Abigail M. Judge, PhD; Jennifer A. Murphy, PhD; Jose Hidalgo, MD; Wendy Macias-Konstantopoulos, MD, MPH
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2605.
Requests for Single Reprints: Abigail M. Judge, PhD, Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Judge: Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114.
Dr. Murphy: Learning and Emotional Assessment Program (LEAP), Children and the Law Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114.
Dr. Hidalgo: Law and Psychiatry Service, Massachusetts General Hospital, One Bowdoin Square, 10th Floor, 15 New Chardon Street, Boston, MA 02114.
Dr. Macias-Konstantopoulos: The Freedom Clinic, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114.
Author Contributions: Conception and design: A.M. Judge, J.A. Murphy, J. Hidalgo, W. Macias-Konstantopoulos.
Drafting of the article: A.M. Judge, J.A. Murphy, W. Macias-Konstantopoulos.
Critical revision for important intellectual content: A.M. Judge, J.A. Murphy, J. Hidalgo, W. Macias-Konstantopoulos.
Final approval of the article: A.M. Judge, J.A. Murphy, J. Hidalgo, W. Macias-Konstantopoulos.
Administrative, technical or logistic support: A.M. Judge, J.A. Murphy.
Collection and assembly of data: W. Macias-Konstantopoulos.
Human trafficking, also known as modern-day slavery, is an egregious human rights violation associated with wide-ranging medical and mental health consequences. Because of the extensive health problems related to trafficking, health care providers play a critical role in identifying survivors and engaging them in ongoing care. Although guidelines for recognizing affected patients and a framework for developing response protocols in health care settings have been described, survivors' ongoing engagement in health care services is very challenging. High rates of disengagement, lost contact, premature termination, and attrition are common outcomes. For interventions to be effective in this marginalized population, challenges in engaging survivors in long-term therapeutic primary and mental health care must be better understood and overcome. This article uses the socioecological model of public health to identify barriers to engagement; offers evidence- and practice-based recommendations for overcoming these barriers; and proposes an interdisciplinary call to action for developing more flexible, adaptable models of care.
Judge AM, Murphy JA, Hidalgo J, Macias-Konstantopoulos W. Engaging Survivors of Human Trafficking: Complex Health Care Needs and Scarce Resources. Ann Intern Med. ;168:658–663. doi: 10.7326/M17-2605
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Published: Ann Intern Med. 2018;168(9):658-663.
Published at www.annals.org on 13 March 2018
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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