Nearly two-thirds of surveyed survivors of human trafficking in Southeast Asia show symptoms of depression, while another 40 per cent suffer from post-traumatic stress disorder, according to a new study.
The research, which was published yesterday in Lancet Global Health and included input from Cambodian victims, found the highly exploitative and dangerous conditions frequently endured by human-trafficking victims inflict an immense psychological toll.
“Physical, sexual, and psychological abuses are signature features of human trafficking. Roughly half of participants were physically or sexually abused – many suffering extraordinary forms of violence (eg, knife and dog attacks, burning, and choking),” the study by the London School of Hygiene & Tropical Medicine and the International Organization for Migration says.
Those instances of often extreme violence and abuse were strongly associated with poor mental health outcomes.
“Participants described various physical health complaints, but symptoms of poor mental health were most prevalent and severe,” the researchers said.
In addition to high rates of depression and PTSD, more than 5 per cent had attempted suicide in the month preceding the interviews.
The survey included participants who were trafficked into myriad forms of forced labour such as fishing, factories, domestic work, undesired marriages and sex work. The worse the conditions – extremely excessive overtime, restricted freedom, hazardous living conditions, severe violence – the more likely the victims were to report mental health issues.
“Findings certainly point out the central importance of providing health care for people who have been trafficked and in particular the need to identify mental health support approaches that can be delivered in relatively low-resource settings,” said Dr Cathy Zimmerman, one of the study’s authors.
But anti-human trafficking advocates noted that such health services are extremely limited in Cambodia, where post-care is mostly provided by NGOs focusing on reintegration and vocational training.
“Most [trafficking victims] are looking for jobs and a way to regain their income, because it is an immediate need,” said Brett Dickinson at the International Organisation for Migration and a contributor to the report.
For cultural reasons and stigma associations, many survivors in Cambodia are also reluctant to discuss the trafficking or seek counselling.
“Many don’t share what happened with their families, and that isolation can further perpetuate health problems down the road,” he said.
The costs of obtaining health services, especially mental health services located in the capital far from their home communities, are also prohibitively high for many victims.
“The family has to borrow money from relatives or the bank, which makes the victim vulnerable to re-trafficking because of even worse poverty,” said Chhan Sokunthear, women and children’s coordinator at local rights group Adhoc.
The Transcultural Psychosocial Organisation, one of the few NGOs providing mental health services, said the few victims who do seek help reflect often severe conditions including psychosis, severe traumatisation and suicidal tendencies.