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This activity qualifies towards Michigan State Licensure requirements for Human Trafficking.

Featured guests: Bridgette Carr, J.D., Human Trafficking Clinic at Michigan Law, and Michelle Munro-Kramer, Ph.D., CNM, FNP-BC, School of Nursing

Objectives

• Identify potential resources to support an individual that is or has been trafficked

Resources

• Find Shelter tool (HUD)
• Helping human trafficking victims (Center for Prevention of Abuse)
• Services available to survivors of trafficking (HHS)

CME

Credits available: 0.75

Visit our CME course overview page for CME credit, or complete this survey for social work CEUs.

Transcript

Syma Khan:

Hello, and welcome to our podcast, Breaking Down Mental Health, with myself, social worker, Syma Khan, child and adolescent psychiatrist, Dr. Heidi Burns, and nurse practitioner, Dr. Christina Cwynar.

Today we are joined by Dr. Michelle Munro-Kramer and Professor Bridgette Carr to focus on the interventions and resources for individuals who have experienced or are experiencing human trafficking.

Dr. Christina Cwynar:

Professor Carr, we have talked a lot about human trafficking over the past two episodes. Could you talk a little bit about what interventions are available once a patient or an individual has been identified as being trafficked?

Professor Bridgette Carr:

So I wish I could tell you that there were a thousand things available in support for trafficking victims, and there are some things, there are some things. But in general it's the same menu of choices that you have in any case, involving some type of abuse or violence or harm.

Now, with one really powerful asterisk that many, many victims of human trafficking, whether it's because they're foreign nationals and they don't have permission to be in the United States, or if they are people involved in the commercial sex industry and they're viewed as criminals by the legal system, they are at risk of being arrested or deported when or if you reach out to involve law enforcement.

Now, this represents a really significant quandary for healthcare providers, because in many states, including Michigan, there are mandatory reporting requirements that do exactly what they say. They mandate that you report cases of human trafficking in certain situations.

So in Michigan, those situations are for minors and for adults only if they would otherwise meet the criteria of being a vulnerable adult. There is no special you have to report an adult victim of human trafficking if they don't otherwise meet that criteria.

But there's a risk that when you make that report, if that report gets in the hands of law enforcement or if you all engage law enforcement more directly, that trafficking victims could be harmed.

Dr. Michelle Munro-Kramer:

I think what I would add to that is that the interventions are very siloed. So I think Bridgette talked a lot about the criminal legal system, whereas if someone needs healthcare they would piece together healthcare in whatever manner they could. If they needed shelter, the shelter is really variable.

Depending on the community, some domestic violence agencies, the way they receive their funding they're pretty strict about who can use shelter there. That means male survivors of human trafficking often cannot.

There are many faith-based organizations that have created housing situations. Sometimes they're termed rehabilitation centers where they provide services. Again, they're very individualized depending on who has created them. And I think the other thing we don't focus on is that a lot of human trafficking survivors do want some sort of job skills training and thinking about job placement.

And again, you're piecing those resources together based on what already exists. So as Bridgette already said, I think the big piece is that it's very siloed and you have to work with the survivor to figure out what they want and try to access those resources.

Professor Bridgette Carr:

I also think it's important that before you experience a case of trafficking, that you've talked to your team, whoever that is, if it's a big team, if you're in a big medical system or a smaller team, because I think you need to know whether your local shelter, who they're going to take in, you need to know.

Because the human trafficking clinic represents survivors all over the state, we know which counties will take individuals who've been sex trafficked into their domestic violence shelter, and we know which counties won't. And we know that in Kalamazoo, the Y has a shelter that will take in men and families. And so there are more options there.

So I think no one listening to this podcast is going to know all those things that we know. So it's really important to know what's available in your community, just like you have to know that for someone who's a survivor of another type of violence.

But the other piece is to know that there is a national human trafficking hotline. It's 1-8-8-8-3-7-3-7-8-8-8, and it's a resource line as well as a line for survivors to call. And so you can call and get information about what's available in your community.

And so they try to keep track of who's serving what types of survivors. The other piece in that is Michelle was very gracious in how she said that there are organizations who open up shelters. I think there's just a lot of people who realize that there are dollars to be had if you say you're serving trafficking survivors, and not all of those people actually know what to do with those dollars, and not all those people should be getting those dollars.

