Idea for research
Helen Bramber Foundation is a human rights charity. We give survivors of trafficking and torture the strength to move on. With an all encompassing care for the whole journey, survivors have the dignity, strength and freedom to live their lives to the fullest. Our care ensures survivors are free, healthy, safe, are protected from re-victimisation, detention and poverty. We guide survivors to recover following their experiences of trafficking and torture. And we support survivors for their whole journey enabling constant and sustained recovery.
For this project the primary objective is to estimate the prevalence of head injury (including TBI) among (a) survivors of modern slavery (e.g., human trafficking) and (b) asylum seekers / refugees.
Secondary Objectives:
- To describe the clinical characteristics of head injury in these populations (e.g., mechanism of injury, severity, time since injury).
- To examine how head injury is assessed in studies (e.g., self-report, clinical history, neuroimaging, validated screening tools).
- To identify comorbidities (e.g., mental health conditions, neurocognitive deficits) associated with head injury in these groups.
- To explore any reported associations between head injury and asylum/legal outcomes, quality of life, or functional impairments.
- To assess gaps in the literature and propose recommendations for future research, clinical practice, and policy.
Impact of idea
Survivors of modern slavery (including human trafficking) and asylum seekers often endure multiple forms of violence and trauma, including physical assaults, torture, and dangerous migration journeys. These exposures put them at risk of head injury, including traumatic brain injury (TBI). Head injury can have long-term neurocognitive, neuropsychiatric, legal, and functional consequences. For example, TBI may impair cognitive function, memory, emotional regulation, and decision-making, potentially affecting asylum credibility, legal proceedings, and resettlement outcomes.
Although there has been some research on head trauma in refugees and asylum seekers, the literature is fragmented. A recent systematic review reported prevalence estimates of head trauma in refugees/asylum seekers ranging from 9% to 78%, but noted heterogeneity in definition and measurement, and lack of validated TBI tools (Saadi et al. Neurology 2023).
In survivors of modern slavery (e.g., trafficking), there is little or no comprehensive synthesis of head injury epidemiology. Most research in this population has focused on mental health (e.g., PTSD, CPTSD) rather than physical injuries such as TBI.
Clinicians have also raised concerns: in a qualitative study, they described TBI in asylum seekers/refugees as frequently underdiagnosed, often mild, overlapping with mental health symptoms, and challenging to manage (Jahan et al. Disabil. Rehabil. 2025).
Given this, a systematic review synthesizing incidence and prevalence data for both refugees/people seeking asylum and survivors of modern slavery is not only timely but necessary to inform clinical screening, service provision, legal support, and policy.
Better epidemiological understanding could inform the development of screening protocols (e.g., routine TBI screening in asylum clinics), tailored rehabilitation services, and training for clinicians working with these populations.
From a legal perspective, evidence of cognitive or neurobehavioral impairments resulting from head injury may affect asylum credibility assessments, asylum litigation, or the design of support for modern slavery survivors.
From a public health and policy standpoint, quantifying the burden of head injury can help shape resource allocation, integration services, and long-term care strategies.
