George, Emma; Tsourtos, George; McNaughton, Darlene --- "It's Just about the Crime, Not the Victim': Critical Insights from Australian Service Providers Working with People Who Have Been Trafficked" [2018] CICrimJust 8; (2018) 30(1) Current Issues in Criminal Justice 1

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‘It’s Just about the Crime, Not the Victim’: Critical Insights from Australian Service Providers Working with People Who Have

Been Trafficked

Emma George,^[*] George Tsourtos^[†] and Darlene McNaughton^[‡]

Abstract

Human trafficking is a global public health issue, prevalent in Australia. Our study aimed to gain in-depth understanding of human trafficking and related service provision from a range of sectors, from the perspective of service providers. Adopting a qualitative descriptive approach, in-depth semi-structured interviews were undertaken with 13 service providers from a range of organisations across three Australian states. Service providers emphasised the challenges posed by Australia’s predominately criminal justice approach to trafficking, in both policy and service provision, with some suggesting the current process is re-traumatising. Results support refocusing policy and services away from a criminal justice response to a more comprehensive and holistic response that includes greater recognition of the social determinants of health and the provision of tailored services. This requires increased collaboration between service providers, some of whom have very different agendas. The findings provide support for recommendations with the Australian government inquiry into modern-day slavery and therefore have important implications for policy and health services nationally to become more holistic in responding to human trafficking.

Keywords: human trafficking – modern slavery – government inquiry –criminal justice – service provision – Australia

Introduction

Human trafficking has been described as a crime against humanity with potentially devastating health consequences of global magnitude (Richards 2014; Zimmerman & Kiss 2017). Over the last two decades, the issue of human trafficking has gained attention from activists, policy-makers and services providers internationally, and in Australia, as human trafficking is thought to be one of the fastest-growing areas of criminal activity (Gozdziak & MacDonnell 2007; O’Brien 2011; Weitzer 2014). This research is timely in the wake of the Australian Government’s inquiry into establishing a Modern Slavery Act in Australia (Commonwealth of Australia 2017). This parliamentary inquiry received 223 submissions and hosted 10 public hearings. The Committee found that, while significant work has already begun to address modern slavery, more can be done to combat this crime and support people who have been trafficked. In this article, we provide an overview of human trafficking and the Australian context. We outline the aim, methods and results of the research exploring service providers’ perspective on human trafficking, and then discuss the findings in light of the recommendations from the inquiry into the Modern Slavery Act in Australia.

Overview of human trafficking

The most recent global estimates of trafficking, slavery and forced labour outline that, on any given day in 2016, 40.3 million people were exploited in modern slavery (International Labour Organization; Walk Free Foundation et al. 2017). Some global reports on trafficking argued that the actual number of trafficked people is much higher than reported in the documented statistics (Walk Free Foundation 2016). However, Goodey (2008) noted that accurate data on the extent of trafficking is difficult to obtain, a common challenge in criminal justice in areas of serious and organised crime, which is ‘under-reported, under-detected and therefore, under-prosecuted’ (p. 425). Inflated statistics on human trafficking have been criticised by Weitzer (2014) because of the lack of evidence cited to support the figures. The ambiguity surrounding estimates of the human trafficking problem reflects the challenges in measuring clandestine crimes, as well as complex definitions applied to trafficking, slavery and slavery-like practice (O’Brien 2011). Despite the contested statistics in human trafficking, Zimmerman and Kiss (2017) reported there is ‘growing evidence on the wide-ranging health consequences of human trafficking’ (p. 2).

Previous research has gained insights into the experience and impact of trafficking (Juodo Larson & Renshaw 2012), much of which is focused on physical, mental and emotional health (Tsutsumi et al. 2008; Zimmerman et al. 2008; Oram et al. 2012; Hom & Woods 2013; Oram et al. 2016; Ottisova et al. 2016; Stanley et al. 2016; Bick et al. 2017; Borschmann et al. 2017; Zimmerman & Kiss 2017); the complexity and severity of trauma and violence (Gajic-Veljanoski & Stewart 2007; Zimmerman et al. 2009); the lives and roles of the traffickers (Molland 2010; Kamazima et al. 2011; Simmons et al. 2013); and policy (George 2012; George et al. 2017). A study by Oram et al. (2016) argued that survivors of trafficking need support to ‘address the chronic and multiple traumatic events they have experienced along with careful risk assessments and safety planning, particularly if they are returning to their countries of origin’ (p. 1076). Research by Bick et al. (2017) argued specifically for access to maternal health services as an important point of contact for identification of people who have been trafficked, and as well as caring for their health needs. A recent study by Irwin (2017) explored police officer understanding and awareness of human trafficking in Australia. Two key findings from this research was the need for relevant training and clear policy direction for frontline workers, and that barriers exist between service providers limiting an effective response to this issue. This study indicates the important perspective of service providers and highlights the gap in knowledge from multiple sectors, including health professionals.

