CEA Day- how we spot exploitation in health care settings

March 18th, 2020

We asked our Young Women’s team to share their experiences and have created a downloadable infographic for any staff based in health care settings.

My name is Fiona and I am one of the Young Women’s Workers for Redthread. I am based in a major trauma centre hospital and support young women aged between 11 and 24, that we meet through their presentation at hospital, or the attached sexual health clinic. Young women we meet have experienced high levels of trauma and often, this includes exploitation in some form.

While our first contact with young women is through the hospital, we then offer ongoing trauma informed support in the community. Content of support is totally lead by each individual and their needs, however my role usually consists of two main threads; advocacy and direct work with young women around safety planning, healthy relationships, self-esteem, emotional regulation, access to housing/education/work and more.

The young women that we support are often labelled as ‘challenging’ or ‘hard to engage’. These labels can be very damaging, especially when in actual fact, these young people are likely to be afraid, traumatised and under pressure not to disclose.

It’s important that as professionals we keep in mind how complex an exploitative situation can be and the barriers that it can present to a young person being able to access support. I believe that we are placed in a unique situation by being within hospitals, enabling us to offer a compassionate presence and ongoing support to young people who may otherwise have flown under the radar of statutory services.


Five signs of CE in hospital and health care settings- download as an infographic here

  1. How are they behaving?– For young people it may feel easier/less vulnerable to be angry, than to be sad or scared. Anger can also be a survival instinct. Those being exploited will likely be anxious and fearful but take note, that they may not express these emotions in the way you may be used to.
  2. What state are their clothes in? – It’s really important to consider both ends of the spectrum when it comes to this, as well as a combination of both.
    – Are they wearing expensive or new clothes that struggle to be explained or were ‘bought by a friend’
    – Is the young person unwashed or reporting having worn the same clothes for several days
    – A combination of both could look like a young person being in unclean clothes but with new trainers
  3. Where have they come from? – Is this A&E local to their home? Or is it miles away? If it is, do we understand what has brought them here? Do they not want to give a home address? Why?
  4. What time is it and who are they with? – Are they accompanied by older individuals who they seem uncomfortable around?Do these individuals request to stay in the room during conversations? Are they alone, 13 y/o and in A&E at 3am? Is the presentation delayed, did the injury actually happened several days ago? What caused the delay?
  5. What concern are they presenting with?
    – Emergency contraception
    – Suspected pregnancy/abdominal pain
    – Injuries that could be consistent with a sexual assault (it’s important that this is explored with young men also)
    – Illnesses consistent with neglect that could be related to poor living conditions (eg: no running water)
    – Does the concern seem minor, but they are adamant about not leaving the hospital
    – OR does the concern seem significant but they are adamant they NEED to leave and are not able to fully explain why?

– Download our infographic here.

To find out more about the Young Women’s Service contact our VAWG lead Jess Macdonald on jess.macdonald@redthread.org.uk

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