The mental health needs of people coming out of slavery are wide-ranging and often severe.
Many suffer from trauma, especially because most people in slavery experienced violence, were threatened with violence and saw violence against others. The emotional and mental health needs of slavery survivors differ from one person to another but difficulties often include depression, anxiety and post traumatic stress disorder.
According to research by Free the Slaves and the Helen Bamber Foundation, most people coming out of slavery need to develop:
Many also need help in:
When these mental health needs of former slaves are not adequately met, then whether they are living in a shelter or in the community, it causes additional problems, beyond the immediate mental suffering of the individual, regardless of whether they are living in a shelter, at their place of work or in the community.
The mental health support of slavery survivors is one of the single greatest gaps in the global response to slavery. Many anti-slavery workers providing general services to survivors do not have a clear understanding of the mental health challenges these individuals are enduring, or knowledge of how best to support them. They then feel a sense of helplessness in the face of the pain of their clients and this contributes to the stress and often exhaustion of these workers.
Although learning about mental health support for slavery survivors has begun, it is happening much too slowly. Little is known about which therapies and combination of therapies are found to be most helpful in which contexts of slavery and which therapies could be safely offered by non-clinicians, with special precautions for former child slaves and those who have been sexually exploited. Above all, lack of investment in psychological support means that those suffering the continued mental pain of slavery are simply not getting the therapeutic help they need.
The Freedom Fund made a grant to the Helen Bamber Foundation, which provides comprehensive assistance including in-depth psychological support to trafficking survivors in the UK. This grant enabled the Helen Bamber Foundation to produce a report representing the first stage in what we hope is a wider initiative focusing on the mental health needs of survivors of modern slavery. The report contains a critical review of the existing research evidence and found that mental health problems, including depression, anxiety and post-traumatic stress disorder (PTSD) occur frequently. Prioritising the mental health needs of survivors is essential for sustained recovery from traumatic experiences and to increase capacity to protect themselves from further harm. Whilst there is limited evidence on the efficacy of specific treatment interventions, some treatments that are adaptable for use in a wide range of cultural contexts have been found to be effective in some areas, such as the reduction of PTSD symptoms.
The practical experience of NGO fieldworkers around the world has also begun to identify emerging possibilities for cost-effective care within low resource settings:
This range of experiences, combined with the literature and evidence from the Helen Bamber report, helps us to identify possible treatment approaches and pathways for research. The Freedom Fund is therefore currently developing an agenda for research together with practical implementation of mental health treatment for those who are most in need.
We are currently piloting an approach to diagnosis of mental health problems within our hotspots and using the results to prepare a psychological intervention that is tailored to the specific needs of those in the area. This approach is being piloted in South-east Nepal and we plan to roll this out in other hotspots as well as share our learning.