Australian research on human trafficking has mostly focused on policy and law (Carson & Edwards 2011; Schloenhardt & Klug 2011; Cameron & Schloenhardt 2012; Davy 2017) and trafficking in the sex industry (Flynn et al. 2012). Research from the Australian Institute of Criminology has emphasised the complex nature of human trafficking and slavery in its different forms (David 2007; Juodo Larson & Renshaw 2012; Lyneham & Joudo Larsen 2013; Lyneham & Richards 2014; Richards & Lyneham 2014), and analysed convicted offenders in Australian cases (Simmons et al. 2013). Research by Davy (2015) and Langhorn (2018) showed that, in Australia, people who have been trafficked do not fit the stereotypical image of a victim who has been enslaved in bounds and shackles, or kidnapped. Instead, she argued that trafficking in Australia is enacted through more subtle coercion through debt contracts. Both studies recognised that people who are trafficked in Australia cannot pay off their inflated debt, and their personal documents are confiscated, which renders them powerless to escape exploitation for fear of arrest or deportation.

Internationally, human trafficking is now understood as a public health issue (US Department of State 2017), even though there has been little population-based prevalence data on morbidity and mortality as a result of human trafficking, because it is accepted that the probability of significant health burdens from exploitation cannot be discounted (Zimmerman & Kiss 2017). From a public health perspective, human trafficking can be explored as an issue of both criminal justice and health. Several scholars have sought to critique the theory that a criminal justice approach to trafficking serves to reduce the prevalence of trafficking, aid people who have been trafficked, and has positive health consequences (Gallagher 2011; Simmons & Burn 2011; George 2012; Macias-Konstantopoulos et al. 2013; Burn 2017). By focusing research on the individual’s experiences, this critique has helped scholars, advocates, and public health actors to better understand how the criminal justice system may adversely affect people who have been trafficked. Therefore, we draw on and extend this literature by exploring the service providers’ perspectives on human trafficking. Gaining the service providers’ perspectives is important because service providers from a variety of sectors who work with people at risk of exploitation are well positioned to observe problems and limitations of services, as well as identify opportunities for improved solutions, including the prevention of human trafficking (DiStefano & Cavetano 2011; Letourneau et al. 2011).

In policy and much of the relevant literature, people who have been trafficked are referred to as ‘victims’. This has become a source of controversy within the anti-trafficking sector (US Department of State 2013). In some cases, ‘victim’ is used to suggest a lack of power or agency within a situation, or to frame people or policy problems in a certain way (Weitzer 2013; O’Brien 2016; Wilson & O’Brien 2016). Therefore, in this article, we refer to people who are trafficked, or survivors, but when the term ‘victim’ is used, it reflects the literature cited or the direct use of this terminology by service providers.

The Australian context

The Australian Government’s ‘National Action Plan to Combat Human Trafficking and Slavery 2015–2019’ (Commonwealth of Australia 2014a) positions Australia predominately as a destination country for people who have been trafficking. Similarly to other destination countries, people who are trafficked in Australia are exploited in the sex industry, domestic work, hospitality, construction, and within relationships. National government statistics show that between 2004 and 2015 there were 588 investigations for trafficking in Australia, resulting in the identification of 273 people who have been trafficked (Commonwealth of Australia 2015). The most recent inquiry into human trafficking at a state level by the New South Wales (‘NSW’) Parliament (2017) recorded that, since 2004, ‘there have been more than 750 human trafficking and trafficking-related referrals to Australian authorities’ (p. 7). Although the total number of investigations could be considered low by comparison to other destination countries, it is concerning that the number of investigations and identification of people who have been trafficked is increasing every year. In Australia, the majority of people who have been trafficked are women, and have similar background, culture, language and socio-economic circumstances to the people who recruited them (NSW Parliament 2017). Most people who have been trafficked into Australia have arrived with legitimate visas. However, the visas may have been obtained fraudulently (Commonwealth of Australia 2014a).

