When treating patients who are victims of human trafficking, or who have other traumatic histories, there “should be no wrong door.”
That according to Kimberly Chang, M.D., site director and physician at California-based Asian Health Services, who said providers often don't realize that for patients the journey to getting help is often cyclical.
That means patients enter and leave the healthcare system at different points, she said, and may cycle through some services more than once. Vulnerable patient populations are at high risk for these setbacks. “It’s not failure when patients are in this cyclical stage,” Chang said.
She was experts speaking at the Department of Health & Human Services’ Health & Human Trafficking Symposium this week, calling for providers to break free of a “linear” view of the care journey when it comes to helping these victims of trauma. The event comes a decade after a 2008 summit on the healthcare needs of patients who are victims of human trafficking.
“For true integration, we have to think about how we may need to redo our services and the care within our four walls,” she said.
At Dignity Health, the system has worked to recognize that patients present on a spectrum of risk—some are, for example, being groomed for trafficking while others are currently victimized—so they may not be ready for help or even seeking it, said Holly Gibbs, program director of Human Trafficking Response at the system.
Patients present on a spectrum of risk—some are, for example, being groomed for trafficking while others are currently victimized—so they may not be ready for help or even seeking it, Gibbs said. That makes it crucial for providers to have trauma-informed communication tools that can make the patients who are actively seeking assistance feel comfortable opening up.
Dignity Health has built a tool called PEARR, which is a four step approach to communicating with patients who may be victims of trafficking. Gibbs said it’s applicable to patients who are dealing with other types of trauma as well.
The four steps are:
- Provide privacy: Offer a safe place, preferably a private room, to patients that are potential trafficking victims.
- Educate: Discuss the situation with the patient in a clear, but nonjudgmental way. Gibbs said some patients may not even know what human trafficking is, let alone that they’re being groomed for it.
- Ask: This may require an indirect approach, especially for the most at-risk patients.
- Respect and respond: Respecting a patient’s wishes extends to accepting that they may not want help, even if that’s hard to accept as a provider.
The tool isn’t intended to replace protocols like mandated reporting, Gibbs said, but instead to serve as a supplement to guide conversations and make patients feel safe.
“When it comes to mandated reporting, a lot of times the patient is left outside of the equation,” Gibbs said.