Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!

Section 2
Identifying Victims of Human Trafficking
in Health Care Settings

Question 2 | Test | Table of Contents

Identify Victims of Human Trafficking in Health Care Settings
There are many areas within United States communities that have the potential to come into contact with victims of human trafficking, despite the difficulties that may present themselves in identifying victims due to the hidden nature of the crime. Recognizing the signs of human trafficking is the first step in being able to identify those who are victims of human trafficking.

Victims of human trafficking are at risk for the same types of injuries as victims of domestic violence and rape, such as frequently contracting sexually transmitted infections or becoming pregnant. Health clinic workers and emergency room personnel can often be first responders and thus, should be trained to be able to assess whether someone is a victim of human trafficking. Another common area that victims could be identified through is through battered women and homeless shelters. Because of this, there are guidelines that have been issued by several domestic violence and sexual assault coalitions for battered women service providers on being able to identify and serve victims of human trafficking.

Other groups that can also encounter and identify potential victims include social workers, mental health professionals, school personnel, community-based organizations, faith leaders, and citizens. Victim referrals to non-governmental organizations has increased as the public’s awareness of the problem of human trafficking has grown (U.S. Department of Health and Human Services).

Law enforcement agencies have the greatest chance of identifying victims of human trafficking. Most of the victims who have been referred to non-governmental organizations and other service providers were initially identified by Federal and local law enforcement. Many of the documented cases of domestic trafficking are the result of law enforcement task force investigations.

These law enforcement task forces face challenges in identifying victims of human trafficking as well. One of these challenges is the inconsistency in the definition of human trafficking. There is a lack of consensus within law enforcement as to whether a minor who is involved in prostitution is a victim or is an offender. Law enforcement personnel often report coming into contact with victims of human trafficking through the investigation of other crimes (U.S. Department of Health and Human Services).
 
Challenges to Victim Identification
There can be many challenges to identifying victims of human trafficking. For example, both adult and minor victims have more than likely been in isolation and have been coached by their trafficker to lie about their circumstances or to fear law enforcement due to their participation in unlawful activity, such as prostitution, or in the case of foreign victims, being an undocumented citizen or having a previous experience with corrupt or violent authorities in the victims’ home country.

These fears that victims have are exploited by the traffickers through threatening the victims with arrest, detention, or deportation if they are encountered by authorities. Sometimes, the victim has other problems in his or her life such as an abusive family, drug addiction, or extreme poverty that the trafficker exploits in order to ensure the victim stays compliant.

Victims of sex trafficking are more likely to be encountered by law enforcement since commercial sex is already illegal in most locations. Victims who are exploited for commercial sex must have been advertised or brought into contact with customers, both of these situations increase the opportunities for the victims to encounter law enforcement or even civilians.

However, that does not mean that the identification of potential victims is any easier. Some of the problems that law enforcement may encounter with identifying victims of sex trafficking include minors who say that they are over the age of 18 and adults who may conceal the use of force, fraud, and coercion.

Unlike identifying victims of sex trafficking, victims of labor trafficking have lower opportunities to encounter law enforcement. This is due to labor trafficking victims being exploited in isolated homes, fields, or factories that allow few opportunities to come into contact with other outsiders (U.S. Department of Justice, 2017).

A significant challenge that occurs when identifying victims of human trafficking is that many victims have historically been, and in some instances continue to be, viewed as criminals (for example, undocumented immigrants or prostitutes) and have been subject to arrest, detention, and/or deportation.

Under the TVPA (Trafficking Victims Protection Act of 2000), those individuals who were previously identified and treated as criminals should be identified and treated as victims of human trafficking. This change is important, however, it is challenging for Federal, state, county, and local law enforcement and prompts the need for not only adequate, but ongoing, education, training, and commitment at all levels of these agencies.

This needed shift in focus of identifying and treating victims of human trafficking has not been achieved consistently, partly due to the decentralized structure of the law enforcement system, there are more than 13,000 local police departments alone in the United States. Other aspects that complicate this shift is that some individuals, such as adults who are engaged in commercial sex activity without the elements of force, fraud, or coercion, may not be considered victims of human trafficking.

Ideally, every law enforcement officer throughout all levels of law enforcement would have the proper training and tools needed (such as knowledge of common screening questions and protocols) in order to correctly apply the trafficking law, make the proper distinctions between victims and criminals, and refer victims of human trafficking for health and human services (U.S. Department of Health and Human Services).