In Australia, the ‘Support for Trafficked People Program’ (‘STPP’) provides services for people who have been trafficked. This is described by the Australian Government as a victim-centred approach with individualised case management and support (Commonwealth of Australia 2014a). There are four streams of assessment within the STPP: assessment, extended assessment, the justice support stream, and the temporary trial support stream. The ‘National Action Plan for 2015–2019’ clearly states that the assessment streams are accessible to all people who have been identified by the Australian Federal Police (‘AFP’), but long-term support remains conditional upon willingness to participate in the criminal justice system (Commonwealth of Australia 2014a). Many support programs worldwide require people who have been trafficked to participate in criminal investigations against the traffickers. This conditional support has been described as disempowering and counterproductive to healing, and one of the largest impediments to effective service provision, including health services (George 2012).

A criminal justice-focused response to human trafficking has prevailed in public policy in Australia and around the world (Segrave & Milivojevic 2010; Schofield et al. 2011). It is a priority in destination countries like Australia that traffickers should be identified, prosecuted, and punished and that stronger international border control is implemented in order to prevent trafficking into the country (Gallagher & Holmes 2008). Farrer (2011) explained that an

anti-immigration sentiment and public fear about border protection provide a foundation for Australian border control policies, a strong feature of Prime Minister Howard’s Federal Government from 1996 to 2007, and again in the Abbott and Turnbull-led Governments from 2013 to present. Devetak (2007) described a moral panic over people movement consistent with Australia’s history of racial anxieties. The perceived need for border protection and subsequent criminalisation of trafficking feeds into Australians’ historically embedded fears of the unknown, which have been fuelled and exploited for political gain. A criminal justice response to human trafficking that is built upon border protection policies, and hidden fears of migrant or illegal arrivals, also overlooks the complexity of trafficking in Australia, which includes the exploitation of citizens and people who have been trafficked on spousal or work visas (George et al. 2017).

In addition, O’Brien (2011) reported moral panic in Australia over a perceived causal relationship between sex work human trafficking. She explained, ‘Abolitionists might argue that legalising prostitution cements social norms that sanction the purchase of women for sex, leading to exploitation.’ However, on the other hand, advocates for the decriminalisation of sex work ‘would argue that the illegal nature of the industry allows for the establishment of norms where sex workers are subject to exploitation and violence’ (p. 559). The moral panic and misunderstandings on causal relationships between sex work and exploitation has fostered division between service providers in anti-trafficking and created barriers for them to collaborative respond to the needs to survivors.

Aim and objectives

The aim of this research was to explore and gain an in-depth understanding from a range of different service providers’ perspectives on human trafficking policy and service provision in Australia, including health services. The following objectives were investigated:

• Objective 1: Gain insight into service providers’ understanding of the barriers to current practices, approaches, and support services for people who have been trafficked.

• Objective 2: Identify service provider recommendations for improving current practice, policy and services for people who have been trafficked.

Method

Qualitative descriptive methodology

We chose a qualitative descriptive methodology (Sandelowski 2010) and used in-depth semi-structured interviews to address the exploratory nature of the project and its aims. This approach allows participants to consider and describe their views, raise new issues and take the interview in directions that are meaningful to them.

Sampling frame

Recruitment targeted service providers working with people who have been trafficked in Australia, from a range of sectors. Twenty-two organisations were identified through government policy documents and reports, and all were invited to participate in the study. We also used snowball sampling, which allowed participants to identify other organisations or key individuals that currently provide services to people who have been trafficked (Liamputtong 2013). A media strategy (Phillips 2014) was also used to seek participants who have previously worked in the field of anti-trafficking or service provision.

The sample included 13 individuals from nine organisations, across three Australian states (the Australian Capital Territory, NSW and South Australia). Participants included a lawyer who works with people who have been trafficked, two representatives from the sex industry, three anti-trafficking advocates, three community health service providers, two human trafficking researchers, a representative from federal law enforcement, and another from federal government who works in the criminal justice sector.