And lots of folks will say that they're running a shelter for trafficking survivors. And then you say, "Okay, can I place my adult male client there?"

"Well, no, it's only for women." And then you say, "Okay, can I place my foreign national client there?"

"Well, no, it's only for US citizens."

"Okay, can I place this 17 year old?"

"Well, no, it's only for adults."

"Okay, so can I place this 22 year old who has just come to our office?"

"Well, does she have a substance use disorder?"

"Well, yes."

"Well, no, then you can't place her here."

And I'm like, "Who are you taking exactly?"

You are taking the movie version of who a trafficking survivor is. And so it can be very hard to find the supports, just like it's hard for other types of violence.

Dr. Michelle Munro-Kramer:

And I would just reinforce that national human trafficking hotline that Bridget expertly recited is a resource for anybody. So you could be a friend, you could be a family member, you could be a healthcare provider, you could be a survivor, but they're there to provide resources to absolutely anyone.

Syma Khan:

I Think we've touched on this a little bit, but is there any differences between the pediatric populations and adult populations between resources that are available?

Professor Bridgette Carr:

Yes, lots of differences. Just like in non trafficking situations, we have child welfare system in every state, and so certain minors can be put in that system and receive support. I will just flag that in Michigan, many people think that children, those under the age of 18, will be treated as survivors if they're sold for sex. And that's not actually the state of our law.

So it is a requirement that all healthcare providers report human trafficking of minors. However, the state of the law in Michigan is that if you are 16 or 17 years old and you are being sold for sex, you are presumed, note a presumption can always be overturned. But you are presumed to be a victim of trafficking as long as quote, you substantially comply with court-ordered services. End quote.

Which means your victimization is based on your obedience and not your exploitation, which means that if you are what folks might want to call a bad kid or a kid who makes choices that those in power don't agree with, you can be charged for prostitution even if you are being sold as a sex trafficking victim.

So I just think it's very important to understand that despite much of the popular and political rhetoric around trafficking, we have yet to truly move in this state or really nationally to recognize that these are folks who are truly victims, which is actually why I use the word victim often instead of survivor, because it's only disempower survivors, it's that we are often in a fight for our clients' lives to get them viewed as victims within the criminal legal system and not criminals.

I have one thing to add after that, which is, and I take a lot of heat about this recommendation from government officials at times, but if I was advising someone who was faced with a 16 and 17 year old who could be labeled a sex trafficking survivor, I would want them to think about using another label. Sexual assault, IPV, whatever other label attaches, because the likelihood of that person being arrested down the line is so much lower if we take the commercial aspect out of the exploitation.

And adding it in doesn't gain them a huge amount of resources or maybe any. And so I encourage folks to be thoughtful, to talk to the lawyers in their healthcare systems and say, what do we do about that 16, 17 year old? Can we categorically refer all these cases under a sexual assault reporting framework?

Because we don't give every single label for everything we turn in. We don't say this is IPV and this is child abuse, and this is sexual assault and this is statutory rape. We don't do that. And so there's no reason within the human trafficking framework that we have to either.

And often how a case is framed initially is how it is seen forever. And so if you can help that 16 or 17 year old with that initial framing so that she is not viewed as a prostitute, that's how people are viewing these clients.

If you can help that child, maybe you can prevent their arrest down the road.

Dr. Michelle Munro-Kramer:

And I would just add to the obligation, the mandatory reporting for children that follows the obligation as it would with anything. So sexual assault, abuse in the home, whatever, you're making the report the exact same way. You're filling out the same paperwork, you're following it up in exactly the same way. And so I agree that we need to think a little less about labels.

It's kind of the same thing as we require a disclosure. We don't need to require a disclosure, we don't need to label somebody. We need to have a suspicion that something is happening to them in order to make that mandatory report.

Dr. Christina Cwynar:

I really appreciate you guys pointing that out, and we actually talk a little bit in our next episode, our final episode of the season about child protective services and what to include in those reports. And you'll hear more about this in the next episode, but keeping it a little vague and just saying, I have concerns for sexual abuse or some exploitation. And not giving it these definitive terms, and letting that CPS, that child protective service worker really do their investigation and see how we can help those children I think is a good step in protecting these children and vulnerable people.

