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O'Doherty LJ, Carter G, Sleath E, Brown K, Brown S, Lutman-White E, Jackson L, Heron J, Kalsi PT, Ladeinde OC, Whitfield D, Caswell R, Gant M, Halliwell G, Patel R, Feder G. Health and wellbeing of survivors of sexual violence and abuse attending sexual assault referral centres in England: the MESARCH mixed-methods evaluation. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-133. [PMID: 39422255 DOI: 10.3310/ctgf3870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
Background One million people in England and Wales experience sexual violence and abuse each year, with nearly half experiencing serious sexual offences; around 30,000 survivors access sexual assault referral centres. Objectives This research was commissioned by National Institute for Health and Care Research to evaluate access, interventions and care pathways for survivors, especially those provided through sexual assault referral centres. Design, setting, participants The sexual assault referral centres care pathway was investigated through six sub-studies. There were two Cochrane Reviews (4274 participants). Seventy-two providers and 5 survivors were interviewed at eight sites; the children and young people study involved 12 participants from two sexual assault referral centres. A cohort study involving three-wave data collection over 1 year (21 sites; 2602 service users screened, 337 recruited) used a multilevel modelling framework to explore risk factors for burden of post-traumatic stress disorder symptoms at baseline and change at 1 year. We analysed costs and outcomes and conducted a narrative analysis (41 survivors). We worked closely with survivors and prioritised the safety/welfare of participants and researchers. Results Cochrane Reviews identified large effects from psychosocial interventions for post-traumatic stress disorder and depression. Sexual assault referral centres delivered a high-quality frontline service for survivors but groups experiencing domestic abuse and some ethnic and cultural minorities were under-represented. The qualitative research emphasised inter-agency collaboration for survivor benefit. The cohort study identified a risk 'triad' of adverse childhood experiences, poor mental health and economic deprivation, which was associated with baseline trauma burden. There were important improvements in trauma symptoms a year later. These improvements were unrelated to different sexual assault referral centre models. Costs and other outcomes were also similar across models. Harmful policing and justice practices/procedures were identified by 25% of participants. In this context, trauma-competent interviewing techniques, regular/timely updates and conveying case decisions with care signalled good practice. Limitations The cohort study lacked a comparison group, reducing confidence in the finding that access to sexual assault referral centres explained the reduction observed in post-traumatic stress disorder. Conclusions and future work Barriers to access call for concerted efforts to implement trauma-informed universal health services. The risk 'triad' underscores the value of holistic approaches to care at sexual assault referral centres and timely follow-on care. Poor mental health was the main barrier to service access beyond sexual assault referral centres. The persistence of trauma symptoms a year after accessing sexual assault referral centres signals urgent need for tackling counselling wait-lists, expanding support options and commitment to lifelong care. Multidisciplinary evaluation of sexual assault referral centres for better health provides a foundation for advancing trauma-informed practices in the context of sexual violence and abuse. Study registration This study is registered as ISRCTN30846825 https://doi.org/10.1186/ISRCTN30846825. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 16/117/04) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 35. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Lorna J O'Doherty
- Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | - Grace Carter
- Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | - Emma Sleath
- School of Criminology, University of Leicester, Leicester, UK
| | - Katherine Brown
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | - Sarah Brown
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Louise Jackson
- Health Economics Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Priya Tek Kalsi
- Centre for Healthcare and Communities, Coventry University, Coventry, UK
| | | | - Dianne Whitfield
- Coventry and Warwickshire Partnership NHS Trust, Wayside House, Coventry, UK
| | - Rachel Caswell
- Sexual Health and HIV Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Medical Centre, Birmingham, UK
| | - Millicent Gant
- Juniper Lodge Sexual Assault Referral Centre, Leicester, UK
| | | | - Riya Patel
- Centre for Healthcare and Communities, Coventry University, Coventry, UK
- ARC East Midlands, Diabetes Research Centre, College of Medicine, Biological Sciences & Psychology, University of Leicester, Leicester, UK
| | - Gene Feder
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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McTavish JR, MacMillan HL. The need for meaningful support following exposure to sexual assault. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1799-1801. [PMID: 35128577 DOI: 10.1007/s00127-022-02232-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/06/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Jill R McTavish
