Annals of Internal Medicine
Volume 168, Issue 9, 2018, Pages 658-663

Engaging survivors of human trafficking: Complex health care needs and scarce resources (Article)

Judge A.M.* , Murphy J.A. , Hidalgo J. , Macias-Konstantopoulos W.
  • a Massachusetts General Hospital, Department of Psychiatry, 55 Fruit Street, Boston, MA 02114, United States
  • b Learning and Emotional Assessment Program (LEAP), Children and the Law Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
  • c Freedom Clinic, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
  • d Massachusetts General Hospital, Department of Psychiatry, 55 Fruit Street, Boston, MA 02114, United States, Law and Psychiatry Service, Massachusetts General Hospital, One Bowdoin Square, 10th Floor, 15 New Chardon Street, Boston, MA 02114, United States

Abstract

Human trafficking, also known as modern-day slavery, is an egregious human rights violation associated with wide-ranging medical and mental health consequences. Because of the extensive health problems related to trafficking, health care providers play a critical role in identifying survivors and engaging them in ongoing care. Although guidelines for recognizing affected patients and a framework for developing response protocols in health care settings have been described, survivors' ongoing engagement in health care services is very challenging. High rates of disengagement, lost contact, premature termination, and attrition are common outcomes. For interventions to be effective in this marginalized population, challenges in engaging survivors in long-term therapeutic primary and mental health care must be better understood and overcome. This article uses the socioeco-logical model of public health to identify barriers to engagement; offers evidence- and practice-based recommendations for overcoming these barriers; and proposes an interdisciplinary call to action for developing more flexible, adaptable models of care. © 2018 American College of Physicians.

Author Keywords

[No Keywords available]

Index Keywords

communication barrier Physician-Patient Relations Communication Barriers mental health service public health service human survivor Survivors social aspect priority journal social support Mental Health Services health personnel attitude Attitude of Health Personnel United States Humans psychology socioeconomics Social Stigma human trafficking doctor patient relationship Article health care utilization patient attitude Patient Acceptance of Health Care Delivery of Health Care practice guideline health care need primary health care public health health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046465816&doi=10.7326%2fM17-2605&partnerID=40&md5=a0879e1c7c780721527d128dc8f3ffaa
DOI: 10.7326/M17-2605
ISSN: 00034819
Cited by: 6
Original Language: English