And when we call APS, I think the same thing would be warranted in those reports as well. And at the University of Michigan, we also have a legal team that can help answer some of these questions as well and guide us as well. So thank you for that framework for this.

Dr. Heidi Burns:

Resources are ever changing. But what are some of the good resources that we do have to provide to patients when we're concerned about human trafficking?

Dr. Michelle Munro-Kramer:

So we've already talked about the National Human Trafficking hotline. We've also created a website, human trafficking.umich.edu that was created primarily for healthcare providers, although it has information that's really relevant to anybody.

And the goal with this website was to provide some samples. So what do human trafficking look like? So there are sample cases. What would a good policy look like in a healthcare system? How can we emulate policies that we already have in place for child maltreatment, intimate partner violence, sexual assault, that we're familiar and comfortable with to encompass human trafficking?

We have information on continuing education, and we have a lot of facts. So trying to displace some of those myths that are continually perpetuated. The other thing we've included is some videos with survivors from the state of Michigan, so a foreign national labor trafficking survivor, and then a sex trafficking survivor who entered the sex trafficking actually as a minor.

And so this conversation about, I think she was around 15, 16, around this age group is really relevant, but they say what they want from healthcare providers, which I think to me is one of the most important things. They had both had numerous interactions with the healthcare system. They had not been identified. They had been mistreated. They had been labeled as a prostitute.

There was clearly bias in some of those interactions. And so just them telling their story I think is really a powerful way to understand what's happening in the healthcare system when we don't always see it around us happening, or even things that we're doing on our own.

So that's another really useful resource to get information that you can continue to come back to.

Dr. Christina Cwynar:

Now both of you have referenced that resources are often piecemeal and depending on what the individual needs. And thinking about survivors of human trafficking in general, are there categories that you think of, oh, this person may need connections with the food bank?

And when you're working with somebody, are there certain, I guess, categories that you guys discuss connecting these individuals with?

Professor Bridgette Carr:

So housing is a huge one. We've talked before about that vulnerability can cut across socioeconomic status. It can be the PhD student or it can be someone who's homeless. But in reality, the majority of the cases look more like the person who is closer to being homeless than the PhD student, and so housing is huge.

Both housing in the moment, meaning where's that person going to sleep tonight? And longer term. Sometimes mental health supports, lots of times vulnerabilities arise because of mental health issues. But then they also are created during the exploitation.

And economic access. Human trafficking's about work. This is about people profiting off of other people's vulnerabilities. And so most of my clients need jobs, and they want jobs that are good and that can support them. And so all those things on top of healthcare and often legal services. But I think mostly about where are they going to sleep, how are they going to eat, and how are they going to take care of themselves?

Dr. Michelle Munro-Kramer:

And I think the needs might change over time. And so I think when we conceptualize human trafficking survivors, we think of that immediate time period when they've been identified. We want to provide them support and resources, but they'll be human trafficking survivors their entire life.

And so those mental health concerns may continue to follow them. I know Bridgette's clinic does a lot of work with individuals who are trying to get a record expunged to get into an educational program. So that's a situation where their experience of trafficking has continued to follow them and they continue to need resources, and it changes over time depending on what's happening in their life.

Professor Bridgette Carr:

For sure. A number of years ago, there was a change in Michigan's law that allowed human trafficking survivors to expunge or erase is a lay person's version. Certain crimes, mostly prostitution crimes that occurred while they're being trafficked. Essentially someone forced you to do this and so you can erase these.

We were fully prepared in the trafficking clinic to get calls from people in their 20s and 30s. The majority of those calls those first few weeks were from women in their 60s, some who had retired already, who had already dealt with this being on their record for jobs or volunteering in their kids' school or trying to find housing.

But I think about that all the time. So I'm so glad Michelle raised it. We are so often focused on that time of being victimized or those moments right after rescue. And I can see her in my mind's eye, this woman, the first one who called us in her mid 60s. And I think, yeah, she has literally carried this as part of her legal record this entire time.

Dr. Christina Cwynar:

I'm just speechless right now. So that's a lot. It's really shaped these individuals lives.

