By Kylie Swinmurn
Access to mental health services in the US is already challenging for most people, but these challenges are especially daunting for survivors of human trafficking. These obstacles to care are compounded by complex trauma experienced, systemic issues in healthcare access, and stigmas surrounding both mental illness and trafficking. For survivors, access to comprehensive trauma-informed mental health services is essential to ensure survivors can choose and complete their path of recovery.
Mental Health Needs and Services for Survivors
Trafficking is an inherently traumatic event, and mental health concerns are a common consequence. Surveys show that 98% of trafficking survivors display symptoms of mental health challenges. Anxiety, depression, eating disorders, memory problems, post-traumatic stress disorder (PTSD), and addiction are all commonly found among survivors. Pre-existing mental health concerns are commonly reinforced by the trauma experienced in trafficking. These concerns may make it not only harder for victims to leave trafficking, but for survivors to remain safe.
The vulnerability and dependency fostered by sustained substance use and unmet mental health concerns leaves survivors at risk of revictimization and further trauma development. Traffickers prey on these vulnerabilities, often weaponizing social stigmas and shame to trap individuals in cycles of abuse. Traffickers frequently use addiction as a control mechanism to decrease escape attempts, create dependency, and make victims more vulnerable to additional trauma. Surveys show that 84.3% of survivors within the US used substances during their period of exploitation, and this substance use often continues as a method for coping with the experience.
Without trauma-informed mental health services accessible to survivors, they are at a high risk for developing long-term mental health conditions that can significantly impair their ability to operate in everyday life. Services such as cognitive behavioral therapy, exposure therapy, EMDR (eye movement desensitization and reprocessing), and peer counseling have all been shown to be especially effective in tackling both substance use and mental health concerns for survivors. All of these services should be trauma-informed, highly individualized, and survivor-centered to ensure that the survivor’s well-being takes precedence over any other considerations.
Barriers to Accessing Mental Health Services
The widespread lack of access to mental health services has been an ongoing issue across the US with over ⅔ of Americans with a diagnosed mental health condition being unable to access necessary mental health services even with health insurance. Shortages in mental health care professionals, inadequate insurance coverage, and social stigmas constitute many of these barriers for the individuals seeking services. For survivors, additional issues such as language barriers, cultural differences, movement between areas, lack of knowledge of the healthcare system, trauma-induced memory issues, and lack of identification documents make finding services even harder.
The impact of social stigmas surrounding mental health, substance use, and trafficking can be an especially challenging barrier to overcome. These stigmas can make the thought of accessing care seem shameful, or out of reach for survivors. People with histories of substance use, sex work, or criminality may be considered “less credible” by healthcare professionals, making it difficult to access and establish therapeutic relationships. Implicit bias from providers, such as biases against sex workers, drug use, or racial biases, can cloud the experience survivors have accessing mental health services, further decreasing available opportunities for care and discouraging further attempts. These stigmas are an especially prominent challenge in engaging male survivors, and survivors with cultural backgrounds that do not place an importance on mental health.
As trafficking survivors require flexible, long-term, and trauma-informed care, traditional therapeutic models are often ill-equipped to handle the complexity of their experiences. In general, people are less likely to seek help if they believe service providers can’t understand or empathize with their background or circumstances. For survivors with such nuanced experiences, finding a provider or peer counselor who can understand their experience, and who they feel comfortable developing a trusting relationship with, is both crucial for positive support and extremely challenging to achieve.
Further, mental health services must be voluntary in order to allow survivors to choose their own treatment paths. While crisis centers may be readily available for people to access, the risk of facing involuntary mental health care is often enough to dissuade people from accessing those resources. For survivors who have already experienced restrictions on control and self-sufficiency, involuntary mental health care may only serve to add further trauma and discourage survivors from accessing care in the future.
Survivors of human trafficking need access to voluntary and comprehensive mental health services to rebuild and heal, yet they face significant barriers. The trauma of trafficking often goes untreated due to systemic issues within the healthcare system, social stigmas, and a shortage of appropriate trauma-informed care. To support survivors, it is crucial that these barriers are addressed, and systems are developed to better support individualized comprehensive care for those who need it.