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Majeed-Ariss R, Mattison M, Rodriguez PM, White C. Exploring the similarities and differences amongst service users with and without learning disabilities attending Saint Marys Sexual Assault Referral Centre. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1288-1296. [PMID: 37503887 DOI: 10.1111/jar.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND People with learning disabilities are over-represented amongst Sexual Assault Referral Centre service users. This work aims to explore the similarities and differences between service users with and without learning disabilities. METHOD Medical notes of 52 service users likely to have a learning disability were compared with 52 service users not likely to have a learning disability (according to the Learning Disability Screening Questionnaire); all of whom attended Saint Marys SARC for a forensic medical examination during a 12-month period. RESULTS Significant associations were found between the likelihood of learning disability and relationship to perpetrator; location of assault; alcohol use; time taken to present to SARC; domestic violence; self-harm; suicide attempts and mental health service involvement. CONCLUSIONS People with learning disabilities in the sexually assaulted population are more likely to present with intersecting vulnerabilities emphasising the need for timely, accessible and appropriate patient-centred care for this group.
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Affiliation(s)
- Rabiya Majeed-Ariss
- Saint Mary's Sexual Assault Referral Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | | | - Pablo M Rodriguez
- Saint Mary's Sexual Assault Referral Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Catherine White
- Saint Mary's Sexual Assault Referral Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Institute for Addressing Strangulation Sexual Offences, Manchester, UK
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4
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Hughes E, Domoney J, Knights N, Price H, Rutsito S, Stefanidou T, Majeed-Ariss R, Papamichail A, Ariss S, Gilchrist G, Hunter R, Kendal S, Lloyd-Evans B, Lucock M, Maxted F, Shallcross R, Tocque K, Trevillion K. The effectiveness of sexual assault referral centres with regard to mental health and substance use: a national mixed-methods study - the MiMoS Study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-117. [PMID: 37953648 DOI: 10.3310/ytrw7448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Background Sexual assault referral centres have been established to provide an integrated service that includes forensic examination, health interventions and emotional support. However, it is unclear how the mental health and substance use needs are being addressed. Aim To identify what works for whom under what circumstances for people with mental health or substance use issues who attend sexual assault referral centres. Setting and sample Staff and adult survivors in English sexual assault referral centres and partner agency staff. Design A mixed-method multistage study using realist methodology comprising five work packages. This consisted of a systematic review and realist synthesis (work package 1); a national audit of sexual assault referral centres (work package 2); a cross-sectional prevalence study of mental health and drug and alcohol needs (work package 3); case studies in six sexual assault referral centre settings (work package 4), partner agencies and survivors; and secondary data analysis of outcomes of therapy for sexual assault survivors (work package 5). Findings There is a paucity of evidence identified in the review to support specific ways of addressing mental health and substance use. There is limited mental health expertise in sexual assault referral centres and limited use of screening tools based on the audit. In the prevalence study, participants (n = 78) reported high levels of psychological distress one to six weeks after sexual assault referral centre attendance (94% of people had symptoms of post-traumatic stress disorder). From work package 4 qualitative analysis, survivors identified how trauma-informed care potentially reduced risk of re-traumatisation. Sexual assault referral centre staff found having someone with mental health expertise in the team helpful not only in helping plan onward referrals but also in supporting staff. Both sexual assault referral centre staff and survivors highlighted challenges in onward referral, particularly to NHS mental health care, including gaps in provision and long waiting times. Work package 5 analysis demonstrated that people with recorded sexual assault had higher levels of baseline psychological distress and received more therapy but their average change scores at end point were similar to those without sexual trauma. Limitations The study was adversely affected by the pandemic. The data were collected during successive lockdowns when services were not operating as usual, as well as the overlay of anxiety and isolation due to the pandemic. Conclusions People who attend sexual assault centres have significant mental health and substance use needs. However, sexual assault referral centres vary in how they address these issues. Access to follow-up support from mental health services needs to be improved (especially for those deemed to have 'complex' needs) and there is some indication that co-located psychological therapies provision improves the survivor experience. Routine data analysis demonstrated that those with sexual assault can benefit from therapy but require more intensity than those without sexual assault. Future work Further research is needed to evaluate the effectiveness and cost-effectiveness of providing co-located psychological therapy in the sexual assault referral centres, as well as evaluating the long-term needs and outcomes of people who attend these centres. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (16/117/03) and is published in full in Health and Social Care Delivery Research; Vol. 11, No. 21. Trial registration This trial is registered as PROSPERO 2018 CRD42018119706 and ISRCTN 18208347.