In-depth interviews

Semi-structured interviews with open-ended questions were chosen for their capacity to allow participants to reflect on the questions, or take the interview in new and unexpected directions, while prompts were used to encourage further elaboration (Liamputtong 2013). An interview schedule was developed and pilot tested with a service provider who was not a participant in the study. The original interview schedule was reviewed and revised in an iterative process of analysing data, as it was collected (Pope et al. 2007). Key questions invited commentary on: the causes of human trafficking; the barriers to current service provision practice; the impact of human trafficking on health; and recommendations regarding solutions.

Interviews were conducted from August to November 2014, with interviews lasting approximately 50 minutes. Three interviews were undertaken with pairs of respondents at the request of participants who were colleagues, and seven interviews were conducted with individuals. Interviews were conducted in suitable offices and meeting rooms at organisations, in cafes and, in one case, in the home of a participant at the person’s request. Three interviews were conducted via phone. The different locations and modality for interviews reflected the preferences of the participants.

All interviews were audio recorded and transcribed verbatim. Jottings were made during the interviews and written up as field notes after each interview (Liamputtong 2013). The accuracy of all transcripts was confirmed by participants and only one participant requested comments be edited for use in publications.

Data analysis

Thematic analysis was adopted to identify and report patterns of meaning, themes, positioning, and differences within the data (Braun & Clarke 2006). The process of analysis involved coding the data into layers of abstraction and interpretation. Comparisons were made within and between transcripts. The voice of participants was at the forefront of analysis of data content and meaning. Three investigators triangulated the data and themes were identified by consensus.

Ethical consideration

The Social Behavioural Research Ethics Committee (number 6350) at Flinders University gave ethics approval and participants gave informed written consent. To protect the anonymity of participants who are members of a very small network of organisations, the names of these groups have not been included. We have provided general descriptors about gender and area of specialisation when quoting respondents.

As an exploratory study into the issue of human trafficking, the research team made an ethical decision not to recruit participants who have been trafficked, to avoid potential traumatisation in the retelling of their story and sharing experience.

Results

Trafficking in Australia was frequently described as a ‘complicated landscape’. Participants reported trafficking as a hidden issue where people do not understand that these kinds of exploitation are in fact occurring around them. But it, ‘actually happens, in the backstreets of Sydney, the backstreets of Melbourne’ as one female advocate expressed it. Participants all mentioned new Australian legislation that distinguishes trafficking from slavery and slavery-like practices (Commonwealth of Australia 2015). However, for all of those interviewed, it was the presence of some form of exploitation, and the needs of survivors of trafficking that was emphasised, rather than any particular definition or legislation. Insights from participants on service provision for people who have been trafficked aligned to the following four themes.

Theme 1: The criminal justice approach to service provision

All the participants in this study had a detailed and accurate understanding of Australia’s policy response to trafficking and the STPP, in which long-term support is only provided when people are willing to participate in the criminal justice system. Notably, all participants from non-government organisations (‘NGOs’) expressed criticism of this condition because participation in investigations and prosecutions can ‘re-traumatise victims’. As one male participant explained, ‘[T]here’s a constant reminding of the disempowerment you’ve undergone and the treatment you’ve gone through. The fact that you’ve been forced into doing something against your will.’ The link between support services and the criminal justice system was described by an advocate as ‘inappropriate’ because ‘people should be able to receive support if they’ve been through such a horrible experience without being forced to participate in a criminal investigation’. A female lawyer argued, ‘It’s horrid. I think it’s just about the crime, it’s not about the victim if you like.’ In addition, the length of time required for investigations was identified as a problem for people who have been trafficked because it was perceived as adversely impacting on their health, work, and family life. One female advocate stated, ‘By going through a lengthy trial process which can take months, are you able to work? How is your health and well-being? How are your kids? How’s everything back home? I think that’s a huge risk for them.’

During the interviews, participants were asked to identify the benefits (as well as the limitations) for people who have been trafficked of participating in investigation and prosecution. Only participants from government organisations could report benefits that were specific to people who have been trafficked. The first benefit identified is a need for ‘closure’, which was considered essential in recovery, highlighting an emphasis on psychological health. As one male participant from the criminal justice system reported, ‘Some people want closure in terms of seeking that person to be held responsible, and you know, brought to justice as such.’ Second, the process of participation in the criminal justice system was also considered to be important because ‘having someone take down what you say and have somebody investigate what you’ve said and actually take you seriously, and give you some credibility is incredibly empowering as well’. A third benefit for people who have been trafficked, identified by government employees, was achieving a sense of justice. One female respondent reported that:

having your day in court, seeing justice delivered, can’t be underestimated in terms of the restorative benefits for the individual to actually have that sense of right restored in their life ... and to be found to be justified in what they’ve complained to the police is incredibly empowering.

