The Joint Commission recently issued an advisory titled “Quick Safety 42: Identifying Human Trafficking Victims.”

According to the organization’s alert, the United States had 40,200 reports of human trafficking cases between 2007 and 2017. Human trafficking is the fastest-growing criminal industry in the world and a major source of income for organized crime.1,2

Recognize the Signs

The advisory gives healthcare professionals tips on recognizing the signs of human trafficking in patients, including the following:

• patient appears fearful, anxious, depressed, submissive, tense, nervous, or paranoid;

• avoids eye contact, refuses to change into a gown or cooperate with a physical exam;

• the patient’s behavior or demeanor do not align with the injury or complaint, such as the person saying “it’s no big deal” when the injury is serious;

• refuses to go to a specialist;

• unable to speak for him- or herself due to a third party insisting on being present or interpreting;

• the patient doesn’t have an ID;

• he or she cannot clarify home address;

• exhibits a loss of sense of time and place;

• inconsistencies in his or her story;

• the patient appears malnourished;

• shows signs of physical abuse, physical restraint, confinement, torture, and/or sexual abuse.2

“Quick Safety 42” encourages medical providers to give trafficking victims information and options while supporting them as they connect with service providers, if they are ready to report their situation.

Offer Support, Resources

When healthcare professionals believe it’s a situation with immediate and life-threatening danger, they should follow institutional policies for reporting to law enforcement. Also, they should provide patients with the National Human Trafficking Resource Center hotline number. They can help the patient memorize the number in the event that it would be dangerous to hang on to the information.

Other actions to take include the following:

• give the patient options for services, reporting, and resources, and ensure that safety planning is part of the discharge planning process;

• if the patient is a minor, follow mandatory state reporting laws and institutional policies for child abuse or serving unaccompanied youth;

• gain permission and consent from adult patients who have been trafficked before disclosing personal information about the patient to other service providers;

• ask social workers to help patients get the support and resources they need, including using resources from the National Human Trafficking Hotline, United Nations Office on Drugs and Crime, the U.S. Department of Health and Human Services, and others.

Quick Safety 42 is available on The Joint Commission website at:


1. Isaac R, Solak J, Giardino AP. Health care providers’ training needs related to human trafficking: maximizing the opportunity to effectively screen and intervene. J App Res Child 2011;2(1). Available at:

2. Quick Safety 42: Identifying human trafficking victims. The Joint Commission, June 18, 2018. Available at: