Photo by Milin John on Unsplash
Jing Xiao
University of New Haven
Human trafficking violates fundamental human rights. Related crimes incite severe economic, social, and health impact on victims and their families. Since the United Nation Convention Against Transnational Organized Crime in 2000 (United Nations, 2000), governments in most nations have initiated special campaigns with specific programs and services in supporting human trafficking victims. However, empirical research has identified many of the programs and services as not meeting the needs of the victims (Davy, 2015; Hemming et al., 2016; Munro-Kramer et al. 2020).
The Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (The Protocol) identifies human trafficking as a transnational crime and provides legal provisions for anti-trafficking laws in most countries in the world (United Nations Office on Drugs and Crime, 2000). The protocol defines human trafficking with three elements: the actions (recruitment, transportation, transferring, harboring, or receipt), the means (human beings), and the purposes (aim of exploitation). Among the estimated number of worldwide human trafficking victims of 27.6 million, women and girls constitute the majority groups (United Nations Office on Drugs and Crime, 2009).
Over 175 nations have acceded The Protocol, and governments are expected to establish laws and regulations in combating such crime and protecting the victims. Aside from legal services, social services have become a main part of victim support programs. This policy brief examines existing programs and services in the United States and proposes to improve the three common approaches when providing services to victims and their families – identification of the victims, treatment for the victims, and long-term support for the victims.
Background of the Issue
As human trafficking occurs in most countries, the United States has recognized such crime in all 50 states (Munro-Kramer et al., 2020). Following the establishment of The Protocol, the public law of Victims of Trafficking and Violence Protection Act of 2000 (TVPA) aims to protect the supported human rights of survivors of trafficking (U.S. Department of State, 2000). Since 2007, through two main forms of trafficking, forced labor and sex trafficking, the Department of State estimates 82,301 cases of human trafficking occurred, with 164,839 victims from these cases, based on statistics provided by the National Human Trafficking Hotline (U.S. Department of State, 2024). However, this estimate does not account for all trafficking cases and victims, due to limited measurement resources (Schwarz et al., 2016). In addition, 2,027 people were prosecuted for human trafficking offenses in 2021, which was a 49% increase compared with 1,360 in 2011 (Bureau of Justice Statistics, 2023).
The TVPA discloses that as one of the fastest growing sources for profits, organized criminal enterprises have perpetuated human trafficking. Fraud, force, and coercion have been inflicted upon involuntary participants (U.S. Department of State, 2000). According to the TVPA, existing laws and legislations in the United States could not effectively deter trafficking or bring justice to victims. Furthermore, instead of the terms of trafficking in persons and human trafficking that emphasis on the transaction of means, the United Nations Trafficking in Persons report (2009) calls for the emphasis on the enslavement aspect of this crime. This modern form of slavery raises two questions: 1) how big the frame of human trafficking is; and 2) what can be done to both combat the crime and help the victims.
Pre-Existing Policies
Being one of the first countries to respond to The Protocol, address the flaws of existing laws, and pass new public laws against human trafficking, the United States has proactively incorporated the “3P” paradigm – prosecution, protection, and prevention – to combat human trafficking (U.S. Department of State, 2024). Based on Code 22, Chapter 78, Section 7105a, the federal government bears responsibilities in eliminating human trafficking. One of these responsibilities is to design effective anti-trafficking programs and services as well as monitor and evaluate them (Office of the Law Revision Counsel, 2008). Since the early 2000s, much funding has poured into human trafficking victim support programs and services, but empirical evaluations of their effectiveness indicate that the services do not meet victim needs.
The current policy brief examines the effectiveness of existing victim support programs and services from three aspects. The first is the identification of the victims. Key stakeholders, such as local hospitals, law enforcement, and social service agencies, must correctly and effectively identify victims to assess their needs and offer corresponding services. But many societal sectors do not meet this standard. For instance, about 28-50% of victims are unidentified in healthcare settings (Barrick et al., 2021; Bryant & Landman, 2020; Munro-Kramer et al., 2020; Schwarz et al., 2016). In many cases, the victims are identified as criminals (De Vries & Farrell, 2023; Rodriguez-Lopez, 2020).
