Care and Support for Adult Victims of Trafficking in Human Beings: A Review

A Review examining the care and support needs of victims of human trafficking and what works to meet those needs, including a consideration of Scottish provision.


This evidence and practice review was commissioned by the Scottish Government to examine the care and support needs of victims of human trafficking and what works to meet those needs. This review is not an evaluation; rather it provides an overview of the identified care and support needs of victims of different forms of human trafficking exploitation; considers good practice in recent adult victim care by identifying different models of care and support in a range of jurisdictions; and considers the extent to which existing evidence is able to provide an indication of what works to meet the needs of different victims. The review also aims to consider how effectively the needs of different adult victims of trafficking are met in Scotland, on the basis of review of international evidence; and to highlight any existing gaps in services and support provision. While acknowledging the interconnection of other issues such as provision of compensation and repatriation, this review is limited to the provision of crisis and short to mid term care and support services.

The review is based on an extensive search of local, national and international documentary data including research reports, evaluations, practice guides, policy documents and website data collection. Until recently, the main sources of information on trafficking came from reports produced by international organisations and Non-Government Organisations (NGOs), often reporting on their experiences in practice and focused upon outlining the extent and nature of trafficking. More recently, attention has been given to the support and protection of trafficking victims. However, as this review highlights, there is a distinct lack of evidence-based data which provides a basis from which the most appropriate and/or cost-effective interventions can be determined.

Section 1: Review Of The Evidence Of Support And Care Needs Of Victims Of Human Trafficking

Victim identification is a crucial aspect of victim support and victims need to be properly identified in order to gain access to services and begin the process of rehabilitation. Victims experiences of being trafficked result in a wide range of significant needs; many of which are characteristic to all trafficking victims, regardless of the type of exploitation for which they were trafficked. At the point of crisis intervention, victims require basic necessities such as emergency accommodation; food and clothing; interpreter services and the facilitation of communication. Victims of all forms of trafficking exploitation may suffer severe physical and psychological consequences likely to result in ongoing traumatisation. Evidence suggests that all victims of trafficking require trauma counselling. Beyond common immediate needs, victims display a wide range of needs that often change during the course of support provision. The extent to which particular needs vary depends on individual circumstances, rather than categories of exploitation.

The shared needs of victims, regardless of forms of exploitation experienced, highlights the importance of individualized approaches to identifying, recognizing and responding to these needs. However, specific needs of women, regardless of form of exploitation highlight the importance of gendered responsive service provision and cultural awareness in all areas of support for all victims.

The tendency to focus on trafficking for the purpose of sexual exploitation has resulted in a lack of equivalent awareness and expertise of other forms of trafficking (such as forced labour and domestic servitude); in turn this has an impact on the identification of victims and provision of support services. Unlike the rest of the UK, recent figures for Scotland (2011) highlight that victims of labour exploitation were the single largest group identified.

Section 2: Review Of Current Models Of Care And Available Evidence Of The Extent To Which They Meet The Needs Of Victims

Knowledge of, and responses to, human trafficking are developing continually. As a result, processes, policies and practices are being refined and amended on an ongoing basis. There are no comprehensive, long-term evaluations of existing practice on which to base a comparative analysis of good practice. International guidance suggests that comprehensive services for victims of all forms of exploitation should include:

  • secure safe shelter, and housing
  • physical health care
  • mental health care
  • legal and immigration advocacy
  • job and life skills training
  • substance abuse services

Components of practice that are considered to be ‘promising’ include: the incorporation of safety planning (for workers and victims), collaboration across a number of agencies, ongoing development of trust and relationship-building, culturally appropriate and gender responsive approaches, trauma-informed programming, and the involvement of survivors in service development and provision. Collaborative and comprehensive services, adequately funded and supported, are viewed as key to effective provision for victims of trafficking.

