Facilitating a conversation about human trafficking can be difficult. It is an emotionally charged topic with numerous myths floating around, a lack of evidence on prevalence and screening tools, and is generally a new topic to most people, including healthcare providers. However, there are a few key points that should be considered by any facilitator discussing human trafficking:1
Ensure that international data is from a reputable source such as the International Labor Organization and that national data is from comprehensive databases such as the Polaris. It is also important not to inflate calls or information seeking about human trafficking with substantiated prevalence rates.
It is important to focus on both labor and sex trafficking occurring among adults, children, foreign nationals, and victims. There is no one profile for human trafficking, so examples and content should encompass a diverse group of victims.
We have all heard the stories about individuals who are “taken” and seen pictures of “chains” and “tattoos” associated with human trafficking; however, these images represent the unicorns of human trafficking not the majority of cases. It is important to avoid reinforcing this misleading imagery.
We must recognize the trauma survivors have experienced and the impact it can have on their health, behavior, and desires. Our mindset should be focused on “What happened to our patients?” instead of “What’s wrong with you?”
Patients should be treated as the experts on their situation and their bodies and we need to respect their desires and recognize the trauma they have experienced. It is important to situate any discussion about human trafficking around survivor voices and choices.
In many health facilities, healthcare systems and providers can build off of pre-existing policies related to intimate partner violence and child maltreatment. Use these principles to provide examples about screening, response, and working with law enforcement.
The priority is to establish trust and rapport, rather than achieve disclosure. Currently there are only a handful of validated human trafficking screening tools. However, research on this topic is growing. It is important to remain up-to-date on current research and recommendations for evidence-based screening.
Do not advise health care providers to contact law enforcement for all cases of human trafficking unless mandatory reporting laws require such disclosures. In many cases, human trafficking is not a mandatory report and involving law enforcement could put the victim or their family at risk of further harm. Some state laws also put individuals, including minors, at risk of arrest for prostitution. Conversations with law enforcement about human trafficking are best accomplished before a case presents.
Human trafficking victims have complex healthcare, social service, and reintegration needs that cannot be addressed in silos. It is essential that we consider interdisciplinary response protocols to make sure we are working together with law enforcement and social service agencies to provide the best care and services we can to these very vulnerable victims.
Most patients are not necessarily going to come out and say that they are a victim of trafficking. Some are in denial, some are being threatened, some people’s families are being threatened. These people may be unwilling to get help for their current situation. One of the most important things to remind healthcare providers is to trust your gut and to take care of themselves. This may include debriefing a difficult situation, seeking employee assistance services, or reminders to engage in self-care.