Anna (not her real name), a soft-spoken young woman, grew up in a small city. Her parents were in an abusive, tumultuous relationship. Repeatedly, she was physically and sexually assaulted by her father, who later started to pimp her to male clients.
At the age of 18, Anna fled her home to escape the abuse. Soon after, she was kidnapped, drugged and raped by an older man who had promised her protection, housing and food. The older man began to pimp her, threatening to kill her if she told anyone. Anna began drinking and using drugs to cope with her situation. She spent the next 10 years being forced to sell her body on the streets under the control of a series of pimps.
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Anna’s story is disturbingly common.
Human trafficking involves the use of force, fraud or coercion to exploit individuals or groups in performing forced labor, sexual acts, domestic servitude or harvesting of organs.
It is a secretive, criminal, multibillion-dollar industry that affects approximately 20.9 million individuals worldwide. In 2015, the National Human Trafficking Resource Center hotline received reports of more than 5,000 potential human trafficking cases in the U.S. Sadly, children comprise up to one-third of all victims, while women make up more than half.
Targeted victims often have underlying risks, such as past experiences of abuse, leaving them more vulnerable to being trafficked. Once entrapped, there are many barriers and challenges that can make it harder to seek help. These include self-blame, isolation, feelings of guilt and shame, limited access to healthcare, difficulty establishing trust with others, a fear of being criminalized themselves, cultural barriers and a lack of knowledge of their rights as victims.
The most commonly reported physical problems include fatigue, headaches, sexually transmitted diseases and back pain. Mental health issues, however, are typically hidden scars that are less reported and persist for much longer.
Victims of human trafficking often experience events that involve threatened death or serious injury to themselves or others, and many ultimately struggle with post traumatic stress disorder (PTSD). Those held captive over an extended period of time are at heightened risk for re-victimization, impulsivity, risk-taking behaviors and problems forming healthy, enduring relationships.
In addition, victims of trafficking may also suffer from a variety of anxiety, dissociative and depressive disorders. Substance abuse disorders, including alcohol and illicit drug use, often occur concurrently with other mental health issues in human trafficking victims. Sadly, the majority of them resort to abusing drugs and alcohol to help cope with their dire situations. Others are forced to use them by their traffickers.
Fortunately, there is help available for victims. A combination of psychotherapy and medication management may provide relief from psychiatric symptoms. Various trauma-focused psychotherapy methods, including cognitive processing therapy and prolonged exposure therapy, provide relief from PTSD, depression and anxiety. Motivational enhancement therapy, 12-step facilitation, and substance-use rehabilitation can help victims suffering from alcohol and illicit drug use.
It has been three years since Anna escaped her traffickers and started receiving help. She now lives independently and is studying for her GED. She has learned how to cope with her anxiety and depression through ongoing psychotherapy and antidepressant medications. She continues to attend Alcoholics Anonymous meetings to maintain sobriety.
If you have been a victim of human trafficking, services are available in South Florida. You can contact the University of Miami THRIVE (Trafficking Healthcare Resources and Intra-Disciplinary Victim Services and Education) Clinic at 305-243-1046. THRIVE is a multi-disciplinary, collaborative, comprehensive care clinic where victims can access comprehensive healthcare including primary care, gynecological and psychiatric services. Additionally, anyone with concerns about a suspected human trafficking victim may call the Miami-Dade State Attorney’s Human Trafficking Hotline at 305-350-5567.
The National Human Trafficking Hotline (NHTH) is a toll-free number available 24/7 that can help connect victims with service providers in the area and provides training, technical assistance, and other resources. To get NHTH help, call 1-888-373-7888 or text HELP or INFO to BeFree (233733).
Lujian Alhajji, M.D. is a psychiatrist in the University of Miami Health System’s Department of Psychiatry. For more information, visit umiamihospital.com/specialties/psychiatry or call 305-355-9028.