SPECIAL POPULATIONS
Human trafficking The Centers for Disease Control and Prevention
should be suspicious when the nature of the injury does not fit the story provided as to how the injury occurred. Also, when suspected of trafficking, clinicians should look for a tattoo that brands or demonstrates ownership of the person. However, tattoos are not conclusive of trafficking (Henderson, 2022). Training opportunities and resources for healthcare workers and others are available to assist in understanding the unique needs of human trafficking victims. For example, the C aring for Trafficked Persons handbook, developed by the International Organization of Migration, helps providers understand how to respond better should they have a trafficked patient. The handbook is written in three languages and used in seven countries (Viergever et al., 2015). In addition, the Polaris Project developed a hotline to report known or suspicious trafficking (2019). Finally, local communities devise most health care and legal services for trafficked persons. A classic example is the Response Initiative Guiding Human Trafficking Services, or RIGHTS, group, a policy developed by three counties in Kentucky and Cincinnati, Ohio, that includes guiding principles to enhance healthcare and legal services for this population (Polaris Project, 2019). Pregnancy is a stressor for both partners and even though most women seek medical care during this time, abused women often miss routine follow-ups or may not start pregnancy care until they are in the third trimester. Because of the lack of prenatal care, babies may be born with healthcare issues. In addition, mothers with substance use disorders often continue using it, leading to poor nutritional status and additional health concerns for the baby. The most alarming healthcare concerns during the pregnancy of an abused female include suicide and homicide. Evidence-Based Practice! Research shows a concerning disparity in police response rates, with individuals with disabilities experiencing lower rates of police intervention (77%) compared to those without disabilities (90%) (NCADV, 2018). This highlights the urgent need to address systemic barriers and biases that may hinder the protection and support of individuals with disabilities facing violence. It is crucial for society to advocate for equitable access to justice and enhanced police responsiveness to ensure the safety and well-being of all individuals, irrespective of their disability status. toward authority. In other words, individuals with antisocial personalities violate socially accepted behavior. Understanding that mental health disorders preclude some people from violence, clinicians must routinely assess patients for the potential of being abused or abusing others physically or emotionally. Training for clinicians needs to include knowledge of proper assessment techniques; providing safety for patients; and providing consulting services, such as motivational or support groups, while enhancing patients’ cognitive and emotional skills. Brem and colleagues (2018) reported that physical and mental health issues credited to violence cost over $19.3 million annually.
defines human trafficking as the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for a commercial sex act (CDC, 2020b). The National Human Trafficking Resource Center (Polaris Project, 2019) estimates that one in six endangered runaways reported that they were likely sex trafficking victims. In addition, an estimated 4.8 million (or more) people are trapped in forced sexual exploitation globally. There were 8,248 sex trafficking cases reported in 2019 to the Hotline (Polaris Project, 2019). Monitoring and caring for victims of human trafficking present many problems. Cultural and language barriers, which are often present, may prevent people from seeking help. Additionally, victims may fear retaliation from their trafficker, legal ramifications, or deportation. This population also faces economic challenges, lack of social support, and social stigma, all considered barriers to their healthcare (CDC, 2020b). Trafficked patients experience repetitive physical and psychological injuries. Many display injuries related to weapons and sexual violence and nonspecific symptoms, such as headaches, depression, and stomach complaints (The Official State of Nevada, 2019). Clinicians Pregnant women The prevalence of physical violence during pregnancy is 28%, according to the World Health Organization (Hrelic, 2019). Ninety percent of the abusers are the biological father of the unborn, and the most common site of injury inflicted is to the abdomen or other sites (Hrelic, 2019). The most common site of physical abuse in pregnancy is bruising, especially on the back and arms, in various stages of healing (Hrelic, 2019). Other signs include changes in personality, anxiety about pleasing a partner, missing work or school, wearing clothing incongruent with the weather, and withdrawal from social settings (Hrelic, 2019). impairments, including physical, developmental, and psychological. Disabilities affect 1 in 4 women and 1 in 5 men in the United States, posing a higher risk of violence than the general population (CDC, 2020). Women are more likely to experience rape, and men are at greater risk for sexual coercion, unwanted sexual contact, and noncontact unwanted sexual experiences (CDC, 2020). Individuals with disabilities Disability can mean many types and degrees of People with mental health disorders Mental health and domestic violence are pervasive problems across the United States and have historically been overlooked. Mental healthcare services play an enormous role in recognizing and treating domestic and family violence. There is a reciprocal link between victims and perpetrators of violence with mental health conditions (Fisher et al., 2022). Brem and colleagues (2018) examined antisocial personality traits and the relationship between distress tolerance and domestic violence. Antisocial personality characteristics are documented as thinking only of oneself, disregarding the rights of others (which starts in early childhood), impulsivity, defiance, irritability, possible drug use (such as alcohol), aggressiveness, and hostility
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