There are many barriers to and challenges in responding to the needs of victims of human trafficking. Some of these barriers result from an overall lack of knowledge about human trafficking and lack of public awareness of the issue, and differing definitions and perceptions regarding who is a victim (Clawson et al., 2004). To compound the problem, research has suggested that trafficking victims are often reluctant to identify themselves as victims; therefore, self-referrals are less common than with other types of crime (Richard, 1999). Victims of human trafficking are also a hard-to-find, hard-to-reach population. Many victims have been taught to fear law enforcement authorities and NGOs, often because of their experiences with corrupt law enforcement personnel or authorities in their countries of origin (Bales, 2004). Additionally, victims are often reluctant to come forward because they fear retribution from their traffickers and fear arrest and deportation.
Despite the definition offered by the TVPA, inconsistencies still exist in how law enforcement and service providers define victims and handle cases, presenting a primary barrier to identification. For example, there is no nationwide consensus regarding the treatment of juveniles engaged in prostitution (whether they should be considered victims or offenders). Data from the FBIs NIBRS 19972000 (prior to the TVPA) were analyzed, looking at a sub-sample of 241 prostitution arrests involving juveniles nationwide (Finkelhor & Ormrod, 2004). Of these incidents, 229 juveniles were counted as offenders and 61 as victims. Further, boys were more likely than girls to be considered offenders. As boys most often do not have the formal coercion of a pimp, this may account for them being more frequently labeled as offenders rather than victims. In addition, law enforcement may fail to record a prostitution offense at all, believing it is in the adolescents best interest to be released or charged with another offense (e.g., disorderly conduct, trespassing). Law enforcement also may be affected by other issues, such as the demeanor of the adolescent, the officers sympathy for a particular teenager, or specific law enforcement policies in a jurisdiction (Finkelhor & Ormrod, 2004).
The stigma associated with sexual exploitation in general, and prostitution in particular, also increases the difficulty in identifying victims. Both international and domestic victims of sex trafficking are not likely to disclose their involvement in prostitution to providers, especially law enforcement, due to their own sense of shame and fear of the response (Lloyd, 2005; Raphael, 2004; U.S. Department of Justice, 2002). Further, the power of the traffickers or pimps seduction and manipulation, as well as the manifestations of Stockholm syndrome, render some victims less likely to see themselves as victims and more likely to protect their perpetrator at all costs (Caliber Associates, 2007; Lloyd, 2005; Raphael, 2004).
For international victims, and perhaps some domestic victims, other significant challenges to accessing services include cultural and language barriers. Victims may not learn about available services if information about these services is not provided in their native language. Additionally, some victims may be illiterate in their native language. While most service providers engage an interpreter/translator to assist with communication, the presence of a third party can make it more difficult for the provider (often the case manager) to develop a relationship of trust with the victim. Cultural differences also can interfere with the ability to provide or receive services and lead to culturally inappropriate services, insensitive responses, and/or misinterpretation of behavior or actions. For example, victims unwillingness to look directly at the person speaking to them may be misinterpreted by providers as a sign that someone is hiding something or not telling the truth rather than understood as a sign of respect, as is the case in some cultures. Basic logistical barriers, including lack of familiarity with the community, transportation, or child care, can prevent victims from accessing available services (Clawson et al., 2004).
Studies of runaways provide useful insights about why these youth do not use available services and programs or discontinue using them (De Rosa et al., 1999; Martinez, 2006). Reported barriers included restrictive rules at shelters; concerns regarding confidentiality, including concerns about being reported to child protective services; lack of age-appropriate therapeutic groups; lack of culturally appropriate services; inability to establish trust with staff members due to high staff turnover; and the need for emotional, financial, and other support that will help empower these victims to leave the streets and exploitation (Aviles & Helfrich, 2004; Dalton & Pakenham, 2002). With the exception of the last barrier, the barriers described here are similar to concerns expressed by international trafficking victims during individual interviews conducted as part of a larger evaluation of comprehensive services for victims of human trafficking (Caliber Associates, 2007).
Seeking some services may have potential legal ramifications for victims. As is the case with adult victims of domestic violence, the legal consequences of being identified with a substance abuse or mental health disorder can be profound for an immigrant illegally in this country. An international trafficking victim may fear that the problem will be documented and negatively affect a future immigration hearing or a possible custody case (Caliber Associates, 2007).
With minors (but also with many adults), one of the greatest barriers is persuading a victim to commit to substance abuse and/or mental health treatment. Research indicates that most adolescents do not present themselves for substance abuse treatment voluntarily and therefore have low motivation for treatment; they are either mandated to services or enter as a result of family pressure (Melnik, DeLeon, Hawke, Jainhill, & Kressel, 1997; Noel, 2006). Studies also document higher rates of attrition in adolescent programs compared to adult programs (Dobkin, Chabot, Maliantovitch, & Craig, 1998; Noel, 2006; Siegal, Rapp, Fisher, Cole, & Wagner, 1993; Spooner, Mattick, & Noffs, 2001). Both research and program administrators identify demographics (younger age, ethnic minority status, female gender, and being pregnant and parenting), substance use severity, mental health symptoms, and motivation/treatment readiness as the leading predictors of dropping out of treatment (Gainey, Wells, Hawkins, & Catalano, 1993; Grella et al., 2001; Haller, Miles, & Dawson, 2002; McCaul, Svikis, & Moore, 2001; McComish, Greenberg, Ager, Chruscial, & Laken, 2000).
Additionally, the complex needs of victims of human trafficking can create tremendous challenges for providers trying to deliver integrated services (Caliber Associates, 2007; Van Leeuwen, 2004). Common difficulties cited include lack of adequate resources to provide intensive case management and follow-on/aftercare services for extended periods of time (Dennis, 2006); lack of training about how to gain victims trust, effective outreach methods, cultural competency, and/or confidentiality (Bird, 1999; Clawson et al., 2004); and staff inability to identify and respond to the co-occurrence of emotional and behavioral problems (especially among adolescents) (Mark et al., 2006). Other agency problems include ineffective coordination of services across agencies (Clawson, Dutch, & Cummings, 2006), safety concerns for victims and staff (Clawson et al., 2004), insufficient monitoring of service quality (Lyons & Rogers, 2004), and a general lack of services in the surrounding community. Services that are particularly lacking include appropriate interpreters/translators, secure housing, and affordable medical/dental care (Clawson et al., 2004).