Mental health network

Supporting victims of modern slavery on their journey to recovery

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30 / 04 / 2019

Overview

In 2018, the Global Slavery Index estimated that there are 136,000 victims of modern slavery living in the UK. In 2018, nearly 7,000 men, women and children were referred into the National Referral Mechanism for the identification of victims of modern slavery. Over the same period, Hestia provided direct support to over 1100 adults who had entered the NRM and over 500 dependent children. Hestia remains the largest provider of support to adult victims in the UK.

Victims of modern slavery present with a host of complex physical and mental health issues. This can be challenging to address but in partnership with other organisations such as the NHS, Hestia’s Modern Slavery Response Team can help to empower individuals and change their lives.

The challenge and the context 

Blessing (pseudonym) is a victim of modern slavery and was trafficked for sexual exploitation. She was sexually exploited as a child, prostituted as a teenager and coerced in to coming to the UK in her mid-twenties and forced to sell sex in London.

She came into Hestia’s modern slavery service in September 2016. She was experiencing sleeplessness, panic attacks and suicidal thoughts and had not been able to receive any therapeutic support. Blessing was extremely anxious at the thought of being left alone in a room with a doctor, as she was terrified that she would sedated and assaulted.

Blessing’s advocate supported her to attend her doctor who was quickly able to provide her with medication and refer her for counselling. This treatment plan has enabled Blessing to start to move forward on her journey to recover from both the physical and psychological effects of her experience. Blessing was supported over time to start to make her own doctor appointments and is now able to attend on her own, asking for whatever support she needs.

What the organisation did

It was important for Blessing to establish trust with her advocate over time and crucial that she could get to know them to build up confidence in the service she was receiving. Once this trust took shape, Blessing grew in self-belief and was able to start to take control of her life again. Blessing now volunteers at her local women’s centre, attends college and is part of a creative arts group, all of which she was too anxious to engage with prior to Hestia’s support.

Further to the support Blessing received from Hestia, the role of the NHS has been crucial in her recovery. When Blessing met with her doctor for the first time, he was non-judgemental and gave her time to fully explain the health issues she was facing to build the right support for her needs. Blessing was very emotional whilst explaining her circumstances and he remained patient and sympathetic, allowing her to lead the pace of the discussion. When blessing was prescribed medication, the doctor explained what it was for, exactly how she should take it and signposted her to the closest chemist.

More recently, Blessing experienced a relapse following a severe flashback, after which she expressed suicidal ideation. Hestia supported her to see her doctor again who has increased her check-ups to once a fortnight, booking the appointments for her as it can be difficult to get through to the receptionist. Blessing reports that this has taken a huge weight off her mind.

Results and benefits

As a result of Hestia’s work, and the supportive approach of her doctor, Blessing is now able to engage with healthcare professionals whenever she needs to. Blessing’s access to medication means she now sleeps through the night and has had a decrease in thoughts of suicide; she says she wants to fight for her future. She has had a full phase of counselling and is about to embark upon a second, reporting that she is feeling much happier and now has hope that there is light at the end of the tunnel. The approach of her doctor has given her confidence to attend appointments without her advocate. Progress is measured through Blessing’s support plan every 28 days by Hestia and every two weeks by her doctor.

The overwhelming majority of the thousands of survivors of modern slavery we have supported are not registered with a GP when they arrive with us. 1 in 4 women arrive heavily pregnant and have never seen a health professional. Untreated injuries, dental problems and sexual health problems are very common because people have been barred from accessing health services. Whilst in our service, 81% of survivors we support told us that we have helped them access health and wellbeing services, while 92% have told us that we allowed them to maintain their independence.

Overcoming obstacles

Blessing’s journey to where she is today was not a neat, upwards trajectory. Prior to attending her GP, she had to cancel several appointments as she could not muster enough courage to attend. Blessing’s advocate reassured her that this was okay and empowered her to go at a pace that she felt comfortable with. Blessing reports that her advocate’s strength became her strength and helped her to feel confident in herself. Her doctor’s approach also helped her to feel comfortable and enabled her to be completely transparent about how she was really feeling, leading to effective NHS interventions.

Being able to support survivors on their journey to recovery and independence depends greatly on our relationship with professionals and organisations from healthcare, safeguarding, legal and voluntary sectors. 98% of our service users told us that we were able to link them to other services that offered them help. Healthcare professionals are well equipped to understand the vulnerability of people we support, but the presence of our advocates helps them understand the particular needs of modern slavery survivors. For instance, an advocate can explain to a sexual health clinic nurse that the question “how many sexual partners have you had” can trigger traumatic memories for a survivor.

Key learning

  • NHS support is crucial in helping victims of modern slavery to recover from their experiences.
  • A crucial part of empowering a vulnerable individual is encouraging and allowing them to make choices.
  • An understanding and sympathetic approach goes a long way to survivors feeling comfortable to open up.
  • Additional measures, such as the doctor supporting the vulnerable person to book their routine appointments, can reduce pressure on the patient.

Takeaway tips

  • All NHS staff should be trained on modern slavery to understand the rights and entitlements of victims.
  • Healthcare practitioners should be supportive and patient to allow victims to open up about their needs.
  • Healthcare practitioners should be willing to explain certain practicalities (i.e. how to take medication) on several occasions. Victims should be encouraged to ask questions.
  • Explanations of simple things should be offered (a victim may never have attended their local chemist or known they were entitled to free medication) to make sure they can access what they need.

Want to find out more?

You can find more information on modern slavery and the work Hestia is doing to support victims here https://www.hestia.org/modernslaveryresponse.

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