Human trafficking is an important social issue that affects some of the most vulnerable individuals with whom correctional professionals may come into contact in their facilities. Corrections staff of all disciplines have a potential role in preventing and disrupting human trafficking that is occurring in our communities. We are presented with a unique opportunity to bring continued awareness to the issue and help victims of this crime, regardless of our role in corrections.
Human trafficking is estimated to be one of the most prevalent crimes in the world, with some estimates placing it third, only behind the drug trade and counterfeiting. Many people associate it with foreign nations, but human trafficking is very prevalent within the United States, and often occurs in both legal and illegal industries. Although usually associated with the sex trade and narcotics trafficking, human trafficking is also known to occur in legal industries and sectors such as agriculture, construction, and various service industries in the form of forced labor.
In 2021 alone, the National Human Trafficking Hotline received nearly 33,000 phone calls and more than 11,000 texts. Medical and law enforcement professionals initiated hundreds of contacts to the hotline, reflecting the real impact these professionals have in identifying and intervening in cases of human trafficking.
Forced labor and sex trafficking are the two primary forms of human trafficking recognized by the U.S. government. Regardless of the context, human trafficking is defined as using force, fraud, or coercion to exploit the labor or services of another person. Migrant smuggling may be a component of human trafficking, but the simple movement of an individual from one point to another does not meet the definition of human trafficking. According to the U.S. Department of State, in 2021 an estimated 27.6 million people were victims of human trafficking worldwide. Individuals from any class, religious, cultural, or ethnic group can be targeted in human trafficking schemes.
Some victims of human trafficking may have initially been voluntarily recruited based on false promises of well-paying jobs or romantic relationships that later become violent or coercive in nature. It is very possible the victims do not even realize they are a victim of a crime. In some cases, illicit substances, primarily opioids, are used to exert and maintain control over victims, in addition to the use of force, fraud, or coercion. Because of the addictive nature of opioids and the violent withdrawal from them, traffickers have been found to use this technique as a method of controlling victims.
Characteristics that put people at risk of being victims of human trafficking include past trauma history, recent immigration, mental health issues, past or current substance use, lack of positive family support, poverty, and unstable housing. Vulnerable populations include women and girls, sex workers, LGBTQ+ youth, and runaway youth.
Prioritizing Human Trafficking
Local, state, and federal agencies have made human trafficking a priority for enforcement strategies, but it can be difficult to identify victims of the crime. In many cases victims are coerced into illicit activities such as prostitution. Those victims end up in our jails as criminal arrestees. Many are unwilling to speak out and discuss their situation. Fear of retaliation, often through physical force, is a significant factor that dissuades victims from coming forward. Many victims, especially those who have immigrated, may be hesitant to trust law enforcement or other individuals in uniform. Many do not understand they are a victim, and that options and services are available to assist them in exiting their situation. Lack of trust will often make it difficult to convince a victim of human trafficking to accept offers of help.
Community intercept models focus on systemic opportunities to identify victims of human trafficking. As awareness has developed, other techniques have been used to promote education and awareness. Those include public advertising, placing placards in airport restrooms or other high-traffic areas where victims may see the information, and social media campaigns. Some victims have taken advantage of the information to exit their situation.
Health care workers, especially those in hospital and community clinics, have been trained to recognize and screen individuals for potential victimization and are an invaluable asset in the process of identifying victims and ultimately holding traffickers accountable.
Human Trafficking in Jails
An underutilized intercept opportunity is available to those of us working in correctional facilities, especially jails that handle new arrestees coming in from the street. While the same stigma about authorities in uniform may apply to uniformed staff in jails, correctional health care staff have an ideal window of opportunity to identify victims of human trafficking, connect them to the resources they need, and assist in the overall effort to stem human trafficking and reduce recidivism.
In most facilities, arrestees are typically screened for medical and mental health needs, ideally shortly after being processed in as a new arrestee. As is seen in community health care settings, screening tools for human trafficking could be considered as part of this process, and easily integrated into pre-screening or assessment processes. Screening tools, training, and supportive resources are available through several organizations, including the U.S. Department of Health and Human Services, nonprofit community organizations, and educational sites.
Education is key to creating awareness and understanding of human trafficking. Jails, especially health care employees, have an opportunity to assist in efforts to help victims. By becoming aware of the issue, we can work together to prevent or reduce the impact of this crime on the most vulnerable in our communities.
