This is a report from the research project Placing survivor wellbeing on the policy and evidence map. The research was conducted by Minh Dang, Caroline Bradbury-Jones, Sian Thomas, Juliana Rinaldi-Semione, Nicola Wright, Vicky Brotherton, Nancy Esiovwa, Jarrai Barrow, Kristen Johannes. The project was led by the University of Birmingham in collaboration with Nottingham University’s Rights Lab and the Survivor Alliance. It was funded by the Modern Slavery and Human Rights Policy and Evidence Centre (Modern Slavery PEC), which in turn is funded and supported by the UK Arts and Humanities Research Council (AHRC).
There is a growing evidence base that highlights survivors of modern slavery experience significant mental health problems, including high prevalence rates of depression, anxiety and post-traumatic stress disorder (PTSD). In Europe, survivors are entitled to assistance with psychological needs through the Council of Europe’s Convention on Action against Trafficking in Human Beings (ECAT). Despite the Convention’s mandate, since 2013 a number of non-governmental organisations have documented the difficulties that survivors experience in accessing psychological support in the UK.
This study aimed to update the evidence base on survivors’ access to psychological assistance in England and Wales and sought to establish if survivors are receiving their entitled assistance, document in what format and settings the assistance is received; and understand barriers to access and the impact of psychological assistance on survivors’ mental wellbeing.
Alongside updating the evidence regarding survivors’ access to psychological assistance and mental wellbeing, this study aimed to increase research capacity within the survivors of modern slavery population. The project included a peer researcher development programme for survivors that was co-designed, implemented and evaluated. This component of the project focused on the process for engaging and collaborating with survivors as peer researchers throughout the research process. This is in response to increased calls from research institutions and survivor-led groups to include people with lived experience in research roles other than subjects or participants.
The findings from the literature review, community profile and stakeholder workshops highlight the vital importance of mental wellbeing and psychological assistance for survivors. However, the study also identifies gaps in the provision and accessibility of appropriate psychological assistance and mental wellbeing support. The findings emphasise the need for holistic support for survivors through a diverse range of mental wellbeing activities that are responsive to survivors’ needs and priorities. Participants highlighted the interconnectedness of ECAT entitlements, with mental wellbeing dependent on the security of other entitlements such as safe accommodation and access to legal rights and assistance. Finally, the impact of harmful policy and procedures on survivor wellbeing was consistently raised by participants, particularly in relation to the NRM process, asylum system and access to housing.
The Mental Wellbeing Impact Assessment (MWIA) model used in this study identifies four key protective factors for mental wellbeing which underpin the findings from this study: enhancing control; increasing resilience and community assets; facilitating participation and promoting inclusion. Participants in this research also identified a key additional factor of safety. These factors are reflected throughout the findings and recommendations in the following ways:
- The MWIA toolkit identifies enhancing control as a significant element of mental wellbeing. In this study, survivors and service providers highlighted the negative impact on wellbeing of a lack of autonomy for survivors due to lack of available choices, resources and awareness of rights.
- Increasing resilience and community assets connects with people’s ability to cope with adversity and the way that the local area can promote resilience. In this study, participants discussed the importance of local services and access to nature for wellbeing, and shared the individual and collective coping strategies that supported their resilience.
- Facilitating participation is defined as increasing engagement in community activities, including leisure activities, volunteering, group membership and political participation. Within this study, participants highlighted the importance of physical and creative activities for wellbeing, and the value of being able to contribute at a local level through volunteering and involvement in activities with the wider survivor community.
- Promoting inclusion refers to the extent to which particular groups are able to access activities and opportunities to support their wellbeing. In this study, participants highlighted the barriers to accessing appropriate mental wellbeing support, including practical issues such as location and transport costs, challenges within service provision such as lack of culturally sensitive and trauma-informed support, and immigration status as a barrier to accessing support and wellbeing activities.
- Safety was a theme that underpinned the discussion in different areas. This included physical safety, particularly in relation to safehouse and asylum accommodation, and psychological safety as a wellbeing need.
Recommendations for UK Government
- Clarify the entitlement to psychological assistance in modern slavery policy, including in s49 Statutory Guidance under the 2015 Modern Slavery Act.
- In line with Article 12 (d) of ECAT, ensure survivors supported in the NRM are provided with information throughout on the services available to them, including psychological assistance, in a language they can understand.
- Enable survivors’ access, through the Modern Slavery Victim Care Contract (MSVCC), to activities to support mental wellbeing, beyond counselling and psychotherapy, such as exercise and volunteering.
- Ensure provision of all ECAT entitlements, especially appropriate and secure accommodation, and that provisions meet Slavery and Trafficking Survivor Care Standards.
- In addition to the Recovery Needs Assessment to determine ongoing mental health needs, seek survivor feedback on, and assess the appropriateness of, psychological assistance provision received in the NRM prior to conclusive grounds decisions.
- Reduce timeframes for NRM decision-making to provide greater stability for survivors’ wellbeing.
- Extend ‘priority need’ housing status to survivors with a positive Conclusive Grounds decision who are eligible for assistance.
Peer Researcher Development Programme
The Peer Researcher Development Programme (PRDP) was created to train and support a group of survivors of modern slavery, who were interested in becoming engaged in academic research as more than research participants.
The PRDP was facilitated by a research associate and co-developed with input from the survivor researchers (peer researchers). The programme supported nine survivors who served as research assistants or research advisory board members in four different research projects. The PRDP included fortnightly seminars of two hours each, all facilitated online.
The curriculum provided a baseline of knowledge about research and research processes and was designed to be supplemented by project-specific training that peer researchers received from their respective project leads or supervisors. The full description of the PRDP and the Curriculum is available on the Survivor Alliance website below.