Although these benefits for people who have been trafficked to participate in the criminal justice system were reported, it is important to note that the overwhelming response from all participants was that involvement in the criminal justice system in order to receive long-term support in the STPP put people at risk of re-traumatisation and further exploitation.

Theme 2: The impact of human trafficking on health

All participants recognised the long-term health impacts of trauma for people who have been trafficked, and supported the argument that, with regards to health, ‘the most harm would come to the mental health of a person who’s been trafficked’ (male advocate). Reporting about the long-term trauma of human trafficking, a female outreach worker explained ‘an assault only lasts for so long, but this sort of exploitation can go on for years and years and years’.

Respondents described a type of ‘depression’ that can ‘set in deeply’ (male government representative). A female community support worker clarified that this influences: ‘[A]ll the dimensions that are in a lifestyle, it affects their eating, their sleeping, it affects their ability to relate, and all of those things have the ability to affect you emotionally, psychologically and spiritually.’

In addition, a female government worker stated the ‘type of depression’ seen with many people who have been trafficked was connected to a ‘real sense of hopelessness’, which was also an outcome of dealing with the deception and coercion involved in trafficking. As one senior male government worker explained: ‘I think it’s the psychological damage that kind of comes through their situation; people are deceived, and it’s hard to get over that I think.’

Participants supported individualised health services to effectively respond to different needs of people who have been trafficked. For example, a female community support worker explained, ‘It’s not a one size fits all, and you have to be flexible to the kind of people that are using the service, and know that it doesn’t always match them.’ Participants also reported service provision needs to vary according to the type of exploitation experienced, as well as the severity and duration of trauma.

Theme 3: The challenge of collaboration among service providers

All participants identified the importance of working together across sectors to provide services for people who have been trafficked. The important role of the AFP in identifying victims and connecting with service providers was vital. An outreach worker explained that the complexity of trafficking means that ‘the AFP response isn’t necessarily a traditional police response, they are certainly sensitised to the needs of trafficked people and to the issues that they may have ... and they do have specialist training on the issue’. Participants from government organisations strongly emphasised that the AFP depends upon maintaining good relationships within the rest of the anti-trafficking sector.

However, participants identified significant barriers to collaboration between service providers, especially when working with people who have been trafficked in the sex industry. It was reported by one of the female advocates that some service providers ‘with a more conservative ethos’ were more likely to object to sex work as a profession on political, moral or religious grounds. A male advocate explained that some ‘people use anti-trafficking to advance another agenda which is anti-sex work’. This was described as a major barrier to collaboration across domestic and international organisations because one group viewed the work of another as ‘inherently bad’. Most participants agreed that some organisations, usually connected to a religious group or a feminist position, considered that ‘any form of sex work is a form of exploitation in and of itself’ (female support worker). A female outreach worker described the hidden agendas in anti-trafficking and sex work when she explained: ‘I don’t think people have the same agendas if we were talking about trafficking to the construction industry or the fruit picking industry ... There’s no argument that those industries shouldn’t exist.’ This participant went on to explain that the sex industry has a strong position against exploitation, but the hidden agendas against sex work can limit collaboration with other services working with people who have been trafficked. Other examples of the lack of collaboration were provided by service providers from NGOs. One female participant explained that on entering the anti-trafficking sector, ‘I got talked down to ... the sector didn’t welcome us.’ Another female participant from an NGO suggested that different organisations ‘hate each other’.

Despite the perceived conflict between service providers, there was strong support in principle across the sectors for collaboration. ‘We believe if you’re going to stop trafficking, stop slavery, it’s going to happen when we’re working together.’ All participants, despite the challenges they face in working together, echoed this commitment to partnership for the prevention of human trafficking.