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Richard Forbus, CCHP, is vice president of program development for the National Commission on Correctional Health Care (NCCHC) and retired from the Las Vegas Metropolitan Police Department in 2021 as a corrections captain. For more information, he can be contacted at richardforbus@ncchc.org or 773-880-1460.
Monica Geiger, DNP, RN, is a lieutenant in the U.S. Public Health Service and the Regional Women’s Health Analyst in Region 6 (AR, LA, OK, NM, TX, and 68 Federally Recognized Tribes). For more information, she can be contacted at OASHRHA6@hhs.gov or 214-767-3523.
Interventions to Address Human Trafficking
A number of interventions can, if taken together, make a significant positive impact in combating human trafficking and supporting survivors.
Develop a human trafficking policy, working cooperatively between health care and custody staff. Policy development plays a foundational role in ensuring that all other planned interventions are coordinated, trauma-informed, gender-sensitive, evidence-based, and compliant with NCCHC standards or other best practices.
Conduct staff training. All staff members who come in contact with incarcerated people should receive training to ensure understanding of and compliance with policies and procedures. Staff from all disciplines need to know how to identify possible victims and traffickers.
Establish identification and assessment procedures. Appropriate screening questions and a trauma-informed approach are critical to effective identification and assessment. Consider the perspective of trafficking survivors when developing language to use, screening questions, and interview techniques. Keep in mind that traffickers routinely instill in their victims the idea that no one outside their circle of control can be trusted, including people in the criminal justice system—and that can include health care staff. Support provided to victims should minimize the risk of retraumatization or stigmatization that may result from acknowledging their victim status.
Develop educational materials for victims, such as a human trafficking flier that lists signs and indicators and the National Human Trafficking Hotline number. Educational materials can be used during the initial health care screening process or at subsequent health care encounters. Fliers can also be laminated and posted in custody-approved locations.
Establish health care referral and reporting procedures. If a suspected trafficking victim has acute medical needs, the first priority is, of course, immediate treatment. If health care staff believe a patient is a victim, the health services administrator or designee and custody staff should be notified immediately. Victims could then be referred to local agencies with experience working with this population. Those steps should be spelled out in policies and procedures.
Create relevant programming to address the needs of trafficking victims, individually and/or in groups. Some correctional systems take a direct approach by offering educational and support groups with titles such as Human Trafficking 101, The Johns, and Ethical Sex. Others take a more subtle approach, with groups on topics such as healthy relationships, boundaries, or other relevant trauma-sensitive topics.
Target discharge/reentry planning to educate and connect victims with local advocacy resources and/or safe home information. Some jurisdictions offer prostitution diversion programs as an alternative to incarceration, similar to drug and alcohol or mental health diversion programs.
(Sidebar taken with permission from CorrectCare magazine, National Commission on Correctional Health Care, 2020)
References
Bureau of Justice Statistics. (2023). Human trafficking data collection activities, 2023 (NCJ 307345). https://bjs.ojp.gov/library/publications/human-trafficking-data-collection-activities-2023
National Human Trafficking Hotline. (n.d.). https://humantraffickinghotline.org/en
National Human Trafficking Hotline. (2023). National Human Trafficking Hotline data report—Report: 1/1/2021—12/31/2021. https://humantraffickinghotline.org/sites/default/files/2023-01/National%20Report%20For%202021.docx%20%283%29.pdf
National Institute of Corrections. (n.d.). Correctional Anti-Human Trafficking Initiative. https://nicic.gov/resources/resources-topics-and-roles/topics/correctional-anti-human-trafficking-initiative-cahti
United Nations Office on Drugs and Crime. (n.d.). Human trafficking FAQs. https://www.unodc.org/unodc/en/human-trafficking/faqs.html
U.S. Department of Health and Human Services. (n.d.). Office on Trafficking in Persons. https://www.acf.hhs.gov/otip
U.S. Department of Health and Human Services. (2018). Toolkit: Adult human trafficking screening tool and guide. https://nhttac.acf.hhs.gov/resources/toolkit-adult-human-trafficking-screening-tool-and-guide
U.S. Department of Homeland Security. (2022). What is human trafficking? https://www.dhs.gov/blue-campaign/what-human-trafficking
U.S. Department of State. (n.d.). About human trafficking. https://www.state.gov/humantrafficking-about-human-trafficking/#how_many