Youth Service Provision and Coordination among Members of a Regional Human Trafficking Task Force

Abstract

Trafficked youth have numerous needs that must be addressed to give them opportunities to rebuild their lives. Few organizations offer comprehensive services to meet all these needs, which forces survivors to seek out services from multiple organizations and puts them at risk for not receiving important services. This study highlights the needs of organizations in an interagency task force that serve trafficked youth to identify barriers and generate potential solutions to service provision challenges. We conducted a mixed-methods needs assessment by conducting interviews with 15 service providers belonging to a regional human trafficking task force, which revealed a need for more services for trafficked youth, particularly in criminal justice and gender-based violence organizations. Implications of these findings include a need for centralized referral processes and more prevention services, such as a youth drop-in center and educational interventions.

Keywords

coalitions interagency responses community-based responses sex trafficking labor trafficking

Sex trafficking is a global problem involving the use of force, fraud, and coercion to exploit individuals for commercial sex (TVPA, 2000). In the United States, when persons under the age of 18 engage in a commercial sex act, it is considered domestic minor sex trafficking (DMST). Under the TVPA, the elements of force, fraud, and coercion do not need to be proven in DMST cases because the youth is legally unable consent under federal law. After youth are able to escape their trafficking situation, they have physical health, mental health, and other life needs that must be addressed to give them opportunities to rebuild their lives. However, these needs can rarely be addressed by one community organization, so survivors often have to seek help from multiple social service agencies to address their needs (Baker & Grover, 2013; Clawson & Grace, 2007).

Human trafficking survivors must navigate a “fragmented patchwork of care” with numerous service providers to address the extensive needs they experience upon escaping their trafficking situation (Powell et al., 2018, p. 257). It is both unrealistic and burdensome for youth to figure out complex, disorganized systems of care, particularly after experiencing severe trauma. As such, there have been concerted efforts in many communities to create coordinated services for DMST survivors. However, this requires agencies to collaborate and that is not without its challenges (Clawson et al., 2003; Davy, 2015; Powell et al., 2018). Specific organizational and structural barriers to partnership must be identified so they can be addressed to improve a community’s response to trafficked youth. Therefore, in this study, we assessed service availability and coordination needs among organizations providing services to young survivors of human trafficking.

Literature Review

The Trafficking Victims Protection Act (TVPA) was passed in the United States in 2000 with the intent of addressing human trafficking through prevention, protection, and prosecution initiatives to both United States (U.S.) and non-U.S. citizens (TVPA, 2000). The TVPA defines sex trafficking as occurring when “a commercial sex act is induced by force, fraud, or coercion.” The law expands this definition to describe the conditions of DMST wherein a commercial sex act occurs and “the person induced to perform such act has not attained 18 years of age.” DMST is a well-hidden crime and youth that are being sexually exploited are often in plain sight throughout communities. Although there are not consistent statistics about the exact number of youth trafficked in the United States each year, tips made to the National Human Trafficking Hotline have increased steadily from 5,714 tips in 2015 to 11,500 in 2019, which suggests awareness and identification of this crime have increased (NHTRC, 2019).

The Needs of DMST Survivors

Physical health

Most survivors of DMST have physical health issues while being trafficked that persist after they escape their traffickers. Unless they are extremely severe or hinder traffickers’ profits, survivors’ health conditions frequently go untreated while they are being trafficked (Lederer & Wetzel, 2014; Muftić & Finn, 2013; Turner-Moss et al., 2014). Youth experience sexually transmitted infections (STIs), unwanted pregnancies, physical injuries, and overall poor health as a result of being trafficked (Varma et al., 2015). However, these needs often go untreated when more time-sensitive, crisis needs, such as safety planning and crisis intervention, are addressed (Gibbs et al., 2015). In addition, these physical health problems are often exacerbated by youth’s marginalized social and cultural identities, which must be attended to throughout the recovery process (Bryant-Davis & Tummala-Narra, 2017).

Researchers have also found higher than usual rates of substance use and abuse among survivors of sex trafficking (e.g., Lederer & Wetzel, 2014; Muftić & Finn, 2013; Cole et al., 2016). In addition, domestic trafficking victims have higher rates of drug and alcohol abuse than international trafficking victims, which is exacerbated by the length of time they spend in the sex industry (Muftić & Finn, 2013). This trend continues when examining the experiences of trafficked youth who show significantly higher substance and alcohol use when compared to youth who experienced sexual abuse but were not trafficked (Cole et al., 2016; Varma et al., 2015).

Mental health

Multiple studies have found that sex trafficking survivors experience high rates of psychological problems such as depression, suicidal ideation, addiction, anxiety, and post-traumatic stress disorder (PTSD) as a consequence of sex trafficking (Hickle & Roe-Sepowitz, 2014; Lederer & Wetzel, 2014; Muftić & Finn, 2013; Sabella, 2011). Lederer and Wetzel’s (2014) study found that when survivors were asked about the presence of roughly thirty psychological symptoms and disorders, 96% reported an average of ten psychological problems after they escaped their trafficking circumstances. The most common psychological symptoms and disorders reported were depression, shame/guilt, flashbacks, and PTSD (Lederer & Wetzel, 2014). Furthermore, racially and ethnically marginalized survivors are likely to have these psychological symptoms and disorders worsened by the stigma associated with being trafficked both within and outside their cultural communities (Bryant-Davis & Tummala-Narra, 2017).

