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Sidi A, Kiio M, Mwangi N, Olum M, Githinji G, Maina K, Kithinji C, Kaloki F, Temmerman M, Manguro G. Prevalence and correlates of depressive disorders in commercially sexual exploited children: A cross-sectional study in Mombasa, Kenya. CHILD ABUSE & NEGLECT 2024; 149:106690. [PMID: 38354599 DOI: 10.1016/j.chiabu.2024.106690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Commercial sexual exploitation of children (CSEC) is a global concern and is among the common forms of sexual violence against children. In Kenya, about 32 % of girls and 16 % of boys experience sexual violence before the age of 18 years. While much has been written about the impact of child sexual exploitation, there's little on the prevalence of depressive disorders among CSE children. OBJECTIVES This study was conducted to assess the prevalence and correlates of depressive disorders among CSE children in Mombasa, Kenya. PARTICIPANTS AND SETTING The study was conducted among CSE children (10-17 years) in Mombasa County. METHODS A cross-sectional study conducted between May 2021 and June 2022. A total of 409 CSE children were enrolled, using a case management approach. Data was collected using the child identification tool and the Patient Health Questionnaire (PHQ-9), at the first counselling session to determine the prevalence of depression levels. RESULTS Of the 409 children, 367 (90 %) were girls while 42 (10 %) were boys. The mean age was 15 years (10-17) (SD = 1.4, t = 0.765). In 286 (70 %) 'Depression unlikely' was recorded, while 123 (30 %) 'Depression likelihood.' Prevalence of mild to severe depression was significantly higher in girls than boys (p = 0.002). Other determinants of depression were having a primary level of education (p = 0.03) and being an orphan. (p = 0.03). CONCLUSION It is important to prioritize mental health interventions such as screening and early diagnosis of mental health among CSE children in order to prevent and manage both short and long term effects.
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Affiliation(s)
- Abigael Sidi
- International Centre for Reproductive Health, Kenya.
| | - Morris Kiio
- International Centre for Reproductive Health, Kenya
| | - Norah Mwangi
- International Centre for Reproductive Health, Kenya
| | - Melanie Olum
- International Centre for Reproductive Health, Kenya
| | | | | | | | | | - Marleen Temmerman
- International Centre for Reproductive Health, Kenya; Aga Khan University, Nairobi, Kenya
| | - Griffins Manguro
- International Centre for Reproductive Health, Kenya; Ghent University, Faculty of Health Sciences, Belgium
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Godoy SM, Perris GE, Thelwell M, Osuna-Garcia A, Barnert E, Bacharach A, Bath EP. A Systematic Review of Specialty Courts in the United States for Adolescents Impacted by Commercial Sexual Exploitation. TRAUMA, VIOLENCE & ABUSE 2023; 24:1344-1362. [PMID: 35001766 PMCID: PMC9262992 DOI: 10.1177/15248380211061403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Nationwide efforts to enhance services for adolescents experiencing commercial sexual exploitation (CSE) in the judicial system have led to the emergence of specialty courts, including human trafficking and girls' courts. Given that prior research has documented competing stances on the effectiveness of specialty courts for CSE-impacted populations, we conducted a systematic review of the literature to identify key characteristics of programming, profiles of adolescents served, and effectiveness of these courts. To identify relevant research and information, we systematically searched scholarly databases and information sources, conducted reference harvesting, and forwarded citation chaining. Articles presenting primary data with quantitative, qualitative, or mixed methodologies or programmatic descriptions of specialty courts serving adolescents at risk or with confirmed histories of CSE that were published after 2004 were included. We identified 39 articles on 21 specialty courts serving adolescents at risk or with confirmed histories of CSE, including seven specialty courts with evaluation or outcome data. Across specialty courts, adolescents benefited from an increase in linkage to specialized services, improved residential placement stability, and reduction in recidivism-measured by new criminal charges. Specialty court participation was also associated with improved educational outcomes and decreased instances of running away. A lack of empirical data, specifically of evaluation studies, emerged as a weakness in the literature. Still, findings support that specialty courts can be an integral judicial system response to CSE. Multidisciplinary collaboration can help target and respond to the multifaceted needs of adolescents, encourage healthy behaviors, and promote their overall wellness.