The second aspect of the issue is the available treatment for victims. Trafficking experiences impose severe physical and mental health problems on victims. Supportive services have not met victims’ recovering needs, especially for mental health problems (Davy, 2015; Ottisova et al., 2016). Finally, the third aspect is the long-term support required to help with victims’ reintegration into communities. Overall, programs and services have not met the needs and demand to successfully help victims in connecting with families and communities (Barner et al., 2018).
Policy Options
To address the three identified issues within existing victim support programs and services, the current policy brief proposes three options based upon approaches that are evidence-based, victim-centered, and trauma-informed (Chambers et al.,2024; Davy, 2016; Hodge, 2014; Hemmings et al., 2016; Tillyer et al., 2023;).
Option one: Increase necessary training courses targeting identification of victims for first respondents.
To address misidentification and mishandling of human trafficking victims, with additional training and courses that are built upon evidence-based research about what works and what needs to be done, healthcare professionals in emergency rooms can identify victims promptly and provide firsthand essential medical, legal, and social services. For law enforcement agencies, the proposed extra training courses can help them correctly distinguish victims from criminals, thus, avoiding re-traumatization as well as fear, shame, stigma, and other labels associated with being victims of human trafficking (Barrick et al., 2021; Rodriguez-Lopez, 2020).
Advantages
- Victims can be better protected once they are identified.
- Victims can get specific services they need for recovery in a timely manner.
- Correct identification with sufficient services can reduce long-term consequences inflicted by trafficking experiences.
Disadvantages
- Costs to facilitate training and courses nationwide can be high, and this option may not gain much support from the financial sector of society.
- Lack of the required effective and sufficient collaboration among agencies may not support this option.
Option two: Emphasize the mental health recovery needs of the victims and provide necessary victim-center mental health services.
To address the neglected needs for mental health services, evidence-based psychological treatments such as Cognitive Behavioral Therapy (CBT) and Cognitive Processing Therapy aim to improve human trafficking victims’ emotional and psychological wellbeing after their traumatic experiences. With help from professionals, human trafficking victims can identify and eventually change troubling emotions and behaviors caused by their traumatic experiences. Evidence-based research shows that victims receiving adequate services have less psychiatric hospitalizations and better work and life functioning (Chambers et al., 2024).
Advantages:
- The victim-centered approach in victim support services improves the lives of victims.
- With increased abilities in coping with traumatic experiences, victims develop self-awareness, learn to handle their own mental health conditions, and seek external help when necessary.
Disadvantages:
- This option requires professional and extensive mental health services that may not be realistic with limited resources.
- Inappropriate treatments can result in re-traumatization of victims.
Option three: Introduce victim-informed long-term support services to help human trafficking victims successfully reintegrate into communities.
To address the lack of long-term support for human trafficking victims, societal sectors must recognize that consequences of trafficking last long after traumatic events, and supportive services for human trafficking victims need to aim at helping the victims to reintegrate into communities. Local governmental and non-governmental agencies must work together to support victims and their families with available resources (Banner et al., 2018; Davy, 2015; Davy, 2016; Monro-Kramer et al, 2020).
Advantages:
- Evidence-based integration programs and services prove that support from families and communities can help victims exit the cycle of trafficking, retore psychological health, and establish stable employment, therefore improving victims’ lives.
Disadvantages:
- Collaboration among various agencies can bear challenges for this option.
- Limited funding creates barriers for this proposed option for long-term services.
Recommendations
Human trafficking in various forms remains a global issue. The cruel nature of the crime, such as use of fraud, force, and coercion, poses severe physical and mental health problems on the victims; therefore, human trafficking constitutes a public health crisis. In the United States, political, legal, and social sectors face challenges in prosecution of offenders, protection of victims, and prevention of the crime with the rise of the estimated trafficked population in the last two decades (U.S. Department of State, 2024). This policy brief reviews assessment and evaluations of existing victim support programs and services, and it makes the following recommendations.
First, human trafficking victims are often misidentified. For instance, when victims are trafficked to commit illegal activities, this form of forced criminality causes victims to be prosecuted as criminals, as the authorities identify them as such (Rodriguez-Lopez, 2020). Another example is that victims remain identified when first responders, such as doctors in emergency rooms and officers in law enforcement, fail to recognize red flags and signs of human trafficking (Hodge 2014; Munro-Kramer et al., 2020). Justice for protecting fundamental human rights fails to include human trafficking victims once they are misidentified. Policy makers must take this fact into consideration, because identifying offenders and victims is the first step in combating human trafficking. An effective strategy is to provide adequate training on correct victim identification based on evidence-based research for emergency room doctors and first responder law enforcement.