Theme 4: Addressing a lack of awareness of human trafficking

Respondents commonly stated that the wider community (schools, churches, community groups, students, co-workers, friends and neighbours) should have their ‘eyes opened’ to human trafficking. The following quote from a female community support worker suggests one reason why raising awareness is important:

It is likely that someone in the community is going to be the first point of help for a victim in these situations. It’s unlikely that they’ll go straight to the police, or to immigration, or to a victim support service place. They’re going to seek help from a neighbour, from a work colleague.

For ‘front-line workers’ (police, migrant services, domestic violence services, refugee services, shelters, healthcare workers, doctors, and teachers), it was reported that education programs to date have prioritised identifying people who have been trafficked. One male participant from the government sector stated that ‘front-line workers’ need to ‘know what the indicators are, know what’s affected, and know what to do if there’s someone there’. However, as several participants pointed out, there can be an overlap between domestic violence and exploitation in forced marriage, making identification and subsequent support for people who have been trafficked difficult.

Participants also identified the need for greater awareness among people who have been trafficked themselves. One female participant explained that the visa system and immigration laws for were ‘difficult to navigate’. Several participants identified international students as a group at risk for exploitation. It was suggested that students don’t know their rights and, in their need to find employment to help cover the cost of their education in Australia, they are at risk of exploitation. Several interviewees suggested providing information to students and other migrant workers in their own languages was essential in increasing awareness of what exploitation entails, and what their rights are. One female outreach worker explained that: ‘Migrant workers might be particularly vulnerable when coming to Australia because they don’t necessarily know the workplace laws ... for example, if they’re a sex worker ... we can help, they’re not going to get into trouble for seeking help.’

Discussion

The findings from this study support many of the recommendations within the Australian Government’s inquiry into modern-day slavery (Commonwealth 2017). The inquiry clearly states that Australia is committed to addressing human trafficking and providing better support to survivors.

The Committee acknowledges the significant work that the Australian Government has undertaken to address modern slavery through the National Action Plan to Combat Human Trafficking and Slavery 2015–19. Nevertheless, evidence to the inquiry suggests that more can be done to combat these crimes and to better support victims (Commonwealth 2017, p. x).

The results from this study provide evidence on the gaps in service provision and frustrations expressed by service providers. For example, participants considered the STPP is not victim centred, even though it claims to be. Participants explained that the criminal justice approach to service provision does offer some beneficial outcomes for people who have been trafficked, however, as a sole approach it is problematic and potentially re-traumatising for people. Participants in the study argued that this type of approach seems to reorient services to focus on the crime, rather than the person. This concern was supported by the NSW Parliament (2017) when it recognised that support for people who have been trafficked should be provided without being tied to involvement in the criminal justice system. For many people who have been trafficked, even though they engage in the criminal justice system, their traffickers may never be able to be prosecuted. The majority of suspected traffickers are not prosecuted, and therefore we suggest that people who have been trafficked may not experience closure or justice as a benefit of the system. The NSW Parliament (2017) stated that the ‘current prosecutorial approach is not working, given that there have only been 20 trafficking convictions in 13 years’ (p. 84). The ‘National Action Plan for 2015–2019’ (Commonwealth of Australia 2014a) documents that those who are not willing to participate in the criminal justice system are not eligible for the associated long-term government health support services in the STPP. Little is known about what happens to them — whether they are sent back to their home country or are Australian residents or citizens that remain in Australia without access to specialised services. These findings that challenge the prioritisation of a criminal justice response to human trafficking support recommendation 21 in the Australian Government’s inquiry into modern-day slavery. ‘The Committee recommends that the Australian Government de-links access to the Support for Trafficked People Program and the Human Trafficking Visa Framework ... from compliance with criminal investigations’ (Commonwealth of Australia 2017, p. 159).

