Potential indicators of child MSHT—mental health (non-exhaustive)40 70 77
| Presenting concern | Possible MSHT-related cause |
| Mental health Headaches, back pain, generalised abdominal or body pain, seizure-like events. | Psychosomatic expressions of fear, stress or trauma. Psychogenic nonepileptic seizures in the context of abuse. |
| Alcohol or substance use, dependency or overdose. | Coping strategies during MSHT and/or deliberate cultivation of addiction by perpetrators to enhance dependency and control. Pretrafficking addictions may have been exploited. |
| Self-harm, suicidal thoughts or suicide attempt. | Coping strategies and actions of a child experiencing severe stress, fear, hopelessness, shame and/or trauma responses. May be exacerbated by alcohol or substance abuse and sleep deprivation. |
| Fatigue or exhaustion. | Deliberate sleep deprivation and overwork, poor sleeping conditions, hunger and difficulty sleeping secondary to stress and fear responses (including nightmares) and/or infestation and bites. |
| Chest pain, palpitations, breathing difficulties, dizziness, sense of choking, weight loss. | Anxiety and panic attacks secondary to high-stress situation. |
| Low mood, hopelessness, lack of energy, self-harm and/or suicidality. | Depression secondary to MSHT situation (may have pretrafficking roots). |
| Day-dreaming, ‘zoning-out’, behavioural regression, different presenting personalities, reporting or appearing to respond to internal voices. | Dissociation as an aspect of trauma response. |
| Flashbacks, anxiety, avoidance of certain people or places or re-enacting traumatic events in play. | Potential post-traumatic stress disorder, in conjunction with other mental health symptoms. |
MSHT, modern slavery and human trafficking.