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Affiliation(s)
- Elizabeth Hughes
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- School of Healthcare, University of Leeds, Leeds, UK
| | - Jill Domoney
- Section of Womens' Mental Health, Kings College London, London, UK
| | | | - Holly Price
- Section of Womens' Mental Health, Kings College London, London, UK
| | | | | | | | | | | | - Gail Gilchrist
- National Addiction Centre, Kings College London, London, UK
| | - Rachael Hunter
- Division of Psychiatry, University College London, London, UK
| | - Sarah Kendal
- School of Healthcare, University of Leeds, Leeds, UK
| | | | - Mike Lucock
- University of Huddersfield, Huddersfield, UK
| | | | - Rebekah Shallcross
- School of Healthcare, University of Leeds, Leeds, UK
- Feminist Therapy Centre, Leeds, UK
| | | | - Kylee Trevillion
- Section of Womens' Mental Health, Kings College London, London, UK
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5
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Baert S, Fomenko E, Machiels A, Bicanic I, Van Belle S, Gemmel P, Gilles C, Roelens K, Keygnaert I. Mental health of sexual assault victims and predictors of their use of support from in-house psychologists at Belgian sexual assault care centres. Eur J Psychotraumatol 2023; 14:2263312. [PMID: 37819370 PMCID: PMC10569350 DOI: 10.1080/20008066.2023.2263312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 08/05/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Sexual assault (SA) can induce a negative impact on victims' mental health. Specialised SA services generally offer medical care and a forensic examination to SA victims. However, there is a large variation in how these services provide mental health support. OBJECTIVE This study aims to assess mental health problems of SA victims attending the Belgian Sexual Assault Care Centres (SACCs) and identify predictors for victims' use of support from in-house psychologists. METHOD Health records of victims ≥ 16 years who presented within one week post-SA to one of the three Belgian SACCs between 25 October 2017 and 31 October 2019 were reviewed. An AIC-based stepwise backward binary logistic regression was used to analyse the association between victim, assault, service use and mental health characteristics and follow-up by a SACC-psychologist. RESULTS Of the 555 victims, more than half had a history of mental health problems. Of those assessed, over 70% showed symptoms of posttraumatic stress disorder (PTSD), depression and/or anxiety disorder. One in two victims consulted a SACC-psychologist. Victims with a mental health history (OR 1.46, p = .04), victims accompanied by a support person during acute care (OR 1.51, p = .04), and victims who were assaulted by an acquaintance in comparison to those assaulted by a stranger (OR 1.60, p = .039) were more likely to attend their appointment with the SACC-psychologist. CONCLUSION The study reaffirms the high mental health burden among victims attending specialised SA services, stressing the need to provide effective mental health interventions at these services and improve their longer-term use by victims. Prescheduling of appointments with an in-house psychologist in combination with phone reminders may improve the uptake of such services. Health care providers must be vigilant about potential barriers faced by victims without a mental health history or social support in attending appointments with mental health professionals.