Second, human trafficking victims are in urgent need of medical treatments, including physical and mental healthcare. Oftentimes, victims are processed in the line of services, but they do not receive proper mental health treatment that suits their specific needs. Traumatization from being trafficked possesses severe mental health influence, and victims need extensive mental health support, but this need often is unmet (Chambers et al., 2024; Munro-Kramer et al., 2020; Ottisova et al., 2016). One effective strategy in providing sufficient victim-centered, trauma-informed, and evidence-based psychological treatments to victims of human trafficking, such as cognitive behavior therapy and cognitive processing therapy, is greater collaboration among mental health providers and agencies. Policy makers should implement programs and services through this strategy, to organize and provide treatment to victims based on their needs.
Third, the goals of supportive services for human trafficking victims include self-identification, exit from the trafficking cycle, and restoration of life (Hodge, 2014). Without support that lasts beyond the point of their physical and mental recovery, victims often experience re-victimization and secondary traumatization. In addition, victims face the barriers set by socio-economic challenges that eventually lead towards negative outcomes (Islam, 2023). Policy makers need to initiate evidence-based reintegration programs and services to generate support from families and communities in better helping the victims in connecting and reintegrating into their environment. Through long-term collaboration among social services, victims identify themselves as members of society and restore their lives with families and local communities.
In conclusion, current policies do not meet the needs of human trafficking victims. To provide effective and adequate services, agencies must employ a collaborative, multifaceted approach. While the government bears responsibilities in combating human trafficking, it is crucial to correctly identify the victims, provide resources for both short-term and long-term physical and mental health services, and adopt trauma-informed and victim-centered care to help the victims through recovery and reintegration into communities.
References
Barner, J. R., Okech, D., & Camp, M. A. (2018). “One size does not fit all:” A proposed ecological model for human trafficking intervention. Journal of Evidence-Informed Social Work, 15(2), 137-150. https://doi.org/10.1080/23761407.2017.1420514
From an ecological perspective, this article proposes that support for human trafficking victims should focus on the five concepts of the ecological model as these concepts affect victims systemically. Instead of solo attention on the victims, services need to induce collaboration among agencies and stakeholders.
Barrick, K., Panichelli, M., Lambdin, B., Dang, M., & Lutnick, A. (2021). Law enforcement identification of potential trafficking victims. Journal of Crime and Justice, 44(5), 579-594. https://doi.org/10.1080/0735648X.2020.1837204
Through random selection of case files from the San Francisco Mayor’s Task Force on Anti-Human Trafficking, this study employs qualitative and quantitative data to demonstrate the challenges that the law enforcement face when identifying victims of human trafficking. Findings reveal stereotypes and traditional vice strategies as sources of misidentifications. Authors suggest that proactive identification strategies are more successful.
Bryant, K., & Landman, T. (2020). Combatting human trafficking since Palermo: What do we know about what works? Journal of Human Trafficking, 6(2), 119-140. https://www.tandfonline.com/doi/full/10.1080/23322705.2020.1690097
With a systematic review of 179 anti-trafficking intervention evaluations, this article finds that most of these evaluations are not publicly available. Also, the reliability of the evaluations remains problematic because they do not meet the established standards for conducting evaluation and providing feedback. Barriers to effective impact assessment remain in this field of study.
Bureau of Justice Statistics (BJS). (2023). Human trafficking data collection activities, 2023. https://bjs.ojp.gov/library/publications/human-trafficking-data-collection-activities-2023
This report provides detail information about ongoing and completed nationwide human trafficking cases including how the suspects are prosecuted and sentenced.
Chambers, R., Gibson, M., Chaffin, S., Takagi, T., Nguyen, N., & Mears-Clark, T. (2024). Trauma-coerced attachment and complex PTSD: Informed care for survivors of human trafficking. Journal of Human Trafficking, 10(1), 41-50.
