Developing a consensus on mental health recovery for modern slavery survivors.

Background: Modern slavery and human trafficking are crimes involving the violation of human rights and include activities such as sexual exploitation, forced labour and domestic servitude. An estimated 40.3 million people are enslaved worldwide, including 136,000 in the UK. Modern slavery is an important policy area.

Survivors have often experienced extreme violence and psychological abuse. International and national policy highlights the importance of addressing mental health. However, policy in this area crosses multiple departments and offices. This means that it can be disjointed and conflicting. One particularly challenging area is the definition of recovery.

Recovery has become the foundation of mental health provision. It situates people with mental health problems as active recipients in their care. It is not the amelioration of symptomatology, but a personal journey to understand the events that have occurred. Survivors experiences of what recovery means to them, is under reported.

However, policies such as the 2018 Human Trafficking Care Standards, S.49 Modern Slavery Statutory Guidance and the Home Office Recovery Needs Assessment are replete with references to it.

To start to address this gap, NIHR funded a qualitative study exploring survivors experiences of mental health and recovery (the MOMENTS-1 study).

This application is for a follow-on study using the MOMENTS-1 data as the starting point for a Delphi consultation to co-produce a survivor informed definition of recovery for use within policy documents.

Aim: To co-produce a survivor-informed definition of mental health recovery to support improved policy making in relation to modern slavery.

Objectives: (1) To conduct an online Delphi consultation with experts to explore the core components of a definition of recovery. (2) To co-produce survivor-informed policy outputs to support improved decision-making. Methods: A Delphi consultation and consensus workshop.

Delphi is a technique defined by its use of experts and a series of questionnaires interspersed with feedback to provide information on group opinion.

Approximately 25 -30 purposively sampled experts from each of 5 groups (policy makers, statutory health services, NGOs and academics) will be approached to participate.

The initial list of items for the Delphi will be developed from the MOMENTS-1 qualitative data and a rapid literature review. Delphi rounds will continue until the consensus estimate is stable. If an item receives an endorsement from 70% of participants consensus will be considered to have been reached.

Timelines for Delivery: 12 months (December 2020 – November 2021).

Month 0-3: ethics and governance approvals obtained; item identification completed; early engagement with policy makers and other stakeholders; Month 4 – 9: Delphi participants identified; survey circulated; data analysed; consensus meeting held; Month 10-12: dissemination to relevant policy audiences, other key individuals and organisations.

Final report to funder.

Anticipated Impact and Dissemination: Outputs will be targeted, with tailored messages and will include policy briefings, social media content and a report launch and policy orientated conference. The success of the impact strategy will be evaluated by collecting testimonial as required.