In addition to psychological disorders, youth also encounter numerous interpersonal psychological challenges as a result of being trafficked. For example, service providers indicated that many of the trafficked youth they encounter have low self-esteem, feelings of shame or guilt, and a general sense of fear (Gerassi et al., 2018). In addition, youth also feel a sense of isolation and loneliness after being trafficked that affects many of their personal relationships and connections to their community (Bruhns et al., 2018). In order for survivors to reconcile other needs throughout their recovery, both psychological and interpersonal mental health challenges must be addressed.

Life and sustainability

Much of what puts youth at risk for being trafficked is abuse and neglect, often at the hands of family members who they rely on for their basic needs (Cole et al., 2016; Fedina et al., 2019; Gerassi et al., 2018). As a result, youth run away from home, skip or have difficulties in school. Not only do these behaviors put youth at risk of being trafficked, they often present sustained challenges of finding stable housing, care, and education. Therefore, DMST survivors must find ways to address these needs when they are no longer being trafficked. For some, they are still considered “youth” in the eyes of the law and some agencies when they escape (i.e., under the age of 18) however, most survivors are considered adults by the time they escape their traffickers making the types of resources available to them different than when they were under 18.

One of the most urgent needs survivors have upon leaving their trafficking situation is to find housing (Aron et al., 2006; Baker & Grover, 2013; Clawson et al., 2009). This is especially likely if the survivor did not have stable housing, was in foster care, or lived in an unstable, neglected, or abusive home prior to or while they were being trafficked and have nowhere to return to. Securing housing for trafficking survivors can be made more difficult by some the health conditions that survivors are more likely to experience. For example, Clawson and Grace (2007) found that substance abuse often excluded survivors from being able to access services or stay in shelters. This challenge to find housing is often compounded for youth who have recently aged out of foster care and still do not have the resources to find stable, safe, housing (Gerassi & Howard, 2018).

Adult survivors will typically need to obtain legal employment and many report that gainful employment is a more important immediate need to them than mental health care (Lynch & Mason, 2014). However, DMST survivors may not have the education, job training, and basic life skills necessary to obtain and maintain gainful employment (Johnson, 2012). Given many survivors’ experiences with truancy and skipping school, some may need to address lingering educational obstacles such as obtaining their GED (Bryant-Davis & Tummala-Narra, 2017; Cole et al., 2016).

Challenges in Addressing the Needs of Survivors

Survivors’ successful recovery can be best fostered by facilitating access to services and supports that help them effectively address their multiple needs (Johnson, 2012). However, the complex and overlapping needs of survivors often create significant barriers that hinder this process. Survivors can be forced to navigate a large number of social, legal, and health service agencies, making them vulnerable for insufficient care (Davy, 2015). Powell et al. (2018) outlined a conceptual framework of barriers relevant to addressing the needs of human trafficking survivors. At the core of this framework is service availability: the most fundamental barrier survivors encounter is that needed services they need are unavailable. Even when services are available, survivors may still encounter organizational and structural barriers that make it difficult or impossible to access comprehensive care (Powell et al., 2018). Organizational barriers include limited funding, staffing, and training. Structural barriers include lack of service coordination among organizations, and lack of human trafficking-specific services.

Recent studies have illustrated the importance of coordination among human trafficking service providers (Baker & Grover, 2013; Clawson & Dutch, 2008; Clawson et al., 2003; Clawson & Grace, 2007; Kim et al., 2018). Although organizations may belong to antitrafficking coalitions or task forces, they face various barriers when coordinating services for survivors. Many organizations that serve survivors of human trafficking are either specialized or only address some of the needs survivors face (Clawson & Dutch, 2008). While larger, less-specialized organizations can refer to different departments within their organizations, smaller organizations must collaborate and refer survivors to outside organizations (Clawson et al., 2003). However, a major barrier among organizations is effectively coordinating and communicating across multiple agencies, often with different goals or responsibilities, at both the federal, state, and local level (Kim et al., 2018).

To address these system-level challenges, some communities have created specialized case management programs designed to facilitate communication across multiple organizations that serve human trafficking victims. Davy (2015) reviewed evaluations of such programs and found that the needs of victims at all three collaborative victim support programs changed over time. Once basic needs such as emergency housing, food, clothing, and safety were addressed, victims were able to shift their focus on their recovery from their trafficking situation and utilize mental health, employment, and education services to rebuild their lives (Davy, 2015). However, these needs could not all be met at one organization. Case managers at the collaborative victim support programs were responsible for addressing victims’ needs by coordinating service referrals when the needs of survivors were unable to be met “in-house” at the programs. These evaluations highlight the importance of interorganizational collaboration and networking as primary components of a successful victim support program. One of the main barriers to effective service provision reported in the evaluations was “insufficient organizational capacity and resources” (Davy, 2015). In addition, when referrals needed to be made the service delivery process was often poorly coordinated and survivors were not able to access the help they needed (Davy, 2015).

