title: Mental health service responses to human trafficking: a qualitative study of professionals' experiences of providing care.
abstract: BACKGROUND
  Human trafficking is a global crime and human rights violation. Although research has demonstrated a high prevalence of mental disorder among trafficked people and that trafficked people are in contact with mental health services, little is known about mental health professionals' experiences of identifying and providing care for trafficked people. This study aimed to understand how people are identified as trafficked within mental health services and the challenges professionals experience in responding to trafficked people's mental health needs.
  
  
  METHODS
  Qualitative study of electronic health records of trafficked people in contact with secondary mental health services in South East London, England. Comprehensive clinical electronic health records for over 200,000 patients in contact with secondary mental health services in South London were searched and retrieved to identify trafficked patients. Content analysis was used to establish how people were identified as trafficked, and thematic analysis was used to explore the challenges experienced in responding to mental health needs.
  
  
  RESULTS
  The sample included 130 trafficked patients, 95 adults and 35 children. In 43 % (41/95) of adult cases and 63 % (22/35) child cases, mental health professionals were informed that their patient was a potential victim of trafficking by another service involved in their patient's care. Cases were also identified through patients disclosing their experiences of exploitation and abuse. Key challenges faced by staff included social and legal instability, difficulties ascertaining history, patients' lack of engagement, availability of services, and inter-agency working.
  
  
  CONCLUSIONS
  Training to increase awareness, encourage helpful responses, and inform staff about the available support options would help to ensure the mental health needs of trafficked people are met. Further research is needed to establish if these challenges are similar in other health settings.
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, United Kingdom. jill.domoney@kcl.ac.uk.
authors.forename: Jill
authors.initials: J
authors.lastname: Domoney
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, United Kingdom. louise.howard@kcl.ac.uk.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Howard
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, United Kingdom. melanie.abas@kcl.ac.uk.
authors.forename: Melanie
authors.initials: M
authors.lastname: Abas
authors.affiliation: South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom. matthew.broadbent@kcl.ac.uk.
authors.forename: Matthew
authors.initials: M
authors.lastname: Broadbent
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, United Kingdom. sian.oram@kcl.ac.uk.
authors.forename: Sian
authors.initials: S
authors.lastname: Oram
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D019548:Crime Victims; D003695:Delivery of Health Care; D030881:Disclosure; D005260:Female; D006282:Health Personnel; D045809:Human Rights Abuses; D064410:Human Trafficking; D006801:Humans; D008131:London; D008603:Mental Health; D008605:Mental Health Services / Q000592:standards*; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D055815:Young Adult