Investigation into healthcare provision for trafficked young people finds high prevalence of mental health needs and barriers to care
Healthcare professionals need to show greater compassion and sensitivity when dealing with young victims of trafficking a new study has revealed.
The study, the largest of its kind, suggests that although young people trafficked into the UK experience significant trauma and violence, their healthcare needs are not being addressed effectively. Complex gatekeeping systems, language barriers and practitioners who fail to take the young people seriously all limit access to healthcare.
The research findings have been published in the international journal, Child Abuse & Neglect. Its lead author is Professor Nicky Stanley from the University of Central Lancashire (UCLan) working in partnership with researchers at King’s College London, the University of Stirling, the University of Melbourne and the London School of Hygiene & Tropical Medicine. The study highlights several areas for improvement that will allow healthcare professionals to provide a more compassionate and supportive service to people who often fall outside of the system.
The study involved health surveys and interviews with 29 young people aged 16 – 21 who were trafficked into the UK and relevant professionals working in the healthcare system. All participants were recruited through voluntary organisations and children’s services. It is believed to be the largest study of trafficked young people in a high income country to directly investigate their health experiences and perceptions of services.
Most of those interviewed experienced sexual violence during trafficking, regardless of gender, leaving some victims pregnant and with sexual health issues.
These young people are facing many barriers which prevent them from gaining access to vital healthcare. They are frequently expected to repeat their stories to a range of practitioners instead of establishing one point of contact.
UCLan Professor of Social Work Nicky Stanley commented: “These young people are facing many barriers which prevent them from gaining access to vital healthcare. They are frequently expected to repeat their stories to a range of practitioners instead of establishing one point of contact. This can add to their distress, they often feel under scrutiny during assessments leading to a lack of trust and language barriers can result in further isolation.
“We are operating in an environment where mental health services are already stretched and healthcare professionals are asked to act as gatekeepers to deny access or charge migrants for their healthcare which causes confusion regarding trafficked young people’s rights to these services.”
The study found that many health practitioners are unsure of where to refer victims of trafficking, which leads to an over reliance on children’s services instead of referring the young people directly for specialist care. This can result in lengthy referral routes and a culture of ‘someone else’s business’.
Dr Sian Oram, Lecturer in Women's Mental Health at King’s College London, undertook much of the fieldwork. She said: “The trafficked young people we spoke to were suffering from a range of health problems, but even after escaping their traffickers, many experienced difficulties accessing the healthcare they needed. Trafficked young people are likely to require considerable support to navigate and access health services: social workers and carers should be prepared to offer practical and emotional assistance with this.”
The research also indicates that support workers from relevant organisations, foster carers and others, including friends, were able to play a key role in championing young people’s health needs and assisting them to navigate services. In one interview, a young woman described how her support worker would break down the health professional’s communication into comprehensible messages. She said “She put it in pieces for me so I will understand.”
Trafficked young people are likely to require considerable support to navigate and access health services: social workers and carers should be prepared to offer practical and emotional assistance with this.
The victims, who could remain fearful of traffickers even after their escape, wanted reassurances about confidentiality in their contacts with health services and to be given time to explain their needs and for their accounts to be respected. Interviewees agreed that sensitivity, attention to confidentiality and continuity of staff were needed from health professionals when engaging with trafficked children and young people.
A copy of the study, ‘The health needs and healthcare experiences of young people trafficked into the UK’, is available here.
The researchers included: Nicky Stanley, Professor of Social Work at UCLan; Dr Sian Oram, Dr Sharon Jakobowitz and Professor Louise M. Howard from King’s College London; Joanne Westwood, University of Stirling; Dr Rohan Borschmann, University of Melbourne; and Dr Cathy Zimmerman from the London School of Hygiene & Tropical Medicine.
The research is independent research undertaken as part of the PROTECT study, which was commissioned and funded by the Department of Health Policy Research Programme (Optimising Identification, Referral and Care of Trafficked People within the NHS 115/0006). The views expressed in the publication are those of the author(s) and not necessarily those of the Department of Health.