Professor Bridgette Carr:

But I also think it shows the power of the stigma of the commercial sex industry, and that traffickers can take advantage of that. Because traffickers will talk about how sometimes they put people out on street corners to get arrested because they know that once that arrest record exists, you are even that much more vulnerable.

And so we often think, oh, traffickers wouldn't want their people arrested, but actually get them arrested, bail them out, then they have a record, they're not going to be able to go to Meyer and get a job really easily.

Dr. Christina Cwynar:

That makes a lot of sense. And it seems like once these individuals are out of these bad situations, that these traffickers are still holding power over them because they have these records, it has changed the path of their life.

Professor Bridgette Carr:

Look, if we think that trafficking is only about traffickers making choices to exploit people, we are ignoring how our society makes people vulnerable. And if we don't attack and address some of those core vulnerabilities, then if you will, the ecosystem that makes it ripe to traffic people will still exist.

If that criminal record did not hold that stigma, did not follow that person around for 40 some years in the case of my client, then the power of that trafficker is taken away.

Syma Khan:

I think also reflecting on maybe potential, some bias in there of who's able to access those types of supports and be able to expunge that record, we again are just thinking of, oh, minors, they didn't consent. But there are probably a lot of young adults or even older adults that have had this experience that maybe the law hasn't caught up and maybe there's a role for advocacy.

Is there anything you'd like to reflect on advocacy that healthcare providers could engage in to help with their patients or the families that they work with?

Professor Bridgette Carr:

So I think I just want to say that your point is so right on, most people don't know that I think it's until 2014, the prostitution laws in Michigan were written as such that only women could be charged with prostitution. So we have represented a number of men who are victims of sex trafficking, but the expungement laws, the [inaudible 00:18:53] laws don't actually technically help them because the laws are only designed to erase the prostitution laws, but that's not what the men were charged with.

So this group and access and how we do it and how we think about it. But from an advocacy perspective, and I say this to healthcare providers all the time, I would love to see healthcare providers putting pressure. I can't lobby as a member of the Michigan faculty, but I can educate. And I love trying to teach healthcare providers to say, "You know what. Talk to the groups you're a part of. Are you part of a nursing group? Are you a part of a physician's group?"

Do they have a presence in Lansing? Tell the legislators that you should not be required to mandatorily report human trafficking survivors who could be at risk of arrest. You have skin in this game as mandatory reporters so you cannot put this on us. There has to be immunity for 16 and 17 year olds, or that cannot be part of the mandatory report structure.

And that voice, I haven't heard it in Lansing. I utterly fail trying to understand how to get things passed in Lansing, so maybe this is bad advice. But I think there really is something to say.

I think the other thing to say is you know what? We as healthcare providers need evidence. Michelle and I are sitting here today saying, there's no evidence-based this, there's no validated screening that, and there's a reason for that because there's not funding attached to do those things.

Because right now, if I get up in front of an audience and tell the saddest, most tear inducing story about a child victim sex trafficking who was snatched from a parking lot, which means it's not even true, I'll get a lot of dollars. So I'm not inclined to lobby for funding that's attached to getting evidence, validating things.

And so we've got to do that, we've got to do that. And I hope that healthcare providers can be part of the push to say, we need this to be more robust. We need this to have data, we need to support it that way.

Dr. Michelle Munro-Kramer:

I think that getting evidence, that advocacy looks a little different too. It's participating, it's trying out some of these tools. It's being willing to collect some of that data and evidence. And even thinking about how it fits in different systems. A lot of these tools we talked about are paper-based. They don't fit in electronic medical records. How do we make that switch and make something that works?

So it can go to identifying survivors, it can go to the policy piece. And then I think it's also advocating for the patients.

So again, that safe space, what do they need now? How can you create those networks so you know who to connect them with when they need shelter? Maybe they have to go all the way to the west side of the state, but you need to have that groundwork in place before a survivor shows up in your exam room or an emergency room and you're not sure what to do with them.

The other place for advocacy, I think in Ann Arbor we are pretty lucky because we have the human trafficking clinic and we talk about this issue, but in other parts of the state and the nation, I think human trafficking survivors are treated much differently by law enforcement. And so it's advocating and having those conversations with local law enforcement, especially in more rural or under-resourced areas where they may not be talking about this issue or even have a lot of resources to support their law enforcement.

