Behavioral Health: HHS and DOJ Offer Grants to Help Human Trafficking Survivors

Summary

What GAO Found Given the trauma survivors of human trafficking have experienced, they may need behavioral health services, including mental health care services, such as therapy, or substance use disorder treatment. The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) fund grant programs that help provide access to such services. In fiscal year 2025, HHS awarded approximately $7.5 million for two key trafficking survivor services programs and DOJ awarded approximately $45 million for two key programs. The programs assisted approximately 2,600 survivors and 11,300 survivors in that year, respectively, helping them access services. GAO’s review of HHS’s two key grant programs found that the agency followed leading practices in assessing how programs perform. HHS did this by, for instance, setting long-term and measurable near-term goals with targets and time frames that communicated what the agency expected the programs to achieve. For example, to assess its long-term goal to provide services for survivors, HHS set a near-term goal for a grantee to deliver services to 50 survivors in a given fiscal year. DOJ also followed leading practices for its minor survivor assistance program, but did not do so for its adult program. Specifically, DOJ did not set measurable near-term goals for what it expects its adult program to achieve. By setting such near-term goals with targets and time frames, DOJ would be better positioned to assess the effectiveness of its adult program and the progress it makes toward supporting the needs of adult human trafficking survivors. GAO’s analysis of literature and interviews with selected HHS and DOJ grantees and selected stakeholders identified factors that can affect human trafficking survivors’ access to behavioral health services. Such factors included shortages of providers specializing in treating survivors of human trafficking. These are longstanding and complex issues, some of which are beyond federal control. HHS and DOJ officials said they are aware of the factors and have taken actions—such as increasing human trafficking training for behavioral health providers—to help improve survivors’ access to services. Factors That Can Affect Access to Behavioral Health Services for Survivors of Human Trafficking Why GAO Did This Study Human trafficking is a crime that involves compelling or coercing a person to provide labor or engage in commercial sex acts. In 2024, the National Human Trafficking Hotline identified nearly 12,000 human trafficking cases in the United States. The Trafficking Victims Prevention and Protection Reauthorization Act of 2022 includes a provision for GAO to study the accessibility of behavioral health services for survivors of human trafficking in the United States. This report (1) describes the key HHS and DOJ programs that fund behavioral health services for trafficking survivors, (2) evaluates how HHS and DOJ assessed the performance of key programs, and (3) describes factors that can affect survivors’ access to services and federal efforts to improve access. GAO reviewed HHS and DOJ documentation and interviewed agency officials. GAO selected four key programs whose grantees reported providing the largest amount of behavioral health services in recent years and interviewed 15 grantees selected to obtain variation in the amount of services provided and location. GAO analyzed fiscal year 2025 grantee performance data for the four programs, the most recent available. GAO evaluated HHS and DOJ steps for assessing the performance of the programs. GAO also conducted a literature search and interviewed six selected stakeholders, including representatives from survivor organizations and a researcher.