Abstract
BackgroundEmerging evidence indicates the extreme forms of violence and acute and longer-term mental health consequences associated with trafficking and exploitation. However, there has been little research on post-trafficking mental health and psychosocial support services for survivors. This study explored the availability and accessibility of mental health and psychosocial support services in Cambodia for women, men and children trafficked and exploited for sex or labour purposes.MethodsSemi-structured interviews were conducted with a purposively selected sample of representatives from seven service organizations providing mental health and psychosocial support services for people who have been trafficked. This qualitative method was selected to gain insights into the service approaches and challenges faced by the small number of post-trafficking service providers in Cambodia. A conceptual framework outlining access dimensions associated with service provision guided the structure of the study.ResultsFindings indicate that among the available post-trafficking services, there are few trained mental health specialists, an over-representation of shelter services in urban versus rural areas and limited services for males, people with disabilities, individuals exploited for labour (versus sexual exploitation) and those with more serious mental illnesses. Providers believe that discrimination and stigma related to both mental health and human trafficking hinder trafficked people’s willingness to access services, but suggest that awareness-raising may reduce these prejudices. Care in this sector is precarious due to over-reliance on financial support by donors versus government. Recent increases in newly qualified professionals and providers suggest potential improvements in the quality and availability of psychological support for trafficking survivors.ConclusionsPsychological support for the growing number of identified trafficking survivors in Cambodia will depend on improved geographical distribution of services, more mental health support professionals and growing acceptability of mental health service use among trafficked people and the Cambodian public.
Highlights
Emerging evidence indicates the extreme forms of violence and acute and longer-term mental health consequences associated with trafficking and exploitation
Cambodia is renowned for its history of genocide, decades of conflict, foreign occupation and political oppression
The studies included in this review found high levels of anxiety (48.0%-97.7%), depression (54.9%-100%) and post-traumatic stress disorder (PTSD) (19.5%-77.0%)
Summary
Emerging evidence indicates the extreme forms of violence and acute and longer-term mental health consequences associated with trafficking and exploitation. There has been little research on post-trafficking mental health and psychosocial support services for survivors. This study explored the availability and accessibility of mental health and psychosocial support services in Cambodia for women, men and children trafficked and exploited for sex or labour purposes. The covert nature of human trafficking and problems in defining who is considered ‘trafficked’ hinder prevalence studies globally and within Cambodia [5]. Official data shows that despite large numbers of women and girls trafficked to, from and within Cambodia for forced sex work [5,6,7], the number of referrals to NGOs by government has declined from 388 in 2013 to 151 in 2014 [6]. One organisation reported repatriating twice as many Cambodian male victims of trafficking from Mauritius, Indonesia, Senegal, Malaysia, and South Africa in 2013 than in 2012 [6]
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