“When a child or young person experiences frequent or prolonged stress, danger or abuse their brain anatomy and function alters to protect themselves by triggering a ‘survival mode’. ‘This can be observed in abused, traumatised and, trafficked children and why our survivor care is critical.”
Lynne Chitty, Director of Care at Love146 UK is well-versed in the affect trauma has on young trafficked survivors. Especially, regarding the long-term mental health issues this impact can have on their recovery and, their future.
That’s why we work towards a joined up and child-centred approach in everything we do. Journeying with a child or young person from ‘survival mode’ to ‘survivor care’..
.. For as long as it takes.
This is Gertjan’s* story.
Gertjan was placed with Love146 on 31st September 2014* and placed on our Immediate Safety Plan. He was previously placed in two children’s homes. But there were grave concerns about his safety, as two Albanian males had approached both the homes asking for him.
“I remember that Gertjan was very distressed while at the safe accommodation. He was unable to sleep, would become very tearful and would be awake late into the night. When he did go to bed, he would only sleep with the bedroom light on.”
‘Since I have known Gertjan he has always been very afraid.’
Gertjan told me that he would run away and go to London. He said that no one would stop him, and no one would find him. This put Gertjan at great risk of going missing, being re-trafficked and exploited.
Children do not always have a well-developed understanding of safety and, following the risk assessment this was evident in Gertjan’s case. Some trafficked children have never felt safe and lack an understanding of the concept. Many children do not view themselves as trafficked, exploited or at risk, or believe they have a right to protection or even to a childhood.
The risk assessment also showed this to be the case for Gertjan.
Gertjan’s situation was complexed therefore, his views also may have been influenced by his traffickers and his family (e.g., being told not to trust authority figures). Additionally, by his cultural views about ‘the family’ where a child is seen as a commodity or an asset and not an individual with human rights.
“During telephone calls to his family, I saw it was clear that Gertjan felt a very strong need to comply with family expectations. Gertjan would ask the staff when he could talk to his family without an interpreter, when he could go out on his own and when he could have a mobile phone.”
The overall aim of the Immediate Safety Plan was to ensure that Gertjan was safe from harm and remained that way. And only if it was in his best interests.
The safety plan addressed Gertjan’s needs and the services required to meet them. It also included specific child-focused outcomes. And it’s important that our safety plan contained realistic strategies to achieve these outcomes.
The focus is to ensure that Gertjan was protected and was prevented from suffering further harm by supporting his strengths, addressing his vulnerabilities and risk factors. Whilst, promoting his health, development and welfare.
Our safety plan also includes an emergency plan in case circumstances change and requires prompt action ‘the Golden Hour’.
Our ‘Safety Plan’ for Gertjan was reviewed regularly as he required a range of integrated support. And always in collaboration with local authorities, so we can address his complex psychological, developmental and cultural needs.
For Gertjan to be able to recover from the abuse of trafficking, he needed stability; consistency and, the ability to continue to access a range of services that met his developmental needs and address the impact of abuse.
“I knew it was imperative that we, and the professionals working with Gertjan understood the trauma that he may have experienced. This understanding ensures and shapes the survivor care support being provided to the individual trafficked young person.”
But sadly, a timeline of struggle for a young survivor can still occur.
In January 2015 he was referred to the Child and Adolescent Mental Health Service (CAMHS). He was not contacted until March 2015 and he was not able to access’s services at that time.
In May 2015 Gertjan was moved to a Local Authority foster placement. His wishes and views were not considered as he had clearly expressed a wish to remain at Love146. His needs and risks were not considered by the Local Authority. Inevitably, the foster placement broke down.
In 2016 he was moved to a hostel type accommodation; this placement broke down and he was moved on again.
During this period Gertjan had enrolled at college and he was passionate about car mechanics. But he struggled with his concentration, as he was still experiencing problems with his sleep; therefore, it was not long before he was asked to leave college.
He tried several times to enrol but his ability to concentrate was so poor he was unable to stay at college. I knew this was a great disappointment for him.