A key insight from service providers was a preference for a more comprehensive and holistic response that is not heavily dependent on involvement in the criminal justice system, with an emphasis on human rights and social determinants of health. This is consistent with Zimmerman and Kiss (2017), who argued for ‘initiatives to tackle modern slavery, forced labor, and human trafficking need to make the links between human trafficking and health by working more closely with the health sector’ (p. 8). Many international studies regarding service provision for people who have been trafficked call for a more comprehensive, intersectoral, multidisciplinary approach, but specialised to meet the severe and unique needs of survivors (Miller et al. 2007; Shigekane 2007; Zimmerman et al. 2008; Potocky 2010). Initial practical support would ideally include provision of clothing, food, transport, appropriate housing, and childcare (Potocky 2010). Beyond crisis intervention, the extant literature has described support services as being prioritised according to safety, security, social support, forensics, counselling, and medical interventions (Shigekane 2007; Zimmerman et al. 2008). Studies have reported that a holistic approach to healthcare is essential, but it must be flexible enough to accommodate perpetual crisis and instability, especially considering that survivors experience setbacks in recovery (Miller et al. 2007; Zimmerman et al. 2009; Potocky 2010). An enhanced understanding of the social determinants of health in the context of human trafficking could support tailored individualised case management (Miller et al. 2007; Shigekane 2007; Zimmerman et al. 2008; Potocky 2010) to help meet the specific needs of survivors of human trafficking with regards to their health, and with other sectors, including housing and employment. Provision of training and employment were identified by participants as important long-term issues that are overlooked for people who have been trafficked. There are only a few new Australian services emerging in the NGO sector, to support employment for people who have been trafficked in response to this gap in services (Irwin 2017), but access to these services is unclear and lacks a systematic approach. Research by Limoncelli (2016) showed that NGOs around the world can offer a wide variety of important services in the anti-trafficking sector. Further research is required to establish not only the needs of people who have been trafficked, but also a salutogenesis or assets-based approach (Morgan & Ziglio 2007) that recognises the individual’s strengths and assets.

A more comprehensive approach to supporting survivors of trafficking would require more than 45 days or 90 days of support currently provided through the STPP. Recommendation 21 in the inquiry into modern-day slavery states:

The Committee recommends that the Australian Government consider extending the 45 day ‘reflection and recovery’ period to 90 days ... [and] consider extending the 45 day period of initial support available under the Support for Trafficked People Program to a minimum of 90 days, with multiple options for extension (Commonwealth of Australia 2017, p. 159).

The findings from this study indicate that collaboration is one of the largest challenges facing service providers and their respective organisations. The inquiry by the NSW Parliament (2017) noted that ‘a lack of coordination can impact the progression of human trafficking cases, the collection of data to identify and understand trends, and the ability to respond quickly to cases’ (p. 21). Participants in this study reflected on the significant diversity within the anti-trafficking sector and tension between some service providers stems from emotive and divisive responses to trafficking (and sex work in particular), ultimately isolating organisations and inhibiting collaboration. Based on this insight from service providers, we propose that fostering unity among stakeholders, and building an intersectoral response in Australia and internationally, is a key component of a comprehensive approach to human trafficking. This finding supports recommendation 26 of the inquiry into modern-day slavery:

The Committee recommends that member agencies of the Interdepartmental Committee on Human Trafficking and slavery strengthen their coordination and engagement with each other, and that frontline Commonwealth agencies strengthen existing relationships with state and territory frontline agencies. This should include establishing multi-disciplinary taskforces that bring together relevant Commonwealth, state and territory agencies and civil society NGOs (Commonwealth of Australia 2017, p. 196).

A more comprehensive approach to support people who have been trafficked should build upon a commitment to intersectoral collaboration by policy-makers and service providers. Collaboration could support referrals across different sectors, including social determinants of health such as housing and employment. In addition, stronger partnerships could strengthen support for people who are likely to fall through the gaps in the system when avoiding police, or not be eligible for the government’s support program (Project Respect 2016). To date, the AFP has been responsible for identifying people who have been trafficked and referring them to the STPP. Changes to this process were included in the inquiry into modern-day slavery in recommendation 21: ‘The Committee recommends that the Australian Government extent the ability to refer potential victims to the Support for Trafficked People Program ... beyond the Australian Federal Police to other approved entities’ (Commonwealth of Australia 2017, p. 159).