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Affiliation(s)
- Saar Baert
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Elizaveta Fomenko
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Aurélie Machiels
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Iva Bicanic
- National Psychotrauma Centre for Children and Youth, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sara Van Belle
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Paul Gemmel
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | | | - Kristien Roelens
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
| | - Ines Keygnaert
- Ghent University, Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent, Belgium
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Varese F, White C, Longden E, Charalambous C, Meehan K, Partington I, Ashman E, Marsh L, Yule E, Mohamed L, Chevous J, Harewood E, Gronlund T, Jones AM, Malik S, Maxwell C, Perot C, Sephton S, Taggart D, Tooze L, Majeed-Ariss R. Top 10 priorities for Sexual Violence and Abuse Research: indings of the James Lind Alliance Sexual Violence Priority Setting Partnership. BMJ Open 2023; 13:e062961. [PMID: 36806139 PMCID: PMC9944274 DOI: 10.1136/bmjopen-2022-062961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/12/2022] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES To establish a James Lind Alliance (JLA) Priority Setting Partnership (PSP) to identify research priorities relevant to the health and social care needs of adults with lived experience of recent and/or historical sexual violence/abuse. PARTICIPANTS Adults (aged 18+ years) with lived experience of sexual violence/abuse (ie, 'survivors') were consulted for this PSP, alongside healthcare and social care professionals who support survivors across the public, voluntary, community, independent practice and social enterprise sectors. METHODS In line with standard JLA PSP methodology, participants completed an initial online survey to propose research questions relevant to the health and social care needs of survivors. Research questions unanswered by current evidence were identified, and a second online survey was deployed to identify respondents' priorities from this list. Questions prioritised through the second survey were presented at a consensus meeting with key stakeholders to agree the top 10 research priorities using a modified nominal group technique approach. RESULTS 223 participants (54% survivors) provided 484 suggested questions. Seventy-five unique questions unanswered by research were identified and subsequently ranked by 343 participants (60% survivors). A consensus meeting with 31 stakeholders (42% survivors) examined the top-ranking priorities from the second survey and agreed the top 10 research priorities. These included research into forms of support and recovery outcomes valued by survivors, how to best support people of colour/black, Asian and minority ethnic and lesbian, gay, bisexual, transgender, and queer (LGBTQ+) survivors, improving access to high-quality psychological therapies, reducing public misconceptions/stigma, the impact of involvement in the criminal justice system on well-being, and how physical and mental health services can become more 'trauma informed'. CONCLUSIONS These research priorities identify crucial gaps in the existing evidence to better support adult survivors of sexual violence and abuse. Researchers and funders should prioritise further work in these priority areas identified by survivors and the professionals who support them.
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Affiliation(s)
- Filippo Varese
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Complex Trauma and Resilience Research Unit, Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Catherine White
- Saint Mary's Sexual Assault Referral Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Eleanor Longden
- Complex Trauma and Resilience Research Unit, Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Christina Charalambous
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Kate Meehan
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Imogen Partington
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Efa Ashman
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Lowri Marsh
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Elizabeth Yule
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Laila Mohamed
- Saint Mary's Sexual Assault Referral Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jane Chevous
- Survivors Voices, Reshapers Community Interest Company, Suffolk, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emma Harewood
- The Lighthouse, University College London Hospitals NHS Trust, London, UK
| | - Toto Gronlund
- James Lind Alliance, University of Southampton, Southampton, UK
| | - Anne-Marie Jones
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
- The Prosper Study, Risk, Abuse and Violence (RAV) Research Programme, School of Nursing and Midwifery, University of Birmingham, Birmingham, UK
| | - Samira Malik
- Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Charlotte Maxwell
- Department of Professional Psychology, University of East London, London, UK
| | - Concetta Perot
- Survivors Voices, Reshapers Community Interest Company, Suffolk, UK
| | | | - Daniel Taggart
- School of Health and Social Care, University of Essex, Colchester, UK
| | | | - Rabiya Majeed-Ariss
- Saint Mary's Sexual Assault Referral Centre, Manchester University NHS Foundation Trust, Manchester, UK
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7
