Consultation-Liaison Psychiatry's Role in Responding to Whole Health Needs of Patients Who’ve Experienced Human Trafficking

Abstract: Human trafficking (HT) encompasses the exploitation of individuals through forced sex or labor, posing a significant public health concern with enduring physical, psychological, and social implications. Men, women, children, transgender, and gender-diverse people can be trafficked for various purposes and therefore abused at multiple levels. Pre-existing mental health conditions and substance abuse heighten the vulnerability to trafficking. Dr. St. Victor will provide an introduction to HT, including different forms of exploitation, risk factors, and physical and psychiatric consequences of human trafficking.

Individuals who survive trauma benefit from trauma-informed care (TIC) approaches when receiving healthcare services. Given the higher rates of trauma among minoritized groups and the influence of cultural and individual factors in the trauma response, cultural humility is recommended when working with patients who've experienced trauma. By recognizing the role of acculturation and historical trauma, providers can better identify the culturally-appropriate tools, resources, and opportunities to bridge the gap in mental health services available to affected communities. Dr. Padilla will discuss potential indicators of HT and barriers to care and will explore how consultation-liaison psychiatrists can manage clinical encounters of patients who've experienced HT by adopting a TIC approach with an attitude of cultural humility to advance health equity further.

A significant barrier to care is merely being able to identify such individuals. Consultation-liaison psychiatrists can educate both persons with lived trafficking experience and fellow healthcare providers about HT and appropriate care while promoting reproductive justice. Critical opportunities for intervention are often present when such trafficked individuals present for obstetrical, gynecological, and mental health care. The risk for substance use disorders and psychiatric illnesses is greatly increased for women who experience unwanted and high-risk pregnancies, pregnancy complicating sexually transmitted illnesses, or abortion complications through commercial sexual exploitation or intimate partner violence. Dr. Reza will review issues related to the pregnancy continuum and maternity care for women who are trafficked.

Addressing the psychiatric needs of trafficked patients necessitates a comprehensive, patient-centered, holistic, trauma-informed approach that integrates care across multiple disciplines. Psychiatrists play a crucial role in addressing HT by providing direct clinical care, conducting evidence-based research, disseminating education and training, advocating for policy changes, and fostering collaboration with community partners. Dr. Alhajji will describe an academic institution's integrated care clinic model that serves patients who've experienced HT, including an interdisciplinary perinatal program expansion that incorporates community partnerships for the parent-infant dyad. She will also discuss a tertiary hospital system's response algorithm when HT is suspected.



References:

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Woo-Cater S. Unearthing Historical Trauma to Advance Health Equity for Survivors of Human Trafficking. HCA Healthc J Med. 2022 Jun 28;3(3):197-202.