While there seems to be consistency between the needs of trafficking victims and the services for which they are eligible and the programs in place to provide these services, there are many challenges and barriers to getting victims into service.
Lack of Knowledge and Understanding. One of the most common and frustrating challenges reported by law enforcement and service providers is the lack of knowledge and understanding regarding human trafficking among service providers, law enforcement, and even victims themselves who often do not believe or understand that they are a victim of crime. As a result, victims often go unidentified and unserved.(4)
Lack of knowledge and understanding of what services are available is a barrier for service providers as well. Many service providers report their own confusion regarding what services their clients are eligible for and can access, which highlights the need for effective case management as identified in a previous Issue Brief.(5)
|There is a general lack of knowledge and understanding of human trafficking and not enough service providers in the healthcare profession, local Social Security Administration offices, department of motor vehicles, and other key agencies are trained on this issue and know they can serve these clients. We are constantly having to take our clients to appointments because they are turned away when they try on their own.
Availability of Services. Even though victims, international or domestic, may be eligible for services, the availability of those needed services is often limited due to long wait lists and associated fees (even if offered on a sliding scale). As one provider indicates, Free clinics are not always free. You spend a lot of time waiting to be seen and there are often some unexpected charges associated with most services. According to service providers, this is particularly true for mental health services and substance abuse treatment.
While accessing basic medical services (physicals, gynecological exams, screenings, etc.) is not reported as a problem for most service providers (with the exception of some providers in rural communities), accessing specialized medical treatment was problematic. Specifically, specialized care for acute, long-term needs, such as diabetes, cancer, and other illnesses, including prescriptions that are part of the treatment, were often cost prohibitive and in some cases, exhaust program resources.
|As a service provider, I find it confusing trying to figure out what services are available for which clients [international or domestic]. Most of my time is spent making calls or running around to agencies. We [service providers] need a road map that helps explain not only what services our clients are eligible for but how we go about accessing these services. What documentation does my client need? What paperwork do they need to fill out? What would make my client ineligible for services? I can barely navigate through all of these systems myself, so how can we expect our clients to take this on?
Similarly, while most service providers are able to find basic dental care for their clients (although sometimes there are long waiting periods), more serious and costly dental procedures, such as root canals and extractions, are difficult to obtain.
Housing is another service that law enforcement and service providers report is limited. While finding emergency shelter for women and girls is not usually a problem, finding the same placements for men and boys is difficult. Transitional and permanent housing is scarce for everyone but in particular for domestic minors with felony convictions and victims with mental health or substance abuse issues.(6)
|There just isnt affordable housing in our community for anyone. We often end up placing groups of victims together in apartments or houses. Sometimes this works but sometimes the only areas where they can afford housing are high crime areas. Weve actually had clients become the victims of other crimes (burglary) because they could only afford to live in unsafe neighborhoods.
Finally, the availability of services in general for domestic victims is viewed as problematic by some service providers. As one provider states, If you just look at what domestic victims are eligible for on paper, it looks promising. However, trying to access those services is another story. Several examples include referrals to child welfare agencies by service providers and law enforcement only to find out that the agencies would not see the domestic victims because the abuse did not occur at the hands of a parent or legal guardian. In these cases, providers and law enforcement report minors falling through the cracks of the mainstream system and not receiving services. In some cases, minors were handed back to their abusers and turned back out on the streets.
Appropriateness of Services. Service providers talk not only of the need for more culturally appropriate services, but also for gender appropriate services. Finding such services can be challenging, particularly in rural communities. Additionally, service providers stress the importance of understanding what is meant by culturally appropriate services. For instance, just having someone from the same culture who speaks the same language does not translate into culturally appropriate services according to service providers. Speaking the same language as clients can help facilitate service provision but that is just one piece of ones culture. Service providers gave examples of victims of sex trafficking who were not comfortable talking about their experiences with someone from their same culture out of the associated shame and stigma. Other examples given by service providers were related to the gender and culture of the victim. For example, in some cultures, it is not appropriate for a female to visit a male doctor. Recognizing these challenges and the implications for providing appropriate services to clients is seen as critical by providers themselves.