Dr. Christina Cwynar:

Switching gears just a little bit. So oftentimes if there is concern for trafficking, let's say in an adult patient, they may choose not to disclose or to return to that situation. What do you tell providers who are distressed by this decision?

Professor Bridgette Carr:

I tell them it is hard, but that's also our job. They say to me, "You don't know what it's like to sit across from someone who will go and leave the exam room and get into a car with a trafficker."

And I say, "Yes, actually I do. I sit across from my client sometimes who I know their trafficker is waiting in the car outside."

We don't help trafficking survivors by disempowering them. I've had providers call me and say, "I have someone in the exam room. They don't want the help, but I know they're going to back to the trafficker. Should I put a 24 hour..."

You all know the mental hold on them. And while inside I'm screaming, no. I then try to say, "Would you do this to someone who was a victim of sexual assault if there was no money involved, if this was not a commercial transaction?"

I will own that I had one person say yes I would. So that is a whole other podcast. But most say I would not. I said then we don't hear.

Dr. Michelle Munro-Kramer:

I think we have this happen with all types of different interactions and illnesses. We have many patients that unfortunately don't necessarily follow recommended advice or come back for a treatment, and there's not a lot we can do there. And so it's very similar to other forms of interpersonal violence.

It's similar to these other disease states and illnesses we see, that it's ultimately up to the patient and the individual. And honestly they know what's safest and best for them at that time. And so there are circumstances and situations where it may not be safe for a survivor to leave their trafficker, and us putting a hold on them or trying to force them to do that isn't necessarily going to help anybody.

And so I would just reiterate that again, the goal is not for healthcare providers to investigate and get a disclosure. It's to be that safe, supportive place where somebody can come back to when it is safe or when they are ready as opposed to them feeling pressured and just hopping around to different health systems and different providers.

Syma Khan:

We've talked a lot about the control of these situations and the power dynamic. And so I think as healthcare providers, we really want to be salient about that power dynamic and to not replicate it within the healthcare system again. And to take that power again away from these individuals and rather to find ways to help support them and empower them to feel safe, hopefully maybe in a future interaction to disclose and take those steps to maybe access the supports that are available to them.

Dr. Michelle Munro-Kramer:

Absolutely.

Syma Khan:

So one question that I had is, are there any special considerations that providers should be aware of when caring for a trafficked individual?

Dr. Michelle Munro-Kramer:

I think we've talked a little about trauma informed care. I personally think that applies to any type of patient, but can obviously be particularly salient with someone who's experienced human trafficking. And the truth is we don't know the trauma that many of our patients have experienced. So that trauma informed care, that patient-centered, so allowing them to make the choices.

And their first concern might be a job when they have some type of health issue that we think is of paramount importance, but really letting them drive the show. Because they're in charge of their bodies. They need that power back. And again, they might know what's safest or best for them at that time.

I think the other piece is thinking about how to remain in contact with them. So scheduling a repeat visit just for a check-in. A lot of times it may not be safe to do a video or a telephone visit, which is what we've moved to a lot during COVID.

So thinking about how you can stay connected with those patients. And it might be a little atypical. You might have the five or 10 minute visit where you just physically check in with them and see them and see what they need, and go from there. And so just being creative.

I think the other piece we talk about is finding a safe space for them. And we haven't really talked about this here, but getting someone alone and trying to talk to them can be extremely difficult. And so having something, like you always take them to the bathroom or you always have the person checking them in ask questions of the person with them, but thinking about what you can do to make their lives a little easier so they can talk to you and get the resources and support they need.

Professor Bridgette Carr:

I think the other piece is just To remember that as a society we haven't decided to support vulnerable people. And the reason I say that is because it always feels like with so much focus on identifying victims of human trafficking and training on trafficking and human trafficking awareness that... Well, it must mean that if we do the identifying and we do the training and we do the assessments, that there is some support waiting for us on the other end.

And the answer is often there's not. And so I really worry that we are over promising and way under delivering. because what most communities have is what they have for other folks who are vulnerable, maybe homeless, who've been harmed by violence. And so for some communities that means some support with some options. Other communities, it means very little.

