188体育

Main messages

Human trafficking involves the recruitment or movement of people for exploitation by the use of threat, force, fraud, or the abuse of vulnerability.

Trafficking is a crime that can occur across international borders or within a country. It often crosses multiple geographic and legal boundaries.

Men, women and children may be trafficked for various purposes. They include labour sectors (for example, agriculture, food processing, manufacturing, services), domestic servitude, forced begging and petty theft and sexual exploitation.

Individuals who have been trafficked are likely to experience prior to, during and after their trafficking experiences, and many suffer acute and long-term health problems. Health consequences of human trafficking may include injuries, physical pain and illnesses, and sexual health problems. They may also include mental health problems such as depression, anxiety, psychosis and post-traumatic stress disorder.

Women trafficked for sexual exploitation and domestic servitude report high levels of sexual violence. Men and women report high levels of symptoms of sexually transmitted infections.

Healthcare professionals should:

• support GP registration, which does not require proof of address or immigration status
• use professional language interpreting services and not family members, friends, children or accompanying person (for safeguarding reasons and to minimise risk of coercion)
• obtain a detailed medical history and sexual history from survivors or suspected victims of trafficking
• identify and suspected human trafficking and modern slavery
• refer individuals to relevant services and specialist health services where needed (physical and mental health)
• apply trauma-informed approaches to service provision
• collaborate with agencies outside of the health and social care sector to identify and coordinate good prevention and response mechanisms, as part of a broader

Background

Trafficking is a process comprising various stages, starting with recruitment and followed by travel and transit, destination and exploitation. The exploitation stage may also be followed by periods of detention or re-trafficking, and later by:

• integration (if remaining at destination); or
• re-integration (if returned home)

Each stage poses different risks to a trafficked person鈥檚 health and wellbeing. They may be at risk of psychological, physical and sexual abuse, forced and coerced substance abuse, social restrictions, and manipulation. Other risks include economic exploitation and debt bondage, legal insecurity, occupational hazards, and abusive working and living conditions.

:

• mental health issues, such as anxiety, depression, psychosis, PTSD, suicide ideation, self-harm, somatic complaints, aggressive behaviour, memory loss and cognitive problems
• poor physical health, such as acute injuries, chronic physical pain, fatigue, exhaustion, poor nutrition, sexually transmitted infections, other sexual and reproductive health complications and unwanted pregnancy
• substance use or misuse, such as drug or alcohol addiction, overdose, self-harm, needle-introduced infection, and sleep problems
• social health consequences, such as feelings of isolation, loneliness, shame, guilt, social withdrawal and risk of re-trafficking
• occupational injuries and disease, such as bacterial and other infections, chemical burns, injury, musculoskeletal injury, exhaustion and poor nutrition
• marginalisation and social exclusion

Individuals who have experienced human trafficking encounter many both during and after exploitation.

Identifying human trafficking

.

Trafficking is a hidden crime and it is rarely obvious that an individual has been trafficked. However, might include a combination of:

• being a migrant in work commonly associated with trafficking (such as labour industries)
• signs and symptoms of abuse or trauma
• appearing fearful and untrusting and presence of a minder

Refer to .

Refer to the for more information on how to conduct interviews with patients.

Healthcare professionals can .

Caring for people who have been trafficked

How people respond to traumatic experiences can vary widely and can be influenced by cultural norms, age, education, gender and personal histories. As a result, there is no simple 鈥榬ight way鈥� to approach and care for all trafficked persons. However, there are some ABCs of caring for people who have been trafficked. You should:

• assure patient and provider safety by consulting with the patient before contacting other support services (such as the police) to be sure this is what they want
• avoid using the possibly trafficked person鈥檚 family, friends or children for language interpreting interpretation. The perpetrator may pose as a relative or friend, and may accompanying a patient to their appointments
• be prepared with good referral options and procedures by having contact details for the main agencies to hand, so no time is wasted looking these up. Try to make referral as easy as possible by providing the trafficked person with contact names or referral letters
• create a clinical safe space for disclosure, discussion and decision-making by learning about the effects of traumatic events, and acknowledging and addressing abuse in informed and sensitive ways. Do your best to make the time and private space for individuals to disclose and describe events and concerns

