First clinical evidence on mental health toll of human trafficking

A new study by researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London provides the first clinical evidence on the toll human trafficking has on mental health, including high levels of post-traumatic stress disorder (PTSD) and depression, amongst a patient population in South London.

Human trafficking is the recruitment and movement of people, by means such as deception and coercion, for the purposes of exploitation. The UK Home Office has estimated that in 2013 there were between 10,000 and 13,000 trafficked people in the UK, including people trafficked for forced sex work, domestic servitude, and labour exploitation in a multitude of industries, including agriculture, construction, and food packaging and processing.

This study, published in The Lancet Psychiatry, is the first to examine clinical and sociodemographic characteristics of trafficked people who have severe mental illness.

The researchers first identified 133 trafficked people, including 37 children, who were in contact with secondary mental health services at the South London and Maudsley NHS Foundation Trust (SLaM), and compared them to a randomly selected sample of non-trafficked patients. They used an innovative text-mining tool, the Clinical Record Interactive Search (CRIS) application, to extract data on socio-demographic and clinical characteristics, as well as history of abuse.

The King’s research team found that 51 per cent of trafficked patients had been trafficked for sexual exploitation. Among adults and children the most commonly recorded diagnoses were PTSD (39 per cent in adults and 27 per cent in children) and depression (34 per cent and 27 per cent respectively). In addition 15 per cent of the patients had been diagnosed with schizophrenia.

These medical records documented high rates of prior childhood abuse among trafficked adults (43 per cent) and children (76 per cent). Among trafficked adults, medical records also documented high levels of adulthood abuse before, during, and after trafficking (60 per cent), including domestic violence and sexual assault after trafficking.

Dr Siân Oram, Lecturer in Women’s Mental Health at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said: ‘Research on the mental health needs of trafficked people is extremely limited and only based on evidence from those in contact with shelter services. Our study shows that mental health services are caring for trafficked people with a range of diagnoses, including PTSD, depression and schizophrenia.

‘The complex needs of this vulnerable group – many of whom will be far from home, cut off from their families and disadvantaged in their access to education, social activities and physical healthcare – must be taken into consideration when assessing patient risk and planning therapeutic interventions.’

Dr Oram added: ‘Although interventions such as Cognitive Behavioural Therapy (CBT) exist for PTSD and depression, further research is required to assess their effectiveness in promoting the recovery of trafficked people.

‘It is also very important that mental health professionals are aware of indicators of possible trafficking and how to respond appropriately to suspicions or disclosures of this extremely serious form of abuse.’

The report is independent research commissioned and funded by the Department of Health Policy Research Programme. The views expressed in the publication are those of the author(s) and not necessarily those of the Department of Health.