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Recognizing and Responding to Human Trafficking in Texas: Summary
• Being reticent to undergo additional testing or receive services due to large debt • Inability to: ○ Leave home or place of work ○ Speak for oneself or share one’s own information • Feelings of helplessness, shame, guilt, self- blame, and humiliation • Loss of sense of time or space; not knowing where they are or what city or state they are in • Emotional numbness, detachment, or disassociation (e.g., “flat affect”) Responding to Victims of Human Trafficking Victims of trafficking do not often disclose their trafficking situation in clinical settings. Before starting any conversation with a patient, assess the potential safety risks that may result from asking sensitive questions of the patient. Recognize that the goal of your interaction is not disclosure or rescue, but rather to create a safe, nonjudgmental place that will help you identify trafficking indicators and assist the patient. • Allow the patient to decide if they would feel more comfortable speaking with a male or female practitioner • If the patient requires interpretation, always • If the patient is accompanied by others, try to find a time and place to speak with the patient privately • Take time to build rapport with potential victims, or if you do not have the time yourself, find someone else on staff who can develop rapport with the patient • Ensure that the patient understands confidentiality policies and practices, including mandatory reporting laws • Use multidisciplinary resources, such as social workers, where available • Refer to existing institutional protocols for victims of abuse/sexual abuse use professional interpreters who are unrelated to the patient or situation
Most recommendations suggest that in order to allow patients the opportunity to speak for themselves, clinic or hospital staff should attempt to interview and assess all patients privately. This may require the use of an independent interpreter, since many survivors have limited English proficiency . Multilingual nonclinical staff who may share a common language with trafficked persons of limited English proficiency may be able to develop rapport with trafficked persons that facilitates trust and frank communication based on their language and/or cultural commonalities. It is recommended, therefore, that healthcare organizations think broadly about the types of employees who are appropriate to receive training about human trafficking to enhance opportunities for identification of and response to potential trafficking situations.
LEARNING TIP! Trained nonclinical workers, such as receptionists, security guards, and accounting personnel, could be instrumental in helping to maintain separation during potential victim identification interviews in a manner that does not alert potential traffickers to victim identification efforts.
Many victims of both sex and labor trafficking fear that if they escape their servitude and initiate investigations against their trafficker, the trafficker and their associates will harm the victims, the victims’ family members, and/or others. Additional patient situations, behaviors, or emotional states may suggest human trafficking. • Paying cash or having no health insurance • Lacking control of identification documents (ID or passport) • Having few or no personal possessions
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