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Human Trafficking, Mental Illness, and Addiction: Avoiding Diagnostic Overshadowing
Hanni Stoklosa1, Marti MacGibbon2, Joseph Stoklosa3
1Executive director of HEAL Trafficking and an emergency physician at Brigham and Women's Hospital in Boston, with appointments at Harvard Medical School, the Harvard T.H. Chan School of Public Health, and the Harvard Humanitarian Initiative, and a researcher, advocate, and speaker in the US and internationally.
AMA Journal of Ethics
|January 21, 2017
Summary
This review addresses complex health issues in trafficked individuals, including pregnancy, mental health, and substance use disorders. It proposes a trauma-informed approach to improve care for vulnerable patients facing human trafficking.
Area of Science:
- Emergency Medicine
- Public Health
- Psychiatry
Background:
- Human trafficking presents complex health challenges, often involving co-occurring conditions.
- Emergency departments encounter trafficked patients with diverse medical and psychiatric needs.
- Literature review on health consequences of trafficking and co-occurring disorders is crucial.
Observation:
- A clinical vignette highlights a trafficked patient with pregnancy, mental health, and substance use issues.
- Authors include a survivor of human trafficking, bringing unique perspectives.
- Multidisciplinary expertise in addiction, trafficking, emergency medicine, and psychiatry informs the review.
Findings:
- Implicit bias and diagnostic overshadowing negatively impact care for trafficked patients.
- Co-occurring addiction and mental illness complicate diagnosis and treatment.
- A trauma-informed, multidisciplinary approach is essential for effective patient management.
Implications:
- Healthcare providers need enhanced awareness of trafficking indicators and health needs.
- Developing standardized, trauma-informed protocols can improve outcomes for trafficked individuals.
- Addressing systemic biases is critical for equitable healthcare delivery to vulnerable populations.
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