The appropriateness of services also extends to examining the culture of the environment in which the service is offered. For example, service providers note that providing services to victims who are living in shelters can be difficult and some environments can result in revictimization. In particular, providers share examples of sex trafficking clients being placed in domestic violence shelters and then facing humiliation and isolation. For international sex trafficking victims, the isolation is usually attributed by service providers to language barriers and cultural differences. But for domestic victims of sex trafficking, the humiliation and isolation, according to service providers and some victims, is attributed to perceptions that domestic victims are prostitutes, or willing participants, rather than victims of abuse and crimes. These misperceptions reflect again, a general lack of understanding and knowledge of the issue, not only among service providers but in the general public.
Access to Services. The two greatest barriers to accessing services for international victims include language barriers and transportation. Service providers indicate that the availability of information and access to providers that speak English, Spanish, and in some communities Korean, is not difficult. It is their clients that speak other languages that have difficulty accessing services.
Additionally, transportation is a problem. In large cities, teaching clients how to use the transportation system can be overwhelming and very time consuming. Service providers report clients missing appointments because they were afraid to use public transportation. In smaller communities, there is often limited or no public transportation, also making it difficult for clients to get to appointments.
|There is no cookie-cutter approach to working with this population. Males, females, adults, children, sex trafficking, or labor trafficking. You just dont know how long you will be working with them. Just when you think they are moving forward, something happens with their case or with their family or they see something in the news that triggers the trauma experience and sets them back sometimes months in their progress. A lot of times it is one step forward and two or three steps back. You just have to be prepared for setbacks.
Length of Services. Another challenge identified by service providers and victims themselves is the length or duration of the services available to victims. Service providers note that the timeline to self-sufficiency varies by client. Some clients may come in, get certified right away and be ready to work, especially among many labor trafficking victims. Other victims, however, may remain pre-certified for a longer period of time and even after becoming certified, they may not be ready to work or move forward with their lives. According to service providers, individual timelines are difficult to predict. However, with close monitoring and anticipation of set-backs (e.g., depositions, appearances at trial, intense counseling sessions, reunification, etc.), providers are able to adjust services to meet the changing needs of clients.
For domestic minors, shelter stays are often limited to 15-, 30- or 90-days and do not allow providers enough time to establish relationships with victims or provide adequate services to meet their longer-term needs. Transitional housing for domestic minors and domestic victims is often limited, and when available victims often find it difficult to follow the rules/restrictions of the facilities (e.g., no drug/alcohol use, required employment).
|When working with a domestic victim, I just need more time. I cant stabilize a client with an extensive trauma history within 90 days or transition them to permanent housing within 18-months. Many of my clients struggle to get clean, get an education (or GED), learn life skills, obtain employable skills, and get employed. This is especially true if they have not begun to work on trauma recovery and this can take years.
Lack of Coordination of Services. For the most part, service providers acknowledge improved coordination of services for clients over the past several years. However, they see the need for a single point of contact within each agency working with victims and a central case manager to ensure communication and coordination of services.
This appears to be especially true in the case of minor victims. According to service providers and law enforcement, when working with minor victims, in particular international minor victims, there are often numerous individuals involved in a case, making coordination and communication difficult. In some cases, providers and law enforcement report not knowing who to contact on behalf of the minor or who could make decisions on behalf of the minor. There were cases of information not getting transferred from one agency to the next, sometimes resulting in minors not getting the services they needed. As one provider states, When the process for [international] minor victims works, it works well. But when it doesnt, it fails miserably. There is agreement among providers and law enforcement alike that there needs to be more information and communication regarding how international minor victims are served. Most providers report positive experiences with the URM programs but communications from these programs, as well as the availability and location of services are seen as limited.