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Elliott SA, Bardwell ES, Kamke K, Mullin TM, Goodman KL. Survivors' Concerns During the COVID-19 Pandemic: Qualitative Insights From the National Sexual Assault Online Hotline. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP84-NP107. [PMID: 35341375 PMCID: PMC8960752 DOI: 10.1177/08862605221080936] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
With the onset of the COVID-19 pandemic and the implementation of stay-at-home orders in March 2020, experts warned of the possible threat of increased interpersonal violence among individuals isolated with abusers. Researchers have sought to understand how the pandemic impacted victims primarily through the analysis of administrative data sources, such as hospital and police records. However, the preponderance of this data shows a decrease in formal help-seeking among victims during the pandemic, speaking to an impaired access to services but limiting our understanding of other ways in which the pandemic has affected survivors. To overcome these limitations, we examined data collected about users of the National Sexual Assault Online Hotline (NSAOH). Information was collected through staff based on retrospective recall following one-on-one chat sessions with 470 victims of sexual violence who contacted the NSAOH in the first six months of the pandemic and discussed COVID-19-related concerns. We qualitatively examined open-ended descriptions of COVID-19-related concerns and identified the four most common: (1) mental health concerns, (2) creation or exacerbation of an unsafe living situation, (3) not being able to access services, and (4) not having access to a mandatory reporter or trusted adult. These findings demonstrate the myriad ways in which the pandemic affected the lives of victims of sexual violence and can inform practices for services and practitioners to best meet the needs of survivors moving forward. Specifically, these findings highlight the need for more accessible mental health services and funding for sexual assault service providers, as well as the importance of safety planning, particularly in times of crisis.
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Affiliation(s)
- Shannon A. Elliott
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Emma S. Bardwell
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Kristyn Kamke
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Tara M. Mullin
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
| | - Kimberly L. Goodman
- Rape, Abuse & Incest National
Network, Research and Evaluation, Washington DC, USA
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8
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Bach MH, Hansen NB, Ahrens C, Hansen M. Giving voice: experiences and needs of sexual assault survivors facing multiple adversities. NORDIC PSYCHOLOGY 2022. [DOI: 10.1080/19012276.2022.2141838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maria Hardeberg Bach
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Nina Beck Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Occupational and Environmental Health, Odense University Hospital, Odense, Denmark
| | - Courtney Ahrens
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | - Maj Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
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9
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Bach MH, Hansen NB, Hansen M. What Characterizes Vulnerability? Interdisciplinary Perspectives on Service Provision for Survivors of Sexual Assault. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14140-NP14165. [PMID: 33866834 DOI: 10.1177/08862605211006358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although research indicates that specialized sexual assault (SA) services are effective in terms of promoting postassault recovery and improving legal outcomes, little is known about how to best support survivors facing co-occurring difficulties and inequalities (e.g., preexisting mental health issues, substance abuse, poverty). This deficiency in knowledge was also expressed by service providers at Danish SA centers (SACs), who described this using the term "vulnerable survivors." Therefore, the present study aims to address this knowledge gap by exploring (a) how service providers understand vulnerability in the context of SA and (b) how service provision is currently approached for these survivors. Interviews were conducted with 18 service providers representing five professional groups (psychologists, social workers, forensic doctors, nurses, police) and analyzed using Interpretative Phenomenological Analysis. A total of eight themes emerged from the analysis, including service providers' descriptions of what characterizes vulnerability in survivors and broader perspectives on service provision for these survivors. Survivors considered least likely to attain desired supports were also those perceived to be most vulnerable with regards to risk and experiences surrounding sexual victimization (e.g., individuals with preexisting mental health issues). Service providers also believed that a large proportion of those served experience ongoing vulnerabilities that are difficult to manage within existing support models. The results thus suggest that survivors' needs cannot be met if vulnerabilities are overlooked or ignored. At the same time, the concept of vulnerability warrants caution since vulnerabilities are often placed within individual survivors, but the formal support system also appears vulnerable in its ability to meet the diverse needs and priorities of those served. The implications for SA services across the globe are discussed, including a need for more individually tailored and trauma-informed responses to SA that simultaneously address co-occurring difficulties and inequalities in survivors.