Scottish support agencies with a remit to support victims of trafficking and expertise in doing so, provide victims with a range of services, or access to services, that meet the criteria of support and assistance in both the crisis situation and the longer-term (for example accommodation, financial support, healthcare, psychological support, interpreters, and contact with family back home if desired by the victim). Dedicated legal advice is also provided for women and children. In general Scotland appears to be compliant with the key requirements of the Convention and Directive for the provision of assistance and care, and has many areas of good practice.

Wider difficulties were identified in practice, not in the support agencies themselves, but with the wider (generally UK wide) systems for responding to human trafficking in Scotland. Limitations with the National Referral Mechanism (NRM) can negatively impact on victim identification, and result in delays in immigration decisions and uncertainties surrounding immigration status causing significant anxiety. The system can also result in an over-emphasis on immigration status by law enforcement and immigration officials. Improvements in awareness-raising by the police and other agencies were noted as significant and likely to have a wider impact. However it was noted that crucial gaps in knowledge among front-line practitioners remained.

While victims who access services such as TARA and Migrant Help will receive a range of care and support services, there is a gap in terms of accommodation provision in Scotland for individuals who may be victims of trafficking but have not claimed asylum and therefore have not entered the identification process. For victims who do claim asylum, most are placed in accommodation provided by the UK Border Agency and respondents expressed serious concerns as to whether this accommodation is always safe and appropriate.

More training is required for those who provide support, although there is evidence of good practice in some areas that could be replicated across Scotland. While provision and expertise is focused in Glasgow, TARA and Migrant Help are proactive in sharing expertise and developing key stakeholders across the rest of Scotland. In particular, it would appear that wider training is required around the identification of victims of trafficking for the purposes of domestic servitude and forced labour, particularly in relation to cannabis cultivation.

From the available evidence it would appear that Scotland has progressively been moving towards an approach which recognizes human trafficking as a violation of human rights; and which emphasizes the support and protection of victims. There was a view that this should be the focus of training to ensure better support services for victims.

Section 3: What Works And What Is Value For Money In Meeting The Needs Of Victims Of Human Trafficking?

Guidance published tends to centre on statements of good practice rather than empirical evidence of what may actually work in practice. Given that recognition of trafficking in human beings is a relatively new concept in terms of policy and practice responses this may explain the absence of empirical baseline data for effective intervention. But the complexity of the issue is also likely to contribute to this, alongside the focus that is often given to immigration control and the securing of borders rather than needs of victims and human rights issues. There is very little evidence of ‘outcomes’ in the available literature; while short term outcomes may be clear (i.e. safety, housing, health), the longer term aims of interventions are less so.

On the basis of the identified needs of victims of trafficking, key components of models of care and support for all victims (regardless of form of exploitation) include:

  • Comprehensive and co-ordinated services
  • Suitable, safe and secure accommodation
  • Easily accessible advice
  • Support with communication and linguistic barriers
  • Provision of medical and psychological support
  • Victim-centred approaches
  • Individualised and holistic care

Agencies are required to respond to complex and challenging circumstances. Sound assessment, meeting individual needs and ensuring very flexible support are crucial. Victims’ needs cannot be categorised on the basis of exploitation or cultural background; it would appear to be crucial that the continuum of exploitation that victims of trafficking encounter is considered. There is a need to ensure that resources are targeted and based on rigorous methods of evaluation in order to avoid the duplication that may arise with provision by multiple services.

Long-term needs as well as short term needs should be considered and addressed which may require developed links with source countries should victims wish to return. Services should be focused on human rights and victim-centred. While the practical provisions required to meet the needs of victims are evident, the international literature is clear that there needs to be consideration of the way in which these services are provided to ensure that they are culture and gender responsive, secure the trust of victims, provide a co-ordinated case management approach to link victims into wider services, and ensure victims participation in their care planning.

While this review identifies the key needs of victims and reviews what is known about best practice based on international literature that currently exists, ultimately, much more in-depth research needs to be conducted in order to be able to identify and address the gaps in services and support for victims of trafficking. Only an in-depth qualitative research project, with a longer-term scope would be able to answer the question of how effectively the needs of different victims are met in Scotland.


Email: Debbie Headrick

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