Current Study

Survivors of DMST must navigate disorganized, fragmented systems of care to address their physical health, mental health, and other life needs upon escaping their trafficking situation (Powell et al., 2018, p. 257). Powell’s (2018) conceptual model outlines multiple service delivery barriers, but little is known about the specific organizational needs of each service sector (i.e., housing services, substance abuse, and mental health treatment, etc.) that survivors must access in their recovery process. Based on previous research, no single organization can address every need a survivor has, therefore a networked approach to care is required when working with trafficking survivors (Clawson et al., 2003; Davy, 2015; Powell et al., 2018). However, working in collaboration presents challenges. Specific organizational and structural barriers must be identified so they can be addressed to improve a community’s response to trafficking survivors. Therefore, the current study was an assessment of service availability and coordination needs among organizations providing services to victims of human trafficking.

To address this focal aim, we used a needs assessment design to examine the service provision and availability needs of organizations serving trafficked youth in a regional human trafficking task force. A needs assessment is the systematic process of identifying and prioritizing needs to develop strategies to address them (Altschuld & Kumar, 2010). Needs assessments vary widely in scope as they can be conducted informally by individuals or formally by researchers, evaluators, communities, institutions, or government agencies (Altschuld & Kumar, 2010). Despite the recent growth and development of trafficking-related research, there is a dearth in knowledge about the needs of organizations providing services to survivors of human trafficking. Understanding the needs of these organizations is necessary to develop more targeted approaches to partnership, particularly in under resourced areas. The core of needs assessment is identifying discrepancies between “what is” available (i.e., the current state) and “what should be” available (i.e., the ideal state), which informs strategies to close the gap between the two conditions. For example, regarding housing services, “what is” would assess what shelters and transitional housing services are currently available for trafficked youth in the community. The “what should be” condition would assess the ideal state of housing service availability that would meet every need of trafficked youth. The differences between these conditions would reveal the service availability needs of housing service providers and relevant next steps toward meeting them.

The discrepancies between the “what is” and “what should be” conditions can be assessed from both an individual organizational level and from a multiorganizational perspective. For individual agencies that serve human trafficking survivors, the “what is” component of a needs assessment evaluates what their current availability is for services across different domains (e.g., housing, mental health, etc.), and the “what should be” component offers an opportunity for program staff to reflect and assess key gaps in their programming. Gaps could include underserving key populations and identifying key resource or personnel needs that they are unable to address. Because organizations must collaborate with one another to adequately address the needs of trafficked youth, this study focused on the “what is” available conditions and the “what should be” available conditions of organizations across the interorganizational tri-county network. At the interorganizational level, the “what is” component of a needs assessment evaluates the current state of collaboration among organizations, and the “what should be” component evaluates how ideal collaboration among organizations would function to identify gaps in current practices. Gaps could include lack of specialized organizations or services in the area or difficult referral processes across organizations.

In this study, we interviewed each organization in a midwestern human trafficking task force about their individual needs and their interorganizational network needs. Quantitative and qualitative data were used to (a) identify the needs and capacity of different types of organizations trafficked youth encounter (e.g., criminal justice agencies, gender-based violence organizations, etc.) and (b) the needs and capacity of all organizations in the taskforce as an integrated network. Data in this article are part of a larger, IRB-exempt study of a human trafficking task force that assists both youth and adult victims of human trafficking. This paper focuses on findings that are unique to serving youth survivors of human trafficking as they are qualitatively different from findings about assisting adult survivors in this region. The research questions we aimed to answer in this mixed-methods needs assessment are as follows:

What is the current state of services for trafficked youth among agencies in the task force?

What do task force members perceive as the ideal state of service provision to address the needs of trafficked youth at their organization and within the tri-county network?

Methods

Sampling and Recruitment

We designed a sampling and recruitment process to include organizations that served local human trafficking survivors and that participated in the task force. We first identified organizations by examining the task force resource guide for local services (n = 25) and the directory of task force meeting attendees (n = 6). These 31 organizations were then screened to ensure that they actively provided assistance to local trafficking survivors. Assistance was defined for respondents as “providing human trafficking survivors with direct services, service referrals, or otherwise facilitating access to services.” Organizations that were not actively providing assistance to trafficking survivors or doing so outside of the task force’s service area were excluded from the study. Twenty-eight organizations met inclusion criteria and were invited to participate in the study.

Our invitation to participate in this study requested that each organization provide the name and contact information of the person at their organization with the most knowledge of human trafficking. We emailed and called the indicated staff members at each of the 28 organizations that provided a response to ask if they would participate in the study on behalf of their organization. If the staff member agreed to participate, we set up a time to conduct the interview. If the staff member declined participation (n = 2), they were thanked for their time and no further attempts were made to involve their organization in this study. If staff members did not respond, we made up to two subsequent communication attempts. Fifteen organizations fit inclusion criteria and agreed to participate in this study for a 54% response rate.