And so I just never want to make folks think that if they somehow can pull out that trafficking label and make it attach, that if we focus so much on disclosure as you keep saying, Michelle, that this magical confetti of resources and funding and support and guidance is going to rain down them, because it just doesn't happen.

Dr. Christina Cwynar:

And I think we see that a lot with anything we deal with. Trauma and mental health, and how many times do we meet with patients and families and we identify what's going on? This is a eating disorder, but I live in the UP. What can you do to help me? Oh, I'm sorry. There's nothing there. You have to drive eight hours to get care.

And it's sad. We've focused a lot on diagnoses and evaluation and assessment, but we haven't put in the prevention or the aftercare almost into our system.

Professor Bridgette Carr:

And that is not healthcare provider's fault. That is all of us. It's our entire society. But some of the hardest phone calls for me that I get at the clinic will be a parent, and they will be just so in anguish and they'll tell me about their child. Often a teenage girl who they believe is a sex trafficking victim.

And I listen and I say, "Maybe." I say, "Or they're a runaway, but runaways are at risk." But then I say, "I don't know. But even if I could say to you your daughter is a sex trafficking victim, it doesn't actually change. There's no special SWAT team I can call that will go get her."

Where is there magic with that labeling? Honestly, for foreign nationals who've been victims of human trafficking who are in deportation proceedings or who need immigration relief, there is some magic that can happen there. But that's so embedded and way down the line.

But in those moments of crisis, we want support. There's no magic yet there.

Dr. Michelle Munro-Kramer:

And that's globally. There are many healthcare providers around the world that are hesitant to screen for different forms of violence because they don't have anything to offer.

There's no resources, there's no support. So it's more about how do you keep them safe where they're at? And I think here and around the world we need to think about that a little bit more. How do we continue to provide the supports? Especially if we are training healthcare providers and teaching them about this topic and how to ask these questions if we don't have the support to provide after.

Dr. Heidi Burns:

And I think a lot of this discussion is very chilling and might feel disempowering, but I'm finding it actually empowering in a lot of ways as a provider to allow myself to realize that that's the truth. And then think about those small ways that you can provide that safe landing place for the people that you see day to day. And the maybe small ways that you can be an advocate, you can get involved.

And I think it's very empowering to think about what organization can I get and do something related to this? What can I do in my clinic or in my day to day that educates me on some of the resources that are local that I might be able to put into place?

So I think this discussion has been really helpful for that. I think a lot of providers feel that pressure and don't know what to do. And I think talking about the fact that the system is flawed is really important, but it's also meaningful to have interactions, as small as they may be, with some of these survivors. And just be a sounding board for them, be someone who's listening, somebody who's caring.

Professor Bridgette Carr:

Look, if you can make the person in front of you feel seen and heard, and that they are a human being that deserves care, you are doing the heavy lifting of anti-trafficking work. Because for traffickers to be successful, humans have to be turned into commodities. And all too often in our society, we all agree to that deal.

Dr. Christina Cwynar:

Before we start wrapping up for this episode, I was curious, Professor Carr, about your clinic. If you could share a little bit about that.

Professor Bridgette Carr:

Sure. So I often call the clinic my first baby. So I started it in 2009, and really started it not knowing what I know now. Meaning I'd been representing survivors of trafficking within the construct of immigration clinics. And I thought, gosh, they have tons of legal needs that are not just immigration based and I want to serve US citizens.

And so I thought to myself, wouldn't it be awesome to have a legal clinic? And for those of you who don't know, a legal clinic is a place, it's like residency. It's a place where students get to practice being a lawyer while also providing free and excellent legal services. And they practice under their professor's bar license, but when I do my job as a clinical professor, I'm invisible to my clients.

So the client has a relationship with the student and then the student has a relationship with me.

And so the clinic launched. And what I didn't realize what that meant though is that we were offering ourselves to be a full service legal office for a population, and quickly learned how trafficking touched upon tax issues and child custody and identity theft, and all sorts of things that I never knew I would have to learn about.

