EXECUTIVE SUMMARY

Every healthcare system should have a protocol and system for handling suspected trafficking victims, according to a speaker and expert on the subject.

  • Protocols might include staff education on providing trauma-informed care.
  • Healthcare professionals need to know how to separate a victim from the controlling perpetrator.
  • Providers should have a mental list of questions to ask of suspected victims.

Healthcare organizations should have a protocol in place for handling suspected human trafficking cases, says Holly Austin Gibbs, a patient care services program director with San Francisco-based Dignity Health.

“I highly recommend that before a potential victim shows up, the healthcare system should be equipped and have everyone educated on the protocol and their role,” Gibbs says.

One place to start would be to define human trafficking by referring to the Victims of Trafficking and Violence Protection Act of 2000, which is designed to combat human trafficking especially in the sex trade, slavery, and involuntary servitude.

“The federal trafficking victims act defines what human trafficking means in America,” Gibbs says.

The protocol should include information about how healthcare staff could identify victims and handle the cases, says Dean White, LCSW, regional director of social work for Dignity Health, St. Joseph’s Hospital and Medical Center in Stockton, CA.

Gibbs and White offer the following tips on what to do when a patient is suspected to be a victim of human trafficking:

Provide trauma-informed care. “What’s important is that professionals provide victim-centered care or patient-centered care, as well as trauma-informed care,” Gibbs says. “These components are important for caring for patients who’ve been through a trauma such as this.”

Trauma-informed care enables healthcare professionals to respond to victims with dignity and respect, and it will identify the healthcare facility as a place where a victim can return when she is ready to receive help, Gibbs says.

The goal is to prioritize the patient’s wishes, safety, and concerns, as a case manager would for any patient. But in the case of patients who are perceived to be victims, healthcare professionals might believe they know which decisions would be best for the person, Gibbs says.

“It needs to be a constant collaborate and ask,” she says. “You can say, ‘I believe this will be helpful for you; are you okay with contacting this resource?’”

Case managers and other healthcare professionals should keep in mind that the victim they see is someone who might have run away from home at age 13 because of an abusive stepfather and was placed in an abusive foster home situation where she lost trust in the authorities, so she ran away, only to experience violence on the street, Gibbs explains.

“Then she meets a trafficker who says he’ll take care of her, but she needs to prostitute for him,” she adds. “She might see this as a better option than going home or going into foster care, so trauma-informed care might help people understand why a victim sometimes will refuse help.”

Have a protocol for separating a suspected victim from a controlling companion. A first step is to get the suspected victim to a private place away from the person who might be the perpetrator.

“If they’re accompanied by a controlling companion, then that may mean getting creative,” Gibbs says. “Keep things friendly and try not to raise any red flags; you could say, ‘We need to do some additional diagnostic testing, could you please wait in the waiting room?’ Or you could say, ‘We’re going to take her to get a urinalysis.’”

Build rapport or call in a social worker. Case managers often are trained to develop rapport with patients, so they can be trained to handle suspected victims with sensitivity. But a healthcare organization might also want to have these cases referred to a trained social worker.

“We ask open-ended questions and the patient will fill in the gap,” White says. “Saying, ‘So I see you came in for a broken ankle’ will shut down conversation.”

Instead, the case manager or social worker could ask, “Do you mind if I come in and talk with you for a minute?” White suggests. “This sets the stage so the patient doesn’t think you’re being overbearing, standing over them, and barraging them with questions; think about everything from the patient’s perspective.”

Rapport-building also includes keeping a calm and reassuring demeanor, and asking suspected victims if they would like water, or a blanket if they’re cold, or a fan if they’re hot, White says.

“Meet their basic needs, listen to them, and try to establish rapport so you can say, ‘I got called in because the nurse thought there may or may not be any issues at home. Are you safe? What’s going on?’”

Ask questions that might provide clues to the person’s status as a victim. One of the first questions to ask is, “Do you feel safe at home?” Another is, “Who is your source of support?” White suggests.

He suggests asking the following additional questions:

- “You seem kind of anxious, what’s going on with that?”

- “Is there someone you feel safe with?”

- If the person says she lives with her boyfriend, ask, “Is he always there, or are there any concerns you have with him?”

- “How are you doing?”

- “Do you have any questions or concerns?”

Offer a safety line. Once a case manager or other healthcare professional has developed rapport with the patient, then it’s time to offer the person a safety line, White says.

If the suspected victim is underage or in a life-threatening situation, it might be necessary to contact child protective services or law enforcement, White says.

In some other cases, the best action is to plant the seed that help is available and offer a safe environment for when the person is ready, he notes.

“You can say, ‘Here’s some information if you ever need to talk with someone outside of the hospital; it’s a national hotline,’” he says. “The trafficking hotline number has access to 200 languages and they’re not mandated reporters.”