History of SARTs

In the 1970s

In 1972, Ann Burgess, a psychiatric nurse, and Lynda Holmstrom, a sociology professor, arranged to be on call day and night to interview and counsel rape victims who came to the emergency room of a Boston, Massachusetts, hospital. They noted that some of the victims' symptoms resembled those of combat veterans and coined the term "rape trauma syndrome." Although the term was not universally accepted until years later, rape trauma syndrome eventually became a conceptual framework that underscored the importance of better victim services in both the health care and criminal justice systems.

Also during this decade, the Federal Government created the first government-sponsored victimization survey. The National Crime Survey (now called the National Crime Victimization Survey) gathered crime data from individuals and households throughout America, an approach that differed from the Federal Bureau of Investigation's (FBI) Uniform Crime Reports (UCR), which included only a compilation of statistics reported to law enforcement agencies. According to the National Victim Assistance Academy Textbook, this survey "made it devastatingly clear that the rates of child abuse, rape, and domestic violence were much higher than imagined."⁸

SART Initiatives

• Alarming Rates of Sexual Assault Addressed
• Full-Service Forensic Exam Facilities Developed
• Sexual Assault Nurse Examiner Programs Created
• Victim Advocacy Begins on Campus
• Partnerships Formed Between Law Enforcement and Advocates

Alarming Rates of Sexual Assault Addressed—Kansas City, Missouri (1973)
The Kansas City Missouri Police Department formed a long-range planning committee to study reported forcible rapes and to address the alarming rates of sexual assault in its jurisdiction. As a result of this study, the Metropolitan Coordinating Committee for Rape Treatment and Prevention was formed on a multicounty, bistate level, with 67 members representing 5 counties (about 50 square miles) on both sides of the Missouri state line. This interagency collaboration was one of the first and largest SARTs in the United States. Advocates, social workers, medical personnel, law enforcement, and researchers forged alliances and Saint Luke's Hospital became the first private sexual assault treatment center in the Nation. The designated sexual assault facility offered victims anonymity and did not require them to go through the criminal justice process. When the program began, 139 victims were treated at the hospital; by the following year, that figure had almost tripled.

Source: Jean Morgan, 1974, "Rape Treatment Center Opens at St. Luke's," The Johnson County Sun (August 3).

Full-Service Forensic Exam Facilities Developed—Honolulu, Hawaii (1974)
Prior to 1974, victims in Honolulu were taken to a city morgue to have sexual assault forensic exams performed. That rather chilling practice prompted the Kapiolani Hospital to create an ad hoc committee to study whether it could establish an in-house center for treating sex abuse victims. The feasibility study revealed that there were not only gaps in services, but also fragmentation. Medical care provided by city and county physicians consisted primarily of checking for physical injuries. It did not include tests and treatment for sexually transmitted infections or respond to victims' reproductive health concerns. If victims went to their private physicians after a sexual assault, they generally received better medical care but evidence collection was either not done, incomplete, or improperly collected. Moreover, some hospitals automatically reported the incident to the police regardless of the victims' intentions. The hospital applied for and was granted a certificate of need from the State Health Planning and Development Agency, which enabled it to open the center to provide victims of sexual assault with crisis intervention, advocacy services, forensic medical exams, and criminal justice assistance. Law enforcement and the hospital signed a memorandum of understanding (MOU) and the prosecuting attorney's office gave a verbal agreement to support the team model.

Source: Paula Chun, 1978, "The Development of the Sex Abuse Treatment, Kapiolani-Children's Medical Center," paper presented at the Annual Conference of the Western Branch of the American Public Health Association, Honolulu, Hawaii.

Sexual Assault Nurse Examiner Programs Created—Memphis, Tennessee; Minneapolis, Minnesota, and Amarillo, Texas (1975–1979)
Prior to 1975, most nurses were doing everything but the pelvic portion of the sexual assault exam to minimize victims' waiting time at the hospital. A study showed that victims generally preferred female nurse examiners when they had just been assaulted by male perpetrators. Unfortunately, the only available hospital physicians often were males.

To consistently meet victims' trauma-related health care needs, including their preference for female examiners, and to better serve criminal justice objectives, nurses were specially trained as sexual assault nurse examiners (SANEs), who would perform the entire exam. The first SANE program started in Memphis in 1976, followed by programs in Minneapolis (1977) and Amarillo (1979). Since the 1970s, SANEs have not only become a core component of SARTs nationally, SANEs also have been instrumental in starting SARTs in many communities.

Victim Advocacy Begins on Campus—Fort Collins, Colorado (1974)
Colorado State University started its team approach through the Office of Women's Programs in 1974. Advocate teams composed of trained students, faculty, and staff referred victims to appropriate resources and helped them choose the resources that would best meet their physical, emotional, and legal needs on campus. This initial step brought together community- and campus-based services to help tailor responses to each student's needs.

Source: Communications with Chris Linder, Director, Women's Programs and Studies, Colorado State University.

Partnerships Formed Between Law Enforcement and Advocates—Logan, Utah (1976)
The Community Abuse Prevention Services Agency (CAPSA)  began in 1976 in Utah as a group of women who met under the sponsorship of the State University Women's Center. Law enforcement worked closely with CAPSA to assist with victims' needs, providing a foundation for broader community partnerships and collaboration with health care and other community organizations in the future.

Source: Communications with Kathryn Monson, Community Abuse Prevention Services Agency, North Logan, UT.