Interventions to support the mental health of survivors of modern slavery and human trafficking: A systematic review
Interventions to support the mental health of survivors of modern slavery and human trafficking: A systematic review
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支持现代奴隶制和人口贩运幸存者心理健康的干预措施：系统回顾
DOI：
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发表时间：
2021
影响因子：
7.5
通讯作者：
R. Lazzarino
中科院分区：
文献类型：
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作者：
N. Wright;M. Jordan;R. Lazzarino
背景资料：现代奴隶制一词包括一系列涉及侵犯人权和奴役个人的剥削情况。这是一个重大的公共卫生问题。释放后，现代奴隶制的幸存者有复杂的心理健康需求。虽然提供心理健康是国际和国家政策的一个组成部分，但提供循证支持仍然是全球反奴隶制反应中的一个差距。目的：确定和综合为奴隶制后幸存者群体制定和评估的心理健康干预措施的证据基础。方法：进行系统的文献回顾。审查方案在PROSPERO进行了前瞻性注册，并在报告中遵循PRISMA指南。采用多阶段检索策略检索研究。使用QualSyst工具进行质量评估。由于研究设计的异质性，采用叙述性方法来综合研究结果。结果：9项研究符合最终纳入标准。叙述性综合将研究分为三个主题：研究设计和人口;干预类型;报告的结果。纳入的研究侧重于特定的亚群体，即儿童卖淫、童工或性贩运。结论：这次审查不仅突出了提供循证心理健康支持方面的重要理论-实践差距，而且还强调了限于特定亚组（儿童卖淫、童工或性贩运）的证据不足。在测试的干预措施中强调创伤后应激障碍有可能使心理健康支持对那些有其他需求的人具有排斥性。在评估干预措施的效力时，需要考虑幸存者所处的复杂社会政治背景以及对整体护理、个人康复和生活经历的日益重视。考虑到这一点，可以在评估心理健康干预措施的有效性时纳入更广泛的非临床结果。
Background: Modern slavery is a term which incorporates a range of exploitative situations that involve the violation of human rights and the subjugation of individuals. It presents a significant public health concern. Post-release, survivors of modern slavery have complex mental health needs. Whilst mental health provision is a component of international and national policy, the delivery of evidence-based support remains a gap in the global anti-slavery response. Aim: To identify and synthesise the evidence base for mental health interventions developed and evaluated for use in a post-slavery survivor population. Methods: A systematic literature review was undertaken. The review protocol was prospectively registered with PROSPERO and followed the PRISMA guidance in its reporting. A multi-stage search strategy was utilised to retrieve studies. Quality appraisal was undertaken using the QualSyst tool. Due to heterogeneity in study design, a narrative approach to synthesising the findings was undertaken. Results: Nine studies met the final inclusion criteria. The narrative synthesis clustered the studies in three themes: study design and population; type of intervention; and outcomes reported. The included studies focussed on specific subpopulations, namely child soldiering, child labour or sex trafficking. Conclusion: This review has highlighted not only important theory-practice gaps in relation to the provision of evidence-based mental health support but scant evidence limited to specific sub-groups (child soldiering, child labour or sex trafficking). The emphasis placed on PTSD within the interventions tested risks mental health support becoming exclusionary to those with other needs. When assessing intervention efficacy, the complex socio-political context in which survivors exist as well as the increasing emphasis on holistic care, personal recovery and lived experience need to be considered. Taking this into account, the case can be made for the inclusion of a wider range of non-clinical outcomes in the assessment of mental health intervention effectiveness.