Procedures

The first author was the sole interviewer for this study, and conducted interviews in person or over the phone, depending on respondents’ preferences. Interviews lasted approximately one hour and were monitored for thematic saturation throughout the duration of data collection. Participants were debriefed at the conclusion of the interview and told how the data were expected to be used. Interviews were recorded, transcribed verbatim, and deidentified by the first author. Finally, the first and second authors debriefed on the interview quality and content.

Measures

We used Altschuld and Witkin’s (2000) process model for needs assessment to inform our quantitative data collection and analysis. Consistent with this model, participants were asked about the current availability, importance, and feasibility of providing services for youth survivors at their organization to establish the “current state” of service provision (Altschuld & White, 2010).

Current availability of specific services was obtained by asking participants “to what extent does your organization currently provide services to trafficked youth.” Participants were asked to answer using five-point Likert scale (i.e., not at all, a little bit, somewhat, quite a bit, to a great extent). Importance was then assessed by asking participants to use the same Likert scale to answer the question, “how important is it for your organization to provide services to trafficked youth.” Feasibility was assessed by asking participants to use the Likert scale to answer the question, “how feasible is it for your organization to provide services to trafficked youth.” Ideal state was assessed by asking participants open-ended questions to describe the ideal service provision they would like their organization to offer to trafficked youth.

Analyses

Research question 1: Current state. The current state of youth service provision was determined by a descriptive analysis of the quantitative triple-scaled needs assessment items (i.e., current availability, importance, and feasibility) at (a) the organizational group level and (b) at the tri-county level.

Organizational group—level scores. Individual organizations were combined into five “organizational groups” before analysis. (a) The criminal justice group (n = 3) contained organizations that were law enforcement departments, agencies, or were part of the court system. This group consisted of one law enforcement department and two juvenile justice representatives. (b) The youth service organization (YSO) Group (n = 3) contained organizations that exclusively or predominantly served youth under the age of 18. This group contained one youth outreach and transitional housing shelter and two organizations that served youth in the foster care system. (c) The gender-based violence group (n = 3) consisted of organizations that specifically served survivors of gender-based violence such as sexual assault, domestic violence, or sex trafficking. (d) The human services group (n = 4) contained organizations that provided a variety of supportive services to human trafficking survivors. These organizations provided services such as vocational training, food banks, and linkage to service referrals. (e) The health group (n = 2) consisted of organizations that primarily provided mental or physical health services. This group contained one mental health organization and one substance use disorder detox facility.

Means were calculated for each organizational group to determine the current state of Youth and Family service provision at those agencies. Youth and Family services were described as any service or program an organization offered to human trafficking survivors under the age of 18 which could include but was not limited to the following: outreach, after-school programs, foster care, shelter, family reunification, treatment for substance use disorder, mental health, physical health, legal services, immigration, and education/vocation programming. This score was generated by calculating the mean of current availability, importance, and feasibility ratings for Youth and Family services within each organizational group to describe each group’s general level of need when serving trafficked youth.

Tri-county-level score. The overall Youth and Family services tri-county mean score was calculated to present a comprehensive view of the needs when serving trafficked youth within this area. This score was generated by averaging all Youth and Family services mean scores across every organizational group in the tri-county area for current availability, importance, and feasibility.

Research question 2: Ideal state. Finally, to understand the ideal state of service for trafficked youth at the tri-county level, a qualitative thematic analysis was conducted on open-ended questions. The analysis was informed by the process outlined by Altschuld & White (2010). First, we reviewed and compiled the portions of the transcripts that discussed Youth and Family services from the larger needs assessment study. Again, since previous research indicated that organizations rarely work alone to address the needs of trafficking survivors, we analyzed the service availability needs of the entire tri-county interorganizational network rather than individual organizations or organizational groups. Next, we identified categories that described the data. Finally, we reviewed the categories to create themes that described the ideal state of service provision at the organizational group and tri-county levels and the barriers service providers face when trying to provide the ideal services to trafficked youth.

Results

Research Question 1: What is the Current State of Services for Trafficked Youth among Agencies in the Task Force?

The current state of service provision for trafficked youth was calculated (a) for agencies within each organizational group and (b) for all agencies in the tri-county area. Taken together, these scores show what type of organizations are best equipped to serve trafficked youth and how this contributes to the tri-county area’s overall preparedness. Table 1 shows the current availability, importance, and feasibility of offering services for survivors of human trafficking under the age of 18 (i.e., Youth and Family services) in each organizational group. YSOs provided the most Youth and Family services of all organizational groups (M = 4.67, SD = .58) and felt these services were both important and feasible to continue offering. Criminal justice organizations had low availability (M = 2.33, SD = 1.53) that is, they were not currently providing many services specifically to trafficked youth. However, these agencies saw services for trafficked youth as being both important and feasible to offer. Gender-based violence organizations had the least amount of services available to trafficked youth compared to all other organizational groups. Although they felt offering services to trafficked youth was highly important, doing so was not feasible for these organizations at the time of the interview. Human Services organizations had many services available for trafficked youth and indicated this practice was both important and feasible for them to continue doing. Health organizations had low availability of services specifically for trafficked youth and thought services were moderately important and feasible to offer at their organizations.