Successful Identification of Victims of Human Trafficking
Even though identifying victims of human trafficking can be difficult to differentiate between those who are victims of human trafficking and others who were arrested for various other crimes, there are steps that can be taken to improve the ability of those who may be more likely to encounter potential victims of human trafficking. Some of these steps include increasing education and training on human trafficking, understanding the rights of victims, knowing how to respond to victims, what the needs of victims are, and the resources that are available to victims of human trafficking.

In addition to the steps listed above, the use of standard protocols that are used to screen for victims of human trafficking (these would include questions that should be asked and techniques for interviewing victims) that are essential for the successful identification and ultimately, cooperation from victims. After the passage of the TVPA and increased funding to non-governmental organizations, law enforcement agencies, and other service providers that may come into contact with potential victims of human trafficking, the availability of these protocols for identifying and responding to victims of human trafficking has grown substantially.

While protocols have been developed to determine if a foreign national is a potential victim of human trafficking, there are few published assessment protocols with questions to determine potential victims of domestic trafficking. While some agencies that conduct outreach to this population (i.e., prostituted children/adults) have developed their own assessment tools, there are no published protocols for use by medical providers, child protection workers, and others as there are for international trafficking and domestic violence victims.

For example, SAGE uses an assessment tool within the juvenile justice system which remains unpublished and unavailable for review. To assist with identification, the HHS Office of Refugee Resettlement has established the Campaign to Rescue and Restore Victims of Human Trafficking. This public awareness campaign has established Rescue and Restore coalitions composed of social service providers, law enforcement, academics, students, and other key stakeholders in 24 cities, regions, and States. The goal of these community action groups is to raise awareness of human trafficking and build local anti-trafficking networks. The Office of Refugee Resettlement’s street outreach grants facilitate identification of victims through direct outreach to individuals involved in or at-risk for trafficking. Additionally, the agency funds the National Human Trafficking Resource Center a toll-free hotline (888-373-7888) where community members, law enforcement, social service providers, victims of human trafficking, and others can report incidents of human trafficking, receive technical assistance, and obtain referrals for a variety of services.

Like coalitions, multidisciplinary teams and task forces are promising approaches to effective identification. Through ongoing communication and sharing of information, coordinated outreach, and service follow-through, these entities are better positioned to identify and respond to all victims of human trafficking than single agencies operating in isolation. Coordinating the identification process also helps protect victims by not requiring them to tell their story repeatedly to different providers. Anti-trafficking task forces funded by the Bureau of Justice Assistance and OVC, other State anti-trafficking task forces and community coalitions, and the Innocence Lost task forces are making inroads in addressing the challenges of identifying victims and coordinating communications and services.

Additionally, Northeastern University, in conjunction with the National Institute of Justice, conducted a study to address how law enforcement defines human trafficking, the number of investigations conducted, the extent of reporting, the nature of coordination with other agencies, and what are considered best practices in responding to human trafficking. Various states are using other mechanisms to ensure providers respond quickly and victims have access to services.

In Suffolk County, Massachusetts, all providers (including law enforcement, medical providers, and school-based personnel) are instructed to file a 51A report of child sexual abuse to the Massachusetts Department of Social Services if they have sufficient reason to believe that an adolescent is being exploited through prostitution. The provider files on behalf of the youth against an unknown perpetrator (i.e., pimp) when more information on the pimp is not available. This report is screened out by the Department of Social Services if the perpetrator is not a family member and is sent to the district attorney’s office as a discretionary referral. An assistant district attorney and a victim/witness advocate are assigned immediately and the Multidisciplinary Team Guidelines take effect.

Update
Identifying and Supporting Victims
of Human Trafficking in the Asylum Procedure

-
Reviewed 2023
Peer-Reviewed Journal Article References:
Lavoie, J., Dickerson, K. L., Redlich, A. D., & Quas, J. A. (2019). Overcoming disclosure reluctance in youth victims of sex trafficking: New directions for research, policy, and practice. Psychology, Public Policy, and Law, 25(4), 225–238. 

Rafferty, Y. (2018). Mental health services as a vital component of psychosocial recovery for victims of child trafficking for commercial sexual exploitation. American Journal of Orthopsychiatry, 88(3), 249–260.

Reid, J. A., Baglivio, M. T., Piquero, A. R., Greenwald, M. A., & Epps, N. (2019). No youth left behind to human trafficking: Exploring profiles of risk. American Journal of Orthopsychiatry, 89(6), 704–715. 

QUESTION 2
Victims of human trafficking can often show the same signs of victims of which two other crimes? To select and enter your answer go to Test.