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Affiliation(s)
| | - Nina Beck Hansen
- University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Odense, Denmark
| | - Maj Hansen
- University of Southern Denmark, Odense, Denmark
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10
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Cheng Y. Occupational Therapy Practice Based on New-Generation Information Technology for Employee Emotion Analysis and Management. Occup Ther Int 2022; 2022:3536911. [PMID: 35949566 PMCID: PMC9345735 DOI: 10.1155/2022/3536911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
This work intends to combine neural network technology with occupational therapy to fully acquire employees' emotional information by constructing an effective emotion recognition network. Firstly, the psychological state of employees is discussed from three aspects of leadership narcissism, organizational identification, and the emotional contagion effect, and the corresponding model is implemented. Secondly, based on the convolutional neural network technology, the facial feature recognition and the body feature recognition are combined, and the employees' emotions can be accurately identified by establishing a multilearning emotion recognition network. Finally, a questionnaire survey is carried out on the employees of enterprises in the coastal areas of Zhejiang. Descriptive statistical analysis, reliability and validity analysis, correlation analysis, regression analysis, mediation effect tests, and other methods are used to analyze the questionnaire data. The results reveal that leadership narcissistic organizational identification plays a mediating role in the process of employees' emotional contagion perception affecting employees' psychology. Compared with younger employees, older employees have better psychological quality and mental health. There are also significant differences in emotion and work enthusiasm among employees with different educational backgrounds and positions. Employees' perception of emotional contagion to pretending expressions, indifferent expressions, contempt expressions, and sincere expressions has an obvious positive impact on the psychological impact of other employees. The classification accuracy and regression error rate of the constructed multilearning emotion recognition network are 28.5% and 9.8%, respectively, which can accurately identify the emotional performance of employees. This work helps enterprises better understand the mental health of their employees.
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Affiliation(s)
- Yueyuan Cheng
- Department of Foreign Languages, Zunyi Medical University (Zhuhai Campus), Zhuhai City 519000, China
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11
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O'Doherty L, Carter G, Lutman-White E, Caswell R, Jackson LJ, Feder G, Heron J, Morris R, Brown K. Multi-disciplinary Evaluation of Sexual Assault Referral Centres (SARCs) for better Health (MESARCH): protocol for a 1-year cohort study examining health, well-being and cost outcomes in adult survivors of sexual assault attending SARCs in England. BMJ Open 2022; 12:e057449. [PMID: 35613767 PMCID: PMC9131084 DOI: 10.1136/bmjopen-2021-057449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/31/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Sexual violence is commonplace and has serious adverse consequences for physical and mental health. Sexual Assault Referral Centres (SARCs) are viewed as a best practice response. Little is known about their effectiveness and cost-effectiveness. Long-term data on the health and well-being of those who have experienced rape and sexual assault are also lacking. METHODS AND ANALYSIS This is a mixed-methods protocol for a 1-year cohort study aiming to examine the health and well-being in survivors of sexual violence after attending a SARC in England. Quantitative measures are being taken at baseline, 6 and 12 months. Post-traumatic stress (PTS) is the primary outcome (target N=270 at 12-month follow-up). Secondary measures include anxiety, depression, substance use and sexual health and well-being. Using mixed-effects regression, our main analysis will examine whether variation in SARC service delivery and subsequent mental healthcare is associated with improvement in trauma symptoms after 12 months. An economic analysis will compare costs and outcomes associated with different organisational aspects of SARC service delivery and levels of satisfaction with care. A nested qualitative study will employ narrative analysis of transcribed interviews with 30 cohort participants and 20 survivors who have not experienced SARC services. ETHICS AND DISSEMINATION The research is supported by an independent study steering committee, data monitoring and ethics committee and patient and public involvement (PPI) group. A central guiding principle of the research is that being involved should feel diametrically opposed to being a victim of sexual violence, and be experienced as empowering and supportive. Our PPI representatives are instrumental in this, and our wider stakeholders encourage us to consider the health and well-being of all involved. We will disseminate widely through peer-reviewed articles and non-academic channels to maximise the impact of findings on commissioning of services and support for survivors. TRIAL REGISTRATION NUMBER ISRCTN30846825.