When caring for people who have been trafficked, you should also:

• apply trauma-informed approaches to service provision
• use a patient-centred approach, which makes the patient central to the decision-making process and helps prevent disempowering or re-traumatising individuals who have been trafficked
• draw on approaches used for other vulnerable populations, such as victims of violence or torture, other migrants, sex workers (if relevant)
• consider (PDF, 1MB)

A is needed for modern slavery and human trafficking prevention and response. In some regions, the health sector is involved in (PDF, 7MB). However, it is currently more common for NHS trusts, ICSs, national and local public health teams to be absent from the system-wide response. Healthcare professionals should collaborate with agencies outside of the health and social care sector to identify and coordinate good prevention and response mechanisms.

Referral options

National Referral Mechanism referrals

The UK has implemented a National Referral Mechanism (NRM). The NRM is a process by which potential victims of trafficking are formally identified and offered temporary government funding in the UK. After receiving support, a person who has no other rights to live in the UK, or who wants to leave the UK, will be supported to return to their country of origin. If a referred person is determined not to be a victim of trafficking and there are no other circumstances that would give them a right to live in the UK, they will be supported to return to their country of origin.

NHS professionals cannot refer directly into the NRM, but with the patient鈥檚 consent may contact the Salvation Army鈥檚 referral helpline.

Other referral options

A small number of charities provide support to victims of trafficking who have not been referred into the NRM. The Modern Slavery Helpline takes calls from potential victims and statutory professionals concerned about trafficking. They can advise on relevant services and referral options.

Referral options for children

NHS professionals concerned that a child or young person may have been trafficked have a legal obligation to:

• follow all child protection guidelines
• speak to their designated Child Protection Lead

Out of hours, contact your local children鈥檚 social services or police service, specifically highlighting your concern about child trafficking.

Resources

Modern slavery: identifying and supporting victims contains guidance from the Department of Health and Social Care for health staff who suspect that a patient may be a victim of human trafficking and slavery.

The Home Office鈥檚 modern slavery training resources contains basic awareness raising materials and provides examples of training products available to public sector professionals and other individuals that might come across victims. As well as helping to raise awareness, these resources allow them to better spot the signs of potential modern slavery cases and have more confidence when reporting.

Potential victims or statutory professionals concerned about trafficking and provides advice on relevant services and referral options can contact the can be contacted on 08000 121 700.

was developed jointly by the International Organization for Migration and the London School of Hygiene and Tropical Medicine.

The provides accommodation, care and support to victims of trafficking. They can provide assistance with referral via their helpline: 0300 303 8151.

The can provide further advice for professionals worried that a young person may be a victim of trafficking via their helpline: 0808 800 5000.

The is a human rights organisation working with survivors of cruelty.

aims to provide safety, hope and choice to women who have been trafficked for sexual exploitation. Unseen UK also provide a resource on the most common signs of modern slavery and exploitation.

provides information for practitioners, including a free national advice and information helpline.

The project (Provider Responses, Treatment and Care for Trafficked People) conducted by King鈥檚 College London and the London School of Hygiene and Tropical Medicine provides evidence about the healthcare needs and experiences of trafficked adults and children. It documents NHS knowledge and experience of responding to the health needs of trafficked people. The (PDF, 2.7MB) is available online.

Freedom from Torture (FfT) provides for frontline healthcare, social and legal workers to address the needs and rights of survivors of torture.

The University of Sheffield, Public Health England (now the Office for Health Improvement and Disparities) and the Office of the Independent Anti-Slavery Commissioner developed . This is an evidence-based approach to developing a strategy for action on modern slavery in the UK. It includes:

• an interactive framework
• a guide for policy, strategy and local partnerships
• a full report

The connects individuals and organisations involved in modern slavery and human trafficking prevention, intervention and aftercare. They promote a whole-person health and public health-informed approach and provide an array of resources through their .