Women who have been trafficked for sexual or labour exploitation continue to experience high rates of mental illness including depression, anxiety, PTSD and suicidal thoughts, many months after leaving their traffickers. New research published in April by King’s College London and the London School of Hygiene and Tropical Medicine confirms that mental and physical health complaints continued to affect the women participants at a high rate, despite them having left their trafficking situations an average of 16 months previously.
The survey looked at both women and men, trafficked for diverse purposes including forced labour, forced prostitution and domestic servitude, and found that while after an average of six months, 40% of men were still reporting high levels of mental ill-health, the women surveyed, who had been free from their trafficking situations for longer, 16 months on average, reported symptoms in nearly 80% of cases.
Beyond the mental health symptoms recorded, women also complained of on-going physical symptoms including headaches, stomach, dental and back pain, fatigue and memory loss. A high level of sexually transmitted infection was also implied through other reported symptoms.
While women trafficked into the sex industry had, in almost all cases, experienced rape, they had also experienced physical violence at very high rates. Meanwhile, women who had been trafficked into domestic servitude were likely to have also been forced into sex, with over half admitting to this experience.
The report calls for better training for workers in the NHS to be able to recognise and report suspected cases of trafficking, so that the NHS could act as a strategic and operational partner of the National Referral Mechanism (NRM). 13% of surveyed NHS staff reported having come into contact with a suspected victim of trafficking, and this rose to 20% among maternity services professionals. However, 87% of NHS staff questioned said that they did not know what questions to ask in cases of suspected trafficking.
Victims of trafficking are unlikely to access NHS services while still trapped in their trafficking situation. The report cited barriers including fear based on irregular immigration status, lack of identity documents, as well as traffickers controlling their movement, as barriers to access to healthcare. The report also notes, however, the lack of understanding of NHS staff as to the rights of victims to access care, especially GPs as another barrier, and calls for a multi-sectoral, sustained support system for trauma-informed and culturally appropriate care.
NRM decision letters following positive or conclusive reasonable grounds decisions should be amended to state explicitly that the victim is entitled to free primary healthcare, and a ‘Green: Paid or exempt from health surcharge’ banner should be put on the NHS records of anyone making an application for leave to remain following a positive trafficking decision in order to avoid difficulties in accessing healthcare, the report argues.
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