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Affiliation(s)
- Sarah M. Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro Street, Room 400-I, Chapel Hill, NC United States, 27599
| | - Georgia E. Perris
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Mikiko Thelwell
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Antonia Osuna-Garcia
- Health and Life Sciences Library, UCLA Science Libraries, 12-077 Center for Health Sciences, Los Angeles, CA, United States, 90095
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children’s Hospital, Los Angeles, CA, UCLA Pediatrics, Box 951752, 12-467 MDCC, Los Angeles, CA, United States, 90095-1752
| | - Amy Bacharach
- Center for Families, Children, and the Courts, Judicial Council of California, 455 Golden Gate Avenue, San Francisco, CA 94102
| | - Eraka P. Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, United States, 90024
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Greenbaum J, Kaplan D, Young J, Asnes AG, Gavril AR, Gilmartin ABH, Girardet RG, Heavilin ND, Laskey A, Messner SA, Mohr BA, Nienow SM, Rosado N, Forkey H, Keefe R, Keeshin B, Matjasko J, Edward H, Stedt E, Linton J, Gutierrez R, Caballero T, Falusi O“LO, Giri M, Griffin M, Ibrahim A, Mukerjee K, Shah S, Shapiro A, Young J. Exploitation, Labor and Sex Trafficking of Children and Adolescents: Health Care Needs of Patients. Pediatrics 2023; 151:190310. [PMID: 36827522 DOI: 10.1542/peds.2022-060416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Exploitation and labor and sex trafficking of children and adolescents is a major public health problem in the United States and throughout the world. Significant numbers of US and non-US-born children and adolescents (including unaccompanied immigrant minors) are affected by this growing concern and may experience a range of serious physical and mental health problems associated with human trafficking and exploitation (T/E). Despite these considerations, there is limited information available for health care providers regarding the nature and scope of T/E and how providers may help recognize and protect children and adolescents. Knowledge of risk factors, recruitment practices, possible indicators of T/E, and common medical, mental, and emotional health problems experienced by affected individuals will assist health care providers in recognizing vulnerable children and adolescents and responding appropriately. A trauma-informed, rights-based, culturally sensitive approach helps providers identify and treat patients who have experienced or are at risk for T/E. As health care providers, educators, and leaders in child advocacy and development, pediatricians play an important role in addressing the public health issues faced by children and adolescents who experience exploitation and trafficking. Working across disciplines with professionals in the community, health care providers can offer evidence-based medical screening, treatment, and holistic services to individuals who have experienced T/E and assist vulnerable patients and families in recognizing signs of T/E.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, Virginia
| | - Dana Kaplan
- Department of Pediatrics, Staten Island University Hospital, Northwell Health Physician Partners, Staten Island, New York.,The Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Janine Young
- Department of Pediatrics, University of California, San Diego, California
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Sex Trafficking: A Literature Review With Implications for Health Care Providers. Adv Emerg Nurs J 2022; 44:248-261. [PMID: 35900246 DOI: 10.1097/tme.0000000000000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sex trafficking often goes unrecognized, yet is a pervasive issue that disproportionately affects marginalized populations. Survivors suffer adverse health effects and often present to health care facilities while still under control of their traffickers. Health care providers, including nurses and advanced practice nurses, lack understanding of risk factors, signs and symptoms, and means of offering assistance. A comprehensive literature search was conducted utilizing EBSCOhost and WorldCat. Studies were considered eligible for inclusion if subject matter dealt directly with domestic sex trafficking and included implications for health care or health care education. There are some identified risk factors that place people at higher risk for victimization and survivors may present for care with a common symptom, including physical and mental health issues. Barriers to care include both survivor and health care system characteristics; however, health care providers can undertake specific actions to help overcome these barriers. Health care providers are in a prime position to identify and assist sex trafficking survivors. However, they need to be aware of common risk factor presentations, and they need to be trained to offer assistance. Ongoing research is needed to determine the best way to develop, introduce, and evaluate these trainings.