I have worked with child trafficking survivors who have experienced multiple, pervasive forms of adversity, traumatising experiences and loss (a high score of Adverse Childhood Experiences or ACEs).
These experiences have profound impacts on the developing brain and body of the child, and which significantly increasing their risks of disease and disorder across their lifetime unless appropriate intervention is provided.
‘Survival mode’ may also present as a withdrawn child with reduced or low emotional responses, slow thinking and movement and poor ability to engage with other people and, the world around them.
When a child or adolescent is unable to find physical safety and critically, relational safety and belonging, their brain and body may be subjected to prolonged and dysregulated stress hormone action which is known to risk damage to cells across the body.
This is also known as ‘toxic stress’ and increases their relative risk of disease across their lifetime including higher risks of cancer, auto-immune diseases, lung problems, and a range of mental health disorders. Leading to long-term damaging coping strategies.
For child trafficking survivors to recover and thrive the provision of safety, stability and available trusted adults is critical.
This trust takes time to develop but can be achieved through repeated appropriate interaction with the child or young person. Relational trust, stability and safety enable the child’s brain and stress hormone pathways to regulate, reducing the pathways of harm and opening the way for them to engage far more effectively with therapeutic work, medical care, learning, education and future planning.
“I’ve seen how crucial it is to have a basic understanding of how a child’s brain and body respond to trauma, and how it is applied to all decisions regarding the placement of child trafficking survivors.”
This understanding was not applied by the Local Authority. And in 2016 the Local Authority no longer commissioned Love146.
Gertjan told me that he did not feel supported in his accommodation. So, he asked if I would still support him as he felt he had no one else he could talk to. He wanted to move into semi-independent living and asked if Love146 could look after him again.
“I told Gertjan that we were unable to help with the accommodation, but I would support him for as long as he wanted me to.”
He eventually left his accommodation as he was frustrated, and he felt abandoned by the local authority. He moved out of his own accord and started living with friends in London. His support from social services stopped.
Throughout my work with Love146 we’ve never close our cases. We always try to continue supporting young survivors we have been involved with.
“I remained in touch with Gertjan. I was concerned about his safety during this time. When someone has no support and nowhere to live their vulnerability increases, so I was worried that he could be exploited during this time.”
Gertjan moved back to Portsmouth and was living with a friend. He tried to re-engage with social services, but support was not forthcoming. They would only support him if he attended college but Gertjan was not well enough mentally to do this.
“I still have concerns about his vulnerability.”
Gertjan desperately wants to get on with his life but he still has problems with his mental health. He doesn’t sleep well.
“Before the Coronavirus lockdown I would meet him to have a coffee, I’d see him regularly. To check in with him and for him to know that we’re still available to him. The pandemic has stopped this, but I have regular phone contact with him.”
In October 2020 Gertjan told me that he had received a Home Office ‘remain to stay’ refusal letter.
He asked me if I could help him and if I would talk to his Solicitor. I assured him that I would be there to support him through this very difficult time.
Gertjan’s Solicitor asked me to read his psychological report and assess his comments about his fears of disclosing information about criminal gangs in Albania. These were consistent with my observations and conversations I’d had with him. And consistent with my knowledge of Gertjan’s mental health.
“I knew I needed to continue to support him. Since I have known Gertjan he has always been terrified of giving detailed information to anyone about the people he fears in Albania.”
He told me that these gangs also operate in the UK therefore, he was still not free from fear.
The trusting relationship that I had built with Gertian enabled him to disclose information that no one else knew and inevitably, and this would support him in getting the individual care he needed.
Gertjan’s Solicitor asked if I could support Gertjan with his appeal, he asked if I could make a statement and attend Court. I said, “Absolutely.” Gertian had no one else to help him.
“I have spent a long time with Gertjan, and I have worked with him on his journey from ‘survival mode’ to ‘survivor care’ and recovery. For 6 years Love146 has been the only constant support he has had and we’ll always be there for him..
.. for as long as it takes.“