Meeting the Needs of Victims of Trafficking:

1. Meeting the Needs of Victims of Trafficking: Achieving the Balance between Support, Care and Protection Bronagh Andrew – TARA Dr Sharon Doherty – Consultant Clinical Psychologist The COMPASS Team – NHSGGC/ TARA

2. Support Services The TARA Project 0141-276-7724 • GCSS, through TARA, provides support to women over 18 yrs where there are concerns they have been trafficked into and/or around the UK and commercially sexually exploited. Support can include safe accommodation, a mobile phone, clothing, basic toiletries, advocacy and access to existing mainstream services such as counseling, legal advice and healthcare. A Clinical Psychologist has been seconded to the service from COMPASS Specialist Trauma Service, NHSGCC. • TARA also act as a First Responder for the National Referral Mechanism and encourage women to speak to the Police about their experience.

3. Assessments and Care Plan • Trafficking Assessment – based on vulnerabilities and indicators • NRM – first responder (informed consent) • Risk Assessment – informed by Domestic Abuse assessments – led by woman’s perceptions of risk • Safety Plan – generic and individual aspects • Accommodation • Mental Health Screening - pilot • Care Plan – Exploration of strengths and problems (mental health, housing, friends/family, education, physical health, finance, legal and ‘me’ time), change plan worksheets, weekly planning, regular review • Repatriation – basic risk assessment drafted, but input required from external agencies • All informed/reviewed through current practice wisdom and project experience • Cultural sensitivity, ability to engage and good practice working with interpreters vital

4. Current Reflections on Practice • Most agency guidance available acknowledges the need to be sensitive to trauma and the impact on VoTs but this is not routinely incorporated or reflected in current practice/interventions/models/processes e.g. detailed disclosures required for all of the above systems – frontloading • Current practice reflection is focused on achieving the balance between screening for and meeting of psychological need and the external requirements of the NRM, Asylum/Immigration and Criminal Justice systems • Working with COMPASS to try to integrate psychological safety and recovery into our current practice e.g. currently interrogating our requirement for detailed disclosure i.e. why, what, how and for what purpose?

5. Psychological healthcare for Victims of Trafficking • The Compass Team is a specialist NHSGGC trauma service for asylum seekers, refugees and trafficked individuals “affected by trauma”. • Service is for children, adults and older adults. • Over recent years, increasing numbers of referrals are of victims of trafficking. • Provide psychological assessment and specialist treatment for trauma • Contribute psychological opinion to asylum process through legal reports • Training and Consultation

6. Identifying and respondingto psychological needs (clinical context) • Early identification of psychological needs and suicide risk through psychological screening of all new referrals (Elliott et al 2005) • Early psychological assessment for clients where there is concern. • Regular case consultation with TARA development workers. • Psychologist involvement in care planning process • Psychological therapy for clients with evident clinical need • Timely onward referral into other arms of mental health service (eg for crisis care and psychiatric management).

7. Identifying and responding topsychological needs (legal context) • “Informed” consent to NRM? • Recommendations re timing of interviews requiring a full disclosure of experiences • Recommendations re Special Measures • Identifying psychological factors which pose a barrier to interview • Transparent therapeutic input to help women tolerate being interviewed. • Legal reports detailing psychological health and impact of experiences to inform NRM/Asylum decisions • “Trauma-informed” perspective on NRM and Asylum processes

8. Models of intervention: Mental health care • COMPASS developing recommendations as to psychological treatment and care of trafficked individuals over the short, medium and long term: • Model to include provision for early identification of psychological need (health and protection) • Model to specify what constitutes appropriate treatment at different stages of recovery. • Model to draw on accepted definitions of mental health “recovery” • Model to emphasise the importance of clinical understanding being used to inform legal processes (OSCE, 2012) • Model to emphasise close inter-agency collaboration and partnership working.

9. Trauma-informed services “Are those in which service delivery is influenced by an understanding of the impact of interpersonal violence and victimisation on an individual’s life and development. To provide trauma-informed services all staff … must understand how violence impacts the life of the people being served, so that every interaction is consistent with the recovery process and reduces the possibility of retraumatisation”. Elliot et al 2005 Jnl Comm. Psychology, 33(4), 461-477

10. Contact Bronagh Andrew: The TARA Project 0141-276-7724 bronagh.andrew@glasgow.gov.uk Dr Sharon Doherty: The COMPASS Team, NHS Greater Glasgow and Clyde 01416304985 / The TARA Project 0141 276 7656 sharon.doherty2@ggc.scot.nhs.uk