Andres Pumariega

Child trafficking continues to be underreported due to multiple factors including differences in state laws, lack of a centralized database, and overall under-recognition. The care of such youth often entails forensic as well as significant clinical considerations given their traumatization. We report on our experience with a 14-year-old female who presented to an Emergency Department (ED), brought in by law enforcement after her parents filed a missing person report in a different state, with concerns about human trafficking; the patient expressed suicidal ideation in our ED. The patient was placed under involuntary hold, after obtaining collateral from the her parents. During the hospitalization, legal challenges presented barriers to safe discharge and a need to collaborate for providing care between disciplines and across state lines. At the same time, through validation and support in the therapeutic milieu of an adolescent psychiatric unit, she was able to understand that she had just survived sexual assault and began to process the impact of it. Although no medication changes were made, the patient began to develop insight at the time of discharge to the Child Protective Team.