First name
Cathy
Last name
Zimmerman

Title

Exploitation, Violence, and Suicide Risk Among Child and Adolescent Survivors of Human Trafficking in the Greater Mekong Subregion.

Year of Publication

2015

Number of Pages

e152278

Date Published

2015 Sep

ISSN Number

2168-6211

Abstract

<p><strong>IMPORTANCE: </strong>Human trafficking and exploitation of children have profound health consequences. To our knowledge, this study represents the largest survey on the health of child and adolescent survivors of human trafficking.</p>

<p><strong>OBJECTIVE: </strong>To describe experiences of abuse and exploitation, mental health outcomes, and suicidal behavior among children and adolescents in posttrafficking services. We also examine how exposures to violence, exploitation, and abuse affect the mental health and suicidal behavior of trafficked children.</p>

<p><strong>DESIGN, SETTING, AND PARTICIPANTS: </strong>A survey was conducted with 387 children and adolescents aged 10 to 17 years in posttrafficking services in Cambodia, Thailand, or Vietnam, which along with Laos, Myanmar, and Yunnan Province, China, compose the Greater Mekong Subregion. Participants were interviewed within 2 weeks of entering services from October 2011 through May 2013.</p>

<p><strong>MAIN OUTCOMES AND MEASURES: </strong>Depression, posttraumatic stress disorder, anxiety, suicidal ideation, self-injury, and suicide attempts.</p>

<p><strong>RESULTS: </strong>Among the 387 children and adolescent study participants, most (82%) were female. Twelve percent had tried to harm or kill themselves in the month before the interview. Fifty-six percent screened positive for depression, 33% for an anxiety disorder, and 26% for posttraumatic stress disorder. Abuse at home was reported by 20%. Physical violence while trafficked was reported by 41% of boys and 19% of girls. Twenty-three percent of girls and 1 boy reported sexual violence. Mental health symptoms were strongly associated with recent self-harm and suicide attempts. Severe physical violence was associated with depression (adjusted odds ratio [AOR], 3.55; 95% CI, 1.64-7.71), anxiety (AOR, 2.13; 95% CI, 1.12-4.05), and suicidal ideation (AOR, 3.68; 95% CI, 1.77-7.67). Sexual violence while trafficked was associated with depression (AOR, 2.27; 95% CI, 1.22-4.23) and suicidal ideation (AOR, 3.43; 95% CI, 1.80-6.54).</p>

<p><strong>CONCLUSIONS AND RELEVANCE: </strong>Children and adolescents in posttrafficking care showed high symptom levels of depression, anxiety, and posttraumatic stress disorder, which are strongly associated with self-harm or suicidal behaviors. Mental health screening and reintegration risk assessments are critical components of posttrafficking services, especially in planning for family reunification and other social integration options.</p>

DOI

10.1001/jamapediatrics.2015.2278

Alternate Title

JAMA Pediatr

PMID

26348864

Title

History of persecution and health outcomes among U.S. refugees.

Year of Publication

2015

Date Published

03/2015

ISSN Number

1557-1920

Abstract

<p>Our goal was to describe the forms of persecution reported by adult refugees in the U.S. and the relationships between persecution and health status among this population. Data were derived from the 2003 New Immigrant Survey, a representative sample of new U.S. lawful permanent residents. Major depression, impairment in daily activities due to pain, poor self-reported health, and declining health were described for refugees who had and had not reported persecution prior to arrival in the U.S. Health status was also examined for refugees who reported different forms of persecution. Half of refugees (46.7&nbsp;%) in this sample reported that they or an immediate family member had been persecuted. One in three persecuted refugees (31.8&nbsp;%) reported&nbsp;both incarceration and physical punishment. Major depression, pain-related impairment, poor health, and declining health were twice as common among persecuted refugees than among non persecuted refugees. Notably, despite these adverse experiences&nbsp;the majority of persecuted refugees did not report poor health outcomes.</p>

DOI

10.1007/s10903-015-0176-2

Alternate Title

J Immigr Minor Health

PMID

25740552

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