This study uses the theorized cycle of trauma and recidivism to illustrate the impact of clinic treatment on human trafficking victims. Evidence-based psychological treatments including Cognitive Behavioral Therapy (CBT) and Cognitive processing Therapy are recommended. Findings suggest that comprehensive care should be delivered in a trauma-informed and survivor-centered manner.
Davy, D. (2015). Understanding the support needs of human-trafficking victims: A review of three human-trafficking program evaluations. Journal of Human Trafficking, 1(4), 318-337. http://dx.doi.org/10.1080/23322705.2015.1090865
This article asks the questions of what support services that the victims of human trafficking need and whether their needs have been met by existing victim support services and programs. Through reviewing three evaluations, findings indicate that victim needs vary over time and supportive services should initiate one-on-one case management to suit the needs. The case managers play crucial roles in delivering effective services across multiple organizations.
Davy, D. (2016). Anti–human trafficking interventions: How do we know if they are working? American Journal of Evaluation, 37(4), 486-504.
Through a review of 49 evaluations of anti-human trafficking programs, this article calls for quality evaluations based on the Maryland Scientific Methods Scale (SMS). Findings point out that whilst victims of human trafficking can offer essential information through sharing their experiences, they are often excluded in the data collection process in the evaluations for vast reasons. Services and programs cannot employ victim-centered and human right-centered approach without the voice of the victims.
De Vries, I., & Farrell, A. (2023). Explaining the use of traditional law enforcement responses to human trafficking concerns in illicit massage businesses. Justice Quarterly, 40(3), 337-362. https://doi.org/10.1080/07418825.2022.2051587
With debates about the effectiveness of traditional police strategies in fighting human trafficking in illicit massage businesses (IMBs), this study seeks answers to three questions through a qualitative design: what the motivations to target IMBs that the police have, how the police decide on their strategies, and the perceives goals and effectiveness as well as the limitations of the decided strategies.
Hemmings, S., Jakobowitz, S., Abas, M., Bick, D., Howard, L. M., Stanley, N., … & Oram, S. (2016). Responding to the health needs of survivors of human trafficking: a systematic review. BMC Health Services Research, 16, 1-9.
With a systemic review of 44 documents, including peer-reviewed and grey literature, this article examines the healthcare needs of the victims of human trafficking. Particularly, based on comprehensive needs assessments, services need to employ a trauma-informed approach and take cultural backgrounds of the victims into consideration. Also, analysis indicates that services should aim for both immediate and long-term recovery.
Hodge, D. R. (2014). Assisting victims of human trafficking: Strategies to facilitate identification, exit from trafficking, and the restoration of wellness. Social Work, 59(2), 111-118. https://doi.org/10.1093/sw/swu002
While conceding human trafficking as an international complex issue, this article highlights the service needs of human trafficking victims from three areas: identify victims, help to exit the trafficking, and support to restore psychological health. The study concludes that victims of human trafficking face negligence and effective services must consider the victims’ perspectives.
Islam, F. (2024). Human Trafficking Law Enforcement Over the Victims and Offenders: The Perspective of Anti-Trafficking Stakeholders. Victims & Offenders, 1-29.
This article argues that the current victim-centered provisions in programs and services are ineffectively implemented through qualitative interviews with anti-trafficking stakeholders. The police have narrowly focused on the severity of the offense and punishment.
Munro-Kramer, M., Beck, D., Choi, K., Singer, R., Gebhard, A., & Carr, B. (2020). Human trafficking victim’s service needs and outcomes: An analysis of clinical law data. Journal of Human Trafficking, 6(1), 95-108. https://doi.org/10.1080%2F23322705.2019.1574476
With secondary data of 65 closed cases collected by the University of Michigan Human Trafficking Clinic from 2009 to 2016, this study finds that the trafficked experiences significantly affect the human trafficking victims’ needs for proper mental healthcare, social services, and legal assistance.
National Institute of mental Health (2024). What is psychotherapy?
The national Institute of Mental Health provides definitions for psychotherapy as well as the elements of psychotherapy. This website posts links to various federal resources for mental health care.