But the students in the clinic are magic. They remind me that things we think aren't possible often are, that when we show up and we care deeply and we push systems, sometimes you win. And I'll never forget, I had this client who testified, she was one of my first clients. She testified before Congress about that right now, the way the law was structured, her mother was not allowed to come into the US. And based in part on her testimony, they changed the law.

And I thought, gosh, what a victory for that client. But the two students who were assigned her case to do other things that semester came to me and said, "You know what? I think that law can be used retroactively to apply to her."

I said, "I don't think so, but you know what? Convince me, don't tell the client because we don't want to raise hopes."

So they convinced me. I thought, okay, well, let's try. We did it the week before, and we were on this huge time crunch because of immigration laws is a disaster. And so we just had a certain number of days we could still try to do this.

They got it in, and the client's mother arrived three days before she gave birth to her first child. And I remember getting a call from a government official, and I don't usually get these calls.

And she said, "I worked on that case for your client." And I said, "Yeah, we're real excited. Do you know that she testified for Congress?"

And she said, "Yes."

And she said, "Did you know she was the first one who received relief under this new law?"

I said, "I didn't." And so it was just this beautiful moment of the student seeing a possibility I had foreclosed upon in my mind, and the magic of their energy and their ambition and their belief and the power of the law to still do good.

I think right now we're in a cultural moment where we can see so much of the laws failings, and I personally feel it in my body. So much of the laws failings, and yet there's still moments where it's still superpower. So I love the clinic for that. I love how we can show up for people, how we can take time for people, and hopefully how we can move the needle a bit.

Dr. Michelle Munro-Kramer:

Can I add something about your clinic?

Professor Bridgette Carr:

Sure.

Dr. Michelle Munro-Kramer:

I would just say when I am at Bridget and was learning about the clinic, the length of time that some of these clients are with the clinic to meet all of their needs is astonishing. This isn't just like, oh, I have this one legal issue. We're going to fix it in a semester or two with this group of students. This is like a five to seven year commitment that the clinic is making to help this person get through this legal issue that also is usually correlated with another one.

And reach out to healthcare providers about the healthcare needs that come up along the way and connect with social work about the other needs. So I think that we focus a lot on the legal aspect of the clinic, but it really becomes this partnership to meet the long term needs of survivors over time.

Professor Bridgette Carr:

Thanks, Michelle.

Dr. Heidi Burns:

And if providers or people would like to find your clinic, where should they look?

Professor Bridgette Carr:

There's a link to it on the Human Trafficking collaborative website, which is... Michelle, you're better at this.

Dr. Michelle Munro-Kramer:

Which is human trafficking.umich.edu.

Professor Bridgette Carr:

Yes, and so there's a link to the clinic there.

Dr. Michelle Munro-Kramer:

And there's no physical space to the clinic. It is a virtual [inaudible 00:36:48].

Professor Bridgette Carr:

We have physical space for us, but it's not a walk in storefront space.

Syma Khan:

Thank you so much for sharing that information. It just, I think, touches back to I think one of the things that you guys shared of really using that team-based approach, and recognizing that one person may not hold all the resources. And so we really need to capitalize on other people's expertise and identifying some of those housing resources, connecting them to the mental health supports, and really recognizing that each person on that team has something to share.

And we really want to take their perspectives too when we're developing our own hospital policies or our unit policies, or when we have discussions about human trafficking that we're not forgetting about the different people in different settings. Are we ensuring that our environmental services staff are aware of these individuals, and how can they support us as well? And that we need to do this on multiple levels.

And thinking outside of the health system and recognizing there's things like the clinic available too for us and for support. The human trafficking hotline, and so knowing that those are available to us.

Dr. Christina Cwynar:

Are there any other thoughts that either of you want to share before we close today?

Professor Bridgette Carr:

Thank you for having us.

Dr. Michelle Munro-Kramer:

Yeah, thank you so much. I think this is a really great way to talk about this topic and demystify some of the things we may have learned from the movie Taken that aren't necessarily true. So really appreciate you giving us this time and space.

Dr. Christina Cwynar:

Thank you both for joining us today. We really appreciate your expertise and your time. Thank you to our audience who tuned in this week. Nurses, social workers and physicians can claim CMEs and CEs at UofMealth.org/breakingdownmentalhealth. You're able to do this anytime within three years of the initial air date.

We hope that you will join us next time.