Human trafficking and the mental health burden of forced migrants in Germany
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Updated: Nov 1, 2026

Social Threat-Safety Test Uncovers Psychosocial Stress-Related Phenotypes
Published on: December 15, 2023
Irja Rzepka-Marot1, Ivo Dönnhoff2, David Kindermann2
1Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany. irja.rzepka-marot@med.uni-heidelberg.de.
Purpose:
Forced migration increases vulnerability to exploitation. Globally, around 50 million people are affected by human trafficking, which often involves trauma with negative mental health effects. Forced migrants already face elevated risks of PTSD, depression, and anxiety, yet the specific association of trafficking on their mental health remains unclear.
Methods:
Symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and overall stress were assessed using standardized screening instruments (PC-PTSD-5, PHQ-4, and the Distress Thermometer). Experiences of human trafficking were measured with a modified version of the Adult Human Trafficking Screening Tool (AHTST) among forced migrants in Germany. Missing data were handled using multiple imputation. Logistic regression analyses were conducted to examine the association between human trafficking and positive screenings for the respective mental health conditions.
Results:
A total of N = 1108 forced migrants participated in the study. Depending on the imputation model, between 49% and 56% of all participants screened positive for PTSD, 60% to 71% for depression, and 41% to 52% for an anxiety disorder. Among participants who screened positive for these mental health conditions, a positive screen for human trafficking was associated with a 30-40% higher probability of screening positive for PTSD and a 15% to 20% higher probability of screening positive for depression or anxiety disorder.
Conclusions:
Forced migrants with a history of human trafficking are at elevated risk for PTSD, depression, and anxiety than those without, underscoring the need for early identification and tailored psychosocial support.
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