Table 1.

Need Dimension of Youth and Family Services by Organizational Group.

Need Dimension	Organizational Group Means (SD)
	YSO(n = 4)	Criminal Justice(n = 3)	Gender-based Violence(n = 2)	Human Services(n = 3)	Health(n = 2)	All Tri-county Organizations
Current availability	4.67 (.58)	2.33 (1.53)	2.00 (.00)	3.67 (1.16)	2.50 (2.12)	3.00 (1.52)
Importance	5.00 (.00)	4.33 (.58)	4.50 (.71)	4.67 (.58)	3.00 (2.83)	4.21 (1.25)
Feasibility	5.00 (.00)	4.33 (.58)	2.00 (.00)	4.00 (1.00)	3.00 (2.83)	3.64 (1.55)

Table 1 also shows the availability of services for survivors of human trafficking under the age of 18 (i.e., Youth and Family services) at the tri-county level. The average current availability of Youth and Family services across all organizations in the tri-county area was moderate (M = 3.00, SD = 1.52). However, on average, organizations thought offering services to trafficked youth was highly important and feasible to implement. Although organizations in the tri-county area were already providing some services to trafficked youth, professionals at the participating organizations felt strongly that their area could still do more to meet survivors’ needs.

Research Question 2: What do Task Force Members Perceive as the Ideal State of Service Provision to Address the Needs of Trafficked Youth?

After assessing the current state of services provision for organizations in the tri-county area, participants were asked what they envisioned the ideal state of care would be for trafficked youth both within their organizations and collaboratively at the tri-county level. Participants also shared what they felt were barriers to reaching the ideal state of service provision for trafficked youth. This section is organized into five subsections that describe the qualitative data provided by respondents from each of the organizational groups. Select stakeholder perspectives are presented to further illustrate the tri-county area’s Youth and Family service needs.

YSO group

The ideal state of service provision at organizations in the YSO group was described as having more resources than are currently available. One organization said they would “would like to have more options for transportation” specifically to expand the amount of vans and staff they can put into their street outreach efforts for youth. However, the biggest barrier to providing this service was available funding. In addition, participants emphasized the need for specialized trainings and services to address the needs of trafficking survivors at their organization. One respondent in the YSO group described the importance of trainings for community members and staff at their organization:

Then once again, just the trainings because we are serving such a small specialized…. It’s such a specialized program that there aren’t a lot of trainings that really hit the nail on the head regarding what our foster families, what our staff, are going to be experiencing.

Organizations in the YSO group that specifically worked with youth involved in the foster care system stated the need for more therapeutic foster homes and trainings for foster parents that care for trafficked youth “so maybe they could foster a child so that child wouldn’t have to go to residential {facility or program}.” In addition, organizations that specifically served youth in foster care discussed the need to make existing services available to youth after they age-out of the system and also “letting them know what resources are available to them” as adults.

When discussing ideal services at the tri-county level, collaboration, coordination of resources, and stronger task force presence were topics emphasized by providers in the YSO group. For example, one participant responded:

I feel like we have a great relationship with the state taskforce and our local taskforce that if there is a victim that is seeking services and they haven’t already reached out to us, we do have a great referral process.

Respondents also wanted to increase their existing collaboration with law enforcement and schools. One participant described a potential area for growth in the tri-county area:

I think one of the biggest disparities right now for human trafficking is educating young people in the schools what the warning signs are and what this looks like. Because I feel like all the professionals are being equipped with the tools. They know how to respond, but all the proactive elements of trying to inform students before it even happens is an area that we need to spend more time in.

However, another participant explained their challenges collaborating with local schools:

I go into the schools and I talk about issues of trafficking, but I only go in health classes. They don’t let me go into any other class. And it’s only eighth grade and above. We know that there’s young people that are sixth grade, fifth grade, that are already starting to understand.

When speaking about the ideal service provision at the tri-county level, organizations in this group stressed the need to keep youth in the community rather than refer them to services far outside the community citing that trafficked youth “might be more willing to participate with the services if they are close to their family or close to their friends or close to their community.” One respondent from the YSO group suggested the following:

But like I said, maybe like a structure or a residential something here to keep them in the community, to try to make it a little less of a struggle for them. I think, like I said with the last, with one of the two {youth}, she ended up running away from the facility, and it’s in {large urban city}, so, that was obviously fearful for us, but we were able to get her back safely. But I think it’s, you’re pulled away from the community and that makes it difficult for them.

YSOs hope these practices will ameliorate structural barriers and lead to more streamlined referrals and service provision. Organizational barriers to providing ideal services included limited funding and transportation. Organizations also cited lack of staff as a barrier because human trafficking case are time intensive and monopolize most of case workers’ time. For example, some trafficked youth who were in foster care lived over an hour away from one agency but their case workers were still required to see them, “Unfortunately, she {the case worker} has other cases, and so it {the human trafficking case} is taking away from those cases and she’s still doing her required work on them.”