Office of the Law Revision Counsel (2008). Increasing effectiveness of anti-trafficking programs. https://uscode.house.gov/view.xhtml?path=/prelim@title22/chapter78&edition=prelim
Referring to the Victims of Trafficking and Violence Protection Act of 2000, the United State Code Title 22 Chapter 78 section 7105a specifies government’s responsibilities in eliminating human trafficking, designing and establishing effective anti-trafficking programs, as well as monitoring and conducting evaluations.
Ottisova, L., Hemmings, S., Howard, L. M., Zimmerman, C., & Oram, S. (2016). Prevalence and risk of violence and the mental, physical, and sexual health problems associated with human trafficking: an updated systematic review. Epidemiology and Psychiatric Sciences, 25(4), 317–341. https://doi.org/10.1017/S2045796016000135
This systemic review of 37 studies focuses on the physical, mental, and health problems among human trafficking victims. Findings suggest that human trafficking victims face increased risk of violence through their experience and develop serious physical and mental health issues. The authors call for effective interventions and services to address these urgent medical needs of the victims.
Rodríguez-López, S. (2020). Telling victims from criminals: human trafficking for the purposes of criminal exploitation. The Palgrave International Handbook of Human Trafficking, 303-318. https://doi.org/10.1007/978-3-319-63058-8_17
As human trafficking victims can often be treated as criminals, this article examines the difficulties in identifying trafficked victims in various types of crimes that are related or connected to human trafficking. On one hand, victims lack the skills for self-identification. On the other hand, the authorities lack the awareness of forced criminality in combating human trafficking. The findings call for further training and capacity-building for law enforcement.
Schwarz, C., Unruh, E., Cronin, K., Evans-Simpson, S., Britton, H., & Ramaswamy, M. (2016). Human trafficking identification and service provision in the medical and social service sectors. Health and Human Rights, 18(1), 181.
Distinguishing between trafficking red flags from risk factors, this article uses data from the University of Kansas Hospital to point out the importance of joint efforts in identifying human trafficking victims and providing adequate site-specific services. Local community engagement from key stakeholders such as law enforcement, social service agencies, and legal sectors plays a crucial role in this process.
Tillyer, M. S., Smith, M. R., & Tillyer, R. (2023). Findings from the US national human trafficking hotline. Journal of Human Trafficking, 9(3), 398-407.
This article uses data from the U.S. National Human Trafficking Hotline to identify the needs and services of the victims. While the demand for interventions and services stays unmet, the findings highlight the need for a victim-centered approach when identify human trafficking cases and assessing victims’ needs.
United Nations Office on Drugs and Crime (UNODC). (2009). Global report on trafficking in persons. https://www.unodc.org/documents/Global_Report_on_TIP.pdf
Supplementing the United Nations Convention against Transnational Organized Crime, this report highlights the “inhuman, degrading, and dangerous exploitation” of victims of human trafficking. The goal of this protocol includes standardizing the definition and terminology of human trafficking in laws and practices in countries that recognize this crime.
United Nations (UN). (2000). Protocol to prevent, suppress and punish trafficking in persons, especially women and children. https://www.unodc.org/res/human-trafficking/2021the-protocol-tip_html/TIP.pdf
Supplementing the United Nations Convention against Transnational Organized Crime, this protocol calls for the emphasis on the enslavement in human trafficking. Instead of trafficking and profiting from the crime, the enslavement element of the crime raises questions about both how to stop the crime and help the victims.
U.S. Department of State (USDOS). (2000). Victims of trafficking and violence protection act of 2000.
This public law clarifies the government’s responsibilities in combating human trafficking. The enslavement element of human trafficking as well as the transnational nature of the crime place victims, most of whom are women and girls, in dangerous environment and violate fundamental human rights. The federal and local government must take initiatives to monitor and combat human trafficking while provide resources to fund necessary services for the victims.
U.S. Department of the State (USDOS). (2024). About human trafficking. https://www.state.gov/humantrafficking-about-human-trafficking/#human_trafficking_U_S
The website of the U. S. Department of State explains what human trafficking is and the scope of human trafficking in the United States. The crime of human trafficking can be conducted in varied forms including forced labor and sex trafficking. The U.S. government currently follows the “3p” paradigm (prosecution, protection, and prevention) as a framework to eliminate human trafficking. In addition, a 4th “p” (partnership) has been added for collaboration among all segments of the society to provide much needed services to the victims on a case-by-case basis.