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Affiliation(s)
- Lorna O'Doherty
- Institute for Health and Wellbeing, Coventry University, Coventry, UK
| | - Grace Carter
- Institute for Health and Wellbeing, Coventry University, Coventry, UK
| | | | - Rachel Caswell
- Sexual Health and HIV Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Gene Feder
- Community Based Medicine, University of Bristol, Bristol, UK
| | - Jon Heron
- Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Richard Morris
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Katherine Brown
- Department of Psychology, Sports Science and Geography, University of Hertfordshire, Hatfield, UK
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Harrison C, Parekh V. Sexual violence in patients with psychiatric conditions: Factors for consideration in case management. J Forensic Leg Med 2022; 86:102303. [PMID: 34999299 DOI: 10.1016/j.jflm.2022.102303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/20/2021] [Accepted: 01/02/2022] [Indexed: 11/17/2022]
Abstract
Patients with underlying psychiatric conditions are vulnerable to the experience of sexual violence. Barriers and facilitators to disclosure exist, at the level of the individual, healthcare system, legal system and society in general. Management requires a trauma-informed approach with a focus on avoidance of stigma, optimisation of pre-existing psychiatric conditions and appropriate treatment of psychological sequalae. Preventive strategies by the patient, practitioner and healthcare system, may assist to reduce the risk of future sexual violence.
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Affiliation(s)
- C Harrison
- Department of General Practice, School of Public and Preventive Medicine, Monash University, Melbourne, Australia.
| | - V Parekh
- ANU Medical School, ANU College of Health and Medicine, Australia
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13
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Bach MH, Beck Hansen N, Ahrens C, Nielsen CR, Walshe C, Hansen M. Underserved survivors of sexual assault: a systematic scoping review. Eur J Psychotraumatol 2021; 12:1895516. [PMID: 33889311 PMCID: PMC8043556 DOI: 10.1080/20008198.2021.1895516] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Despite knowledge about the extensive and often long-lasting consequences of sexual assault, many survivors remain underserved by formal support systems (e.g. medical, mental health and criminal justice systems). Reasons for underutilizing services are as diverse as the survivors themselves, and little is known about which survivors are most underserved and why they are underserved. Objective: To help organize existing findings on this topic, a systematic scoping review was conducted to identify adult survivors of sexual assault, who may be particularly underserved when attempting to obtain services in Western countries. Method: Five databases (PsycINFO, Embase, MEDLINE, Scopus and CINAHL) were systematically searched for studies published in English from 2000 onwards using terms such as 'sexual assault', 'help seeking', 'formal support', 'barriers' and variations thereof. Results: A total of 41 studies were included in the present scoping review, resulting in seven main categories of underserved survivors: Ethnic and cultural minorities, Disabilities, Financial vulnerability, Sexual and gender minorities, Mental health conditions, Problematic substance use, and Older age. Barriers encountered by survivors with these characteristics included limited access to formal supports and insufficient training and awareness among service providers about how to best support survivors. Conclusions: Recommendations include the need for more survivor-centred, culturally appropriate and trauma-informed services and more attention to survivors belonging to underserved groups in policy, practice and research.
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Affiliation(s)
- Maria Hardeberg Bach
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Nina Beck Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Occupational and Environmental Health, Odense University Hospital, Odense C, Denmark
| | - Courtney Ahrens
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | | | | | - Maj Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
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