Criminal justice group

Organizations in the criminal justice group described the ideal state of Youth and Family service provision within their organizations as an extension of the services they already provide. More specifically, these organizations wanted to sustain their existing services, such as a trafficking-specific treatment court for adjudicated youth who are at risk for or have already been trafficked, and add preventative and educational interventions. For example, one participant stated that they wished their organization “had more, in a prevention kind of way, intervention with kids that builds their self-esteem and healthy relationships.” This would ideally be in a group setting, with outside trauma-informed professionals running the intervention several times a week.

When considering what services the tri-county area should offer to trafficked youth, professionals in the criminal justice group stressed the importance of increased collaboration, specifically when tracking prior service provision and law enforcement involvement. One respondent gave the following suggestion:

But in a perfect world, something like that where you’ve got one system, one tracking system, whether it is an app or maybe it’s some sort of a protected online portal. Something like that. Where then it’s start to finish. That way we’re not … CPS can’t send us a report. And we can’t send them parts of our report. You know, I don’t know what all those requirements are. …but I’ve had that with different organizations before where, just because we’re law enforcement or whatever, they can’t share and vice versa. Which makes it a whole other layer of added or duplicated work, too.

When discussing ideal services at the tri-county level, criminal justice organizations mentioned nonjustice system alternatives for youth such as a drop-in center or a local residential facility specifically for trafficking survivors. One respondent stated, “But when I talk about ‘we push kids into trafficking situations,’ we really do as a system. And we recognize that … so yeah, a drop-in center, a place where kids can go that’s safe in our community when they make a mistake or want to run.” However, participants also recognized that this could not be accomplished by criminal justice agencies alone:

I think that it’s the housing issue like I told you. There’s got to be a separate group outside the court, outside DHHS, outside the system that says, “Hey we want to provide some sort of housing for trafficking girls.” And I know in {redacted} County, they have the {organization name} and so they have that one place where runaway kids can go. And they can sign a fake name, and they can stay there for three or four days. I think that’s a great idea. I just don’t know who in our community … we don’t have money like {city name}.

Strict licensing restrictions for serving youth were noted as a structural barrier for criminal justice organizations when looking for alternative options for supporting trafficked youth at the tri-county level. This was because organizations “have to be licensed to take kids in a placement” at a residential facility, which “looks completely different for kids than it does for adults.” Criminal justice organizations also cited restrictive information-sharing policies across agencies because “it is sensitive. What can be shared, what can’t be shared. That presents a lot of hurdles for us to share with other agencies or organizations and/or them sharing with us.” Finally, the urgency and time-sensitive nature of some trafficking cases presented a structural barrier for agencies to have enough time to fully collaborate with others to provide ideal services to trafficked youth.

Gender-based violence group

Most of the organizations in the gender-based violence group stated their organization would not be able to specialize in offering Youth and Family services. However, when asked about the services they would offer in an ideal, well-funded scenario, one participant provided the following:

I don’t know that we necessarily are at a point where we would be able to take that {providing services for trafficked youth} on. However, if we were going to, I would say having funding for advocates for trafficking. For labor trafficking or sex trafficking advocates. Then the advocates could be in charge of finding resources and making sure we have community partners and those kinds of things.

Since most of the gender-based violence organizations did not have specific funding to provide trafficked youth with services, they relied heavily on other organizations in the tri-county area to address the needs of trafficked youth. Organizations in this group described ideal tri-county service provision as “having a more streamlined referral process,” increased information sharing among organizations, and increased access to resources when serving youth and families. At the tri-county level, gender-based violence organizations would ideally like to have better connections to housing services, schools, and youth service agencies. Additionally, organizations in the gender-based violence group would ideally like the local task force to be more visible and have more of a presence in the community. For example, one respondent said, “I would like to see a lot of collaboration. I’d like to see more collaboration too from the trafficking coalition. I’ve heard they’re doing a lot of good things but haven’t really seen a lot in the community yet.”

Funding restrictions and technicalities were cited as barriers to providing ideal services to youth. One respondent explained, “Even with us, if you identify as human trafficking but you don’t say you were sexually assaulted or you don’t identify it as domestic violence, we can’t … We can give you resources, but we ourselves can’t provide you with our services.” Geographic isolation of the organizations and inadequate transportation availability were also seen as barriers. One organization in a county that is more rural than the others in the task force explained how some of the youth they serve “don’t even have transportation to school. Then they’re missing school and dropping out of school. So, transportation would be great just for those basics.”

Human services group. Overall, organizations in the human services group stated they ideally see their organizations as being able to fill the gaps in service other organizations cannot address. When describing how they would do this, one organization said:

What {organization’s name} is not able to do, maybe we could say, “Well, let’s do the other part.” I always like the idea of expanding services and collaborating with other agencies. You don’t have to recreate the wheel if it’s there. You could add another spoke to it. That’s what I would really like it to be.

