked persons seek out medical care for a range of issues from pre-existing health concerns to injuries directly related to their trafficking experience to other health needs, including complications from COVID-19. They visit emergency rooms, general practitioners, dentists, addiction treatment programs, counselors, and community health providers. Some visit gynecologists, women’s health nurse practitioners, or midwives seeking birth control, prenatal care, or treatment for sexually transmitted infections. Because trafficked persons do not usually identify as such, the onus is on the provider to identify patients who may be at risk for exploitation. If they are unable to do this, a critical opportunity to offer assistance is lost. Healthcare professionals need to be trained to identify persons who are being trafficked or at risk for trafficking so they can connect them to appropriate resources.
Recently, a group of expert health professionals from around the U.S. – representing general practitioners, psychiatrists, pediatricians, emergency room physicians, child abuse physicians, nurses, nurse practitioners, behavioral health clinicians, educators, researchers, and administrators – were brought together by the U.S. Department of Health and Human Services to create a strategy for improving the health sector response to human trafficking. The committee created a set of “core competencies” addressing four levels of the medical and behavioral health sector: 1) individual professionals, 2) health institutions or organizations, 3) researchers, and 4) health education institutions.
The primary goal of the core competencies is to improve outcomes for individuals who have been trafficked and those at risk by empowering health and behavioral health systems to adopt a system-wide approach that implements an effective, evidence-based, trauma-informed, and culturally-responsive approach to human trafficking. Further, the core competencies provide guidance to academic researchers so that a solid evidence base may be developed to guide and support best practices for medical and behavioral healthcare of trafficked persons. The core competencies also include recommendations to train the next generation of health professionals to provide optimal care to an underserved population.
The premise is simple – if healthcare practitioners and organizations institute these competencies as standard health professional education and practice, people experiencing trafficking will be more likely to be identified and offered appropriate care. People at risk of trafficking also will be identified, and offered services that may prevent future exploitation. Human trafficking is a public health problem and efforts to address it should focus on both prevention and response. This set of competencies will assist healthcare professionals in doing just that.
The core competencies outline specific skill sets that will guide health professionals and trainees in their care for individuals who have been trafficked and those at high risk of trafficking. They provide tangible and feasible recommendations to create healthcare environments that are culturally safe for patients and supportive of practitioners. hose competencies include:
- Employing a trauma- and survivor-informed, culturally responsive approach
- Understanding the nature and epidemiology of trafficking
- Evaluating and identifying risk of trafficking
- Evaluating the needs of individuals who have been trafficked or who are at risk of trafficking
- Providing patient-centered care
- Employing relevant legal and ethical standards
- Integrating trafficking prevention strategies
As noted above, trafficked and vulnerable individuals may access medical and behavioral health services in a variety of settings, including outpatient clinics, hospitals, and emergency or urgent care centers. The core competencies for clinicians and healthcare institutions should be integrated into existing healthcare practices across the United States to ensure that no matter how a person who has been trafficked engages with the healthcare system, they will receive appropriate care and referrals.
Access to quality healthcare is a basic human right and can play a major role in helping individuals who have been trafficked access justice.
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