By Jessicah Ray, PA & Concussion SpecialistTraumatic Brain Injury Awareness for Survivors of Human Trafficking
Much advancement has been accomplished in the recognition of the comprehensive and trauma-informed health needs for survivors of human trafficking. However, publications and guidelines have yet to consistently include the consideration for traumatic brain injury (TBI) assessment and care. This can be a critical miss due to the high rate of abuse and secondary risk of head injuries in this population. In fact, over 92% of survivors of sex trafficking reported suffering from physical violence with most from direct blows to the head or face (Chisolm-Straker & Stoklosa, 2017). Such a high statistic is astonishing considering violence and abuse statistics are constantly underreported.
TBI research has confirmed that children and females are at increased risk of prolonged recovery from traumatic brain injuries. But unlike the general population, human trafficking victims are even more likely to not only sustain multiple TBIs, but also to not recover well from them because of the continued abuse and risk factors. Recovery from TBI is dependent on head injury education, proper rest, gradual return to activity, supportive care, healthy lifestyle choices, and access to medical care when needed.
However, survivors of human trafficking experience barriers in all these TBI recovery respects due to:· High risk of sustaining multiple TBIs· No opportunity to recover between injuries· No available emotional support· Little access to education or healthcare· Forced to return to work immediately
· At risk of malnutrition, substance abuse, and anxiety disorders
The real danger is that without proper diagnosis of TBI, the TBI remains untreated and many of the common symptoms of chronic TBI may be misattributed to other diagnoses. These TBI symptoms include memory difficulty, disorganized thinking, headaches, anxiety, insomnia, dizziness, vision problems, hormone changes, and in cases of children – developmental problems. Many of these symptoms can be mislabeled as secondary to post-traumatic stress disorder (PTSD), depression, personality disorders, addiction, or even behavioral problems. Misdiagnosis can also lead to new problems from the wrong treatment choice worsening the untreated TBI symptoms.
The great news is that treating TBI can reduce these symptoms and the recovery time, even if the head injuries were multiple and occurred years ago. In fact, because victims of abuse often have both TBI and PTSD, treating one often improves symptoms of the other. That is, treating the TBI can improve the PTSD, and vice versa. Most current evidence-based treatment recommendations for TBI, PTSD, and survivors of human trafficking endorse multi-disciplined trauma-informed care. Therefore there is a promising opportunity to integrate TBI assessment and treatment into health management recommendations for survivors of human trafficking, and we can be encouraged to use TBI care as a targeted way to enhance the recovery and quality of life of this vulnerable population.References: Chisolm-Straker, M., & Stoklosa, H. (Eds.). (2017). Human Trafficking Is a Public Health Issue. https://doi.org/10.1007/978-3-319-47824-1