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Ram S, Goldin D. Primary Care Clinician's Knowledge of Trafficking in Persons: A Systematic Review. J Transcult Nurs 2022; 33:388-397. [PMID: 35075928 DOI: 10.1177/10436596211070285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Human trafficking is an enormous global threat. Primary care clinicians are part of a safety net of professionals who may be able to identify and assist trafficking in persons (TIPs). The purpose of this systematic review was to explore clinicians' knowledge, attitudes, and behaviors in identifying and assisting TIPS in health care settings. METHODOLOGY The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. Searches were conducted using PubMed, Medline Plus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases that yielded 130 articles, of which 10 quantitative articles met eligibility criteria. Eligibility determination, data extraction, synthesis, and evaluation were independently conducted by the authors. RESULTS Findings revealed deficits in clinician's knowledge, attitudes, and behaviors on identifying TIPs in clinical settings. In addition, cultural influences affect TIP's decision-making. DISCUSSION To support the wide-ranging needs of TIPs, education programs that include clinician trainings on the skills required to identify and assist TIPs across cultures is warranted.
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Affiliation(s)
- Sharda Ram
- Florida International University in Miami, USA
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Greenbaum J. Child Labor and Sex Trafficking. Pediatr Rev 2021; 42:639-654. [PMID: 34850175 DOI: 10.1542/pir.2020-001396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Regardless of their practice setting or subspecialty, pediatricians are likely to encounter children who have experienced sex or labor trafficking or who are at risk for exploitation. Only 24.1% of health professionals in one study reported receiving previous training on human trafficking; after a brief presentation on the topic, 39.6% indicated that they knew or suspected they had cared for a trafficked person in the past 3 months. Trafficked and exploited children can present with myriad physical or mental health conditions; most have experienced repeated, significant trauma; and few are likely to spontaneously disclose their exploitative situation. As a result, clinicians face challenges in recognizing and appropriately responding to potential human trafficking. Knowledge of common risk factors and potential indicators of exploitation can assist the pediatrician in recognizing affected and at-risk youth. However, health professionals report that existing training tends to focus on general information about trafficking, with relatively little time spent discussing the specifics of the trauma-informed approach to patient interactions. Given the critical importance of building patient trust, empowering patients to share their concerns, and engaging them in their own care and safety planning, this article focuses on the practical aspects of working with trafficked and exploited children. A brief overview of human trafficking is followed by an extensive discussion of rights-based, culturally sensitive, trauma-informed strategies for interacting with vulnerable patients.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA.,Institute on Healthcare and Human Trafficking, Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA
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Kafafian M, de Vries I, Farrell A, Goldfarb S, Bouchard E. Understanding factors associated with re-referral of youth for commercial sexual exploitation. CHILD ABUSE & NEGLECT 2021; 117:105092. [PMID: 33992876 DOI: 10.1016/j.chiabu.2021.105092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/28/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Since the passage of the Victims of Trafficking and Violence Prevention Act of 2000 in the United States, awareness has increased about the problem of commercial sexual exploitation of children (CSEC). Moreover, United States Federal law calls upon child welfare agencies to establish policies and practices that help identify and provide services to minors at risk of CSEC. Although awareness has increased about the problem of CSEC, little attention has been paid to understanding why some youths are re-referred to CSEC programs after initial referral and intervention. OBJECTIVE The present study examines which factors drive re-referrals of youths for CSEC concerns. PARTICIPANTS AND SETTING Data about a population of high-risk youths (n = 416) referred to a CSEC-specific program in the Northeast of the United States between 2011 and 2018. METHODS Using logistic regression analyses, we investigate what factors are associated with youth having multiple referrals. RESULTS Youths with multiple referrals were more likely to have histories of missing from care (OR = 2.996, p < 0.001), substance misuse (OR = 2.802, p < 0.01), and greater agency involvement (OR = 1.260, p < 0.05). However, youths with multiple referrals were not at heightened risk of CSEC as compared to youths that were not re-referred. CONCLUSION The results demonstrate that re-referred youths meet the profile of a victim as depicted on screening and assessment instruments, which has important implications for victim services and referral systems dedicated to identifying CSEC and protecting youths who may experience re-victimization for CSEC.
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Affiliation(s)
- Matthew Kafafian
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, 02115, United States.
| | - Ieke de Vries
- Institute of Criminal Law and Criminology, Leiden University, Leiden, The Netherlands.
| | - Amy Farrell
- School of Criminology and Criminal Justice, Northeastern University, Boston, MA, 02115, United States.
| | - Susan Goldfarb
- Children's Advocacy Center for Suffolk County, Boston, MA, 02215, United States.
| | - Elizabeth Bouchard
- SEEN Support to End Exploitation Now, Children's Advocacy Center of Suffolk County, Boston, MA, 02215, United States.
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