Organizations in the human services group also stated they would like to be better connected to housing and gender-based violence organizations and to have human trafficking advocates on staff to help coordinate services with those organizations. At the tri-county level, one participant explained the ideal collaboration as being “one stop, one phone call, to get everything. Wrap around services and all that kind of stuff. And I don’t see that for the average youth out on the street or that needs help.” Overall, respondents from this group stressed the need to address youth homelessness and youth aging out of foster care but did not see those as things their organization would be able to take-on alone. The ideal circumstances to address those issues would include expanding services and establishing a youth drop-in center in the community, similar to what participants from other organizations described. These organizations also called for the need to increase community awareness and provide more trainings to professionals so more youth human trafficking survivors can be identified and receive services. The main organizational barrier to providing these ideal services was lack of funding.

Health group

The ideal Youth and Family service provision described by organizations in the health group would focus on addressing gaps in services that are not being met by other organizations in the area and would have specialized staff trained to work with human trafficking survivors:

Now people are expected to get training around human trafficking. Even just knowing what to look for, or how to … we vet in our assessments. I think targeting those specific things is always useful. The more information we have, the more we try to weave that in. The more supervisors are informed as we are hearing about situations, we can help staff be aware.

Organizations in the health group said ideal tri-county service provision would include more information sharing about best practices for serving trafficking survivors and serving non justice-involved youth survivors of trafficking as one respondent noted, “I think when kids aren’t involved in court programming, we certainly need to figure out how to fill in the gaps there.” Barriers to providing these ideal services to youth and families included insurance acceptance limitations and lack of knowledge about best practices when working with human trafficking survivors.

Discussion

Summary of Key Findings

As awareness and identification of youth victims of human trafficking increases, service providers will be called upon to work with other organizations in their communities to address the complex and diverse needs of trafficking survivors. Findings from previous literature established the needs of survivors and the needs of individual service sectors (i.e., mental health providers) but more work is needed to examine the needs of multiple organizations that seek to coordinate youth services in the same geographic area (Clawson et al., 2003). This study demonstrates the service provision needs across multiple sectors and organizations and describes how those needs intersect and are addressed by others within an interagency, collaborative body.

Most results from the current study are consistent with prior literature about structural barriers (i.e., lack of service coordination among organizations and lack of trafficking-specific services) when serving trafficked youth. For example, participants in the current study reinforced the importance of coordination among organizations to address the structural needs for Youth and Family services (Davy, 2015). This was particularly important with Youth and Family services because of the added structural barrier of sharing information about minors across organizations, such as between foster care workers and law enforcement. To address this challenge, providers interviewed in previous studies have stressed the importance of having a main contact person within the organizations and agencies that are collaborating to make sure communication is not lost, especially in time-sensitive cases (Clawson & Dutch, 2008; Kim et al., 2018). Furthermore, the designated contact person should be someone who understands and uses common language to discuss the issue of human trafficking and the needs of survivors (Clawson & Grace, 2007). Providers in this study faced similar structural barriers during the referral process, namely having to make multiple phone calls to multiple organizations for a referral. These findings suggest that building institutional relationships among organizations will make information sharing and subsequent service provision easier on both service providers and trafficked youth.

Organizations in this study experienced the aforementioned structural barriers despite the existence of human trafficking task forces in their area. Consistent with previous literature on service coordination for trafficking survivors, respondents emphasized the need for task forces to have a greater presence in the community, preferably through outreach and information sharing (Kim et al., 2018). Although previous researchers studied the goals and expectations of task force members who serve survivors of human trafficking, there has not been research conducted on what nonmembers and the community overall expects from human trafficking task forces (Kim et al., 2018). Consistent with previous research on human trafficking coalitions, providers in this sample felt the most valuable role task forces can have in their communities, aside from addressing the needs of survivors, is facilitating trainings and prevention interventions since much of the community still lacks understanding or knowledge about human trafficking (Clawson & Dutch, 2008). As far as what is expected of the task force by its members, taking on some of the service and referral coordination among its members, a responsibility that service providers predominately navigate alone, would be most beneficial.

Limitations

This study has several limitations that must be considered. First, it was challenging to define a comprehensive sampling frame for this project because some organizations mentioned collaborating or referring to organizations that were not listed on the resource guide. In addition, although the resource guide we used to inform our sampling was created within a year of data collection, some of the organizations that were included had since closed, were no longer serving trafficking survivors, or were no longer attending task force meetings as regularly as when the resource guide was created, thus affecting the response rate. Future studies should not solely rely on resource guides as a sampling frame but should rather use them as a starting point for sampling and be flexible with snowball sampling to account for inaccurate, limited, or outdated resource guides.

Some organizations in this study did not necessarily provide direct services to survivors of human trafficking but rather, provided referrals. Participants in this sample did not always have direct services available at their organization but knew of and had well-established referral processes with other organizations to meet the needs of survivors. Therefore, the results of this study reflect the current state of direct services and referrals in the tri-county area. Future studies should explicitly keep items about referrals and direct services separate from one another or omit one construct from the survey entirely.

