Post-trafficking stressors: The influence of hopes, fears and expectations on the mental health of young trafficking survivors in the Greater Mekong Sub-region.

BACKGROUND: Human trafficking and labor exploitation are prevalent in Southeast Asia and have substantial health consequences for children and adolescents. Research on pre-departure circumstances and trafficking experiences show that gender plays a key role in shaping the experience of exploited children and adolescents. OBJECTIVE: This study estimates how youth's concerns and hopes for the future influence the mental health outcomes of male and female children and adolescents. PARTICIPANTS AND SETTING: Data were collected in face-to-face interviews with 517 children and adolescents (10-19 years old) who attended post-trafficking services between year 2010 and year 2013 in Cambodia, Thailand or Vietnam. METHODS: Multivariable logistic regression models were fitted to estimate the association of children and adolescents' post-trafficking concerns and hopes for the future with mental health outcomes, namely symptoms of depression, anxiety and Post Traumatic Stress Disorder (PTSD). The analysis was stratified by sex. RESULTS: In adjusted analysis, children and adolescents' concerns about social ostracization and maltreatment by others in their community of origin were associated with all three outcomes in males and with depression in females. Being concerned about their own mental health was associated with all outcomes, with a potentially stronger effect observed in males for depression (AOR 9.14, CI:1.21-68.68), anxiety (AOR 13.47, CI:1.70-106.48) and PTSD (AOR 8.36, CI:1.22-56.9) than in females where the odds for depression (AOR 3.24, CI:1.92-5.48), anxiety (AOR 3.05, CI:1.82-5.11) and PTSD (AOR 1.85, CI:1.08-3.14) were much lower. CONCLUSIONS: Young people's post-trafficking care needs and reintegration planning should be designed based on their current mental health, personal security, family and financial resources and age-related capacity.