There remains concern for people who have been trafficked who are fearful of police, but this is a concern of all the service providers interviewed, including law enforcement. Numerous other studies argued that services for people who have been trafficked must take into account this fear that can trap people in a cycle of exploitation and result in difficulty developing trust with others, including service providers (George 2012; Macias-Konstantopoulos et al. 2013; Dewan 2014). In response, opportunities to enhance teamwork across health, education, employment, law enforcement, immigration, housing, and the sex industry would provide a more comprehensive response, which participants in our study have reported as essential to diminishing survivors’ fears and enhancing trust. Sandhu et al. (2012) emphasised that building trusting relationships at the provider level and promoting greater inclusion at the systems level would help to develop trust and reduce marginalisation of people who have been trafficked. They argued that stronger collaboration could decrease isolation and eventually allow people who have been trafficked to direct their own recovery journey. In doing so, individual experiences of trauma can be considered and responded to appropriately. This specialised, personalised comprehensive service provision resists the criminalisation of human trafficking. Instead, it focuses more holistically on human rights, on the person and his or her familial group, while keeping the lens on gross global inequities and human rights violations, in addition to addressing criminal justice issues (Miller et al. 2007; Shigekane 2007; Schofield et al. 2011). The service providers who participated in this study all reported that partnerships do exist in Australia between sectors and service providers, but there are opportunities for significant improvement. It is essential that government and

non-government service providers are funded to support survivors of trafficking. Recommendation 24 of the inquiry into modern-day slavery states: ‘The Committee recommends that the Australian Government continue to fund NGOs and civil society to support victims of modern slavery, and increase this funding where deemed appropriate’ (Commonwealth of Australia 2017, p. 173).

The participants in this study argued for the need for greater awareness of human trafficking among the community, front-line workers and people who have been trafficked. This was echoed in the inquiry into modern-day slavery in recommendation 26 of the inquiry into modern day slavery: ‘The Committee recommends that the Australian Government increase public awareness in Australia and in the region, particularly for new migrants’ (Commonwealth of Australia 2017, p. 196). Anti-Slavery Australia, utilising Australian Government funding, has launched an online training course that is available for front-line workers, lawyers, students and educators (Anti-Slavery Australia 2014). Since 2014, more than 48,000 lessons have been completed with over 90 per cent of participants surveyed indicating that they would recommend the course (NSW Parliament 2017). However, the inquiry into human trafficking in NSW revealed that despite important education provided by Anti-Slavery Australia, further awareness raising was required across all front-line workers, as well as in the community. The inquiry into modern-day slavery further highlighted the importance of awareness through training in recommendation 26:

The Committee recommends that the Australian Government: expand training for frontline staff employed by the Australian Federal Police, the Department of Immigration, and Border Protection and the fair Work Ombudsman, as well as other frontline agencies including Centrelink and Medicare ... and ensure that this training includes references to non-government organisations working on human trafficking, modern slavery and slavery-like practices so that they can refer victims for support and assistance offered through non-government organisations (Commonwealth of Australia 2017, p. 195).

The findings from this study highlight the need for a more comprehensive and holistic approach to human trafficking, with a stronger emphasis on people who have been trafficked themselves, currently missing from policy and service provision. Collaboration between sectors and service providers, together with a more comprehensive approach, can enhance a survivor-centred response, consistent with the many recommendations with the Australian Government’s inquiry into modern-day slavery (Commonwealth of Australia 2017).

Limitations of the study

Although the participants in this study represent service providers from a range of sectors, not every organisation working with people who have been trafficked in Australia participated in the research. Therefore, we cannot say that the research captured the insight from every sector. We recommend more research that could capture the perspectives of organisations that are not included in our data.

Conclusion

According to participants in this research, survivors of trafficking in Australia continue to be disempowered through conditional long-term support in what is predominately a criminal justice approach. Service providers reported that this situation is likely to increase isolation, limit their ability to find work, prevent them from seeking support for health issues, and may result in re-traumatisation. Without a more holistic approach, the criminal justice approach is in danger of inadvertently harming many of the people it is trying to help. Our study has highlighted some of the limitations of a criminal justice approach from the perspective of service providers, and the need for policy and practice that can address complex issues and direct services towards a more comprehensive and holistic response to human trafficking. In addition, the service providers highlighted that stronger partnerships between health, immigration and law enforcement can help to identify potential people at risk of human trafficking, and support early intervention. Working together across regions and sectors poses a considerable challenge; however, participants in this study reported a strong commitment towards collaboration. We argue that in order to address these gaps and barriers in service provision, the Australian Government must implement the recommendations of the parliamentary inquiry into modern day slavery. The findings from this study support many of the recommendations made by the committee, some of which are highlighted within this article.

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^[*] Lecturer, College of Nursing and Health Science, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia. Email: [e-mail].

^[†] Senior Lecturer, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia. Email: [e-mail].

^[‡] Senior Lecturer, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia. Email: ../customXml/[e-mail].