The interview survey asked about all services these organizations provide to survivors of all forms of human trafficking—both sex and labor trafficking. For the analyses presented in this paper, the quantitative data reflect ratings for current state of services for any type of trafficked youth. In the qualitative component, we had the opportunity to explore and differentiate participants’ responses for sex and labor trafficking. Responses were mainly focused on serving female youth survivors of sex trafficking and did not explicitly discuss services for male or labor trafficking survivors. Therefore, future studies should attempt to minimize these effects by asking each survey item about sex and labor trafficking separately and inquiring about population-specific services.

Finally, our qualitative findings did not elucidate the state of trauma-informed or culturally sensitive programming in the region, particularly for ethnically and racially marginalized survivors. Because interview questions were open-ended, there was an opportunity for participants to mention these services. Therefore, the absence of this information suggests that trauma-informed and culturally specific supports are not core approaches in this service network. Future research and needs assessments should specifically inquire about the use of trauma-informed practices and culturally specific supports for survivors.

Implications for Practice, Policy, and Research

Although YSOs in this study were providing adequate services to trafficked youth, the overall state of Youth and Family services in the tri-county area was considered “in need.” Based on recommendations from Altschuld and Witkin’s needs assessment process model, task force members should design and implement solutions to address Youth and Family service needs within organizations with the capacity to do so. In this study, organizations in the criminal justice group were the most likely to be able to prioritize and provide services to trafficked youth if given additional resources. This is because respondents from these organizations already think it is both important and feasible to offer services to trafficked youth (i.e., have the capacity).

However, responses from criminal justice group participants in this study advocate for services to be provided to trafficked youth outside of the criminal justice system. Providers at gender-based violence organizations are highly trained in the principles of trauma-informed care, which is critical for addressing the needs of trafficked youth with sensitivity and respect (Gerassi & Howard, 2018). Yet of all the organizational groups in the sample, gender-based violence organizations were the only group who had a low feasibility score, whereas YSOs and criminal justice organizations had the highest scores. Feasibility directly relates to available resources and capacity at an organization, which was a notable challenge for providers in this sample who had to navigate restrictive or nonexistent funding streams to serve trafficked youth. Therefore, it is important to consider and prioritize equitable division of resources to address the stark differences in feasibility scores.

Results from the current study have direct implications for practice particularly for task forces. First, organizations serving human trafficking survivors in this study wanted the local task forces to be more present in the community because they relied on partnerships especially when working with youth. The numerous needs of survivors and information-sharing restrictions associated with serving youth drove organizations in this study to reach out to task forces for support. Therefore, task forces should anticipate this need and make continuous outreach to youth service providers as an integral part of their functioning as a preventative measure for effective service provision.

Findings from this study underscore the importance of prevention efforts among multiple community stakeholders. Although this study focused on understanding intervention service needs, multiple organizations emphasized the need for preventative services as part of ideal service provision. Almost all the currently available services for trafficked youth in this community were intervention rather than prevention oriented. The most recommended preventative practices identified by participants were educating and involving school administrators and youth. Previous literature on DMST support these strategies, particularly when educational preventative programs are done in a safe environment (Countryman-Roswurm & Bolin, 2014). Multiple participants from the current study acknowledged there was no such place in their community and were enthusiastic about creating a safe, youth-friendly place in the form of a drop-in center. Therefore, communities should prioritize preventive services, such as drop-in centers and healthy-relationship educational programming, to foster judgement-free spaces for youth to have access to tangible and interpersonal resources.

In conclusion, this study validates previous findings that trafficked youth have numerous needs and require multiple service sectors and organizations to meet those needs. Partnerships and collaboration among organizations serving trafficked youth is a challenging but necessary process to ensure survivors get the services they deserve. Despite the recognition that survivors are consistently forced to navigate the patchwork of care to access services, more work is needed strengthen task force processes and interagency communication. This study demonstrates the utility of needs assessments to strengthen interagency partnerships and address organizational and structural barriers when serving trafficked youth.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Lauren Vollinger

Rebecca Campbell

Author Biographies

Lauren Vollinger, MA, is a doctoral candidate in Michigan State University’s Ecological-Community Psychology program. Her research focuses on community response to human trafficking by evaluating service provision and coordination efforts among organizations that serve survivors. She is a member of the Michigan Human Trafficking Task Force where she serves on the Curriculum Committee to develop trainings for education settings.

Rebecca Campbell, PhD, is a professor of Psychology and Presidential Advisor on Relationship Violence and Sexual Misconduct. Dr Campbell studies how contact with the legal and medical systems affects sexual assault survivors’ victims’ psychological health. Her research has been funded by National Institute of Justice, the National Institute of Mental Health, the National Science Foundation, and the Centers for Disease Control and Prevention. She was the lead researcher for the NIJ-funded Detroit Sexual Assault Kit Action Research Project to study Detroit’s rape kit backlog, which was designated an Exemplary Project by the Association of Public and Land Grant Universities (APLU).

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