SART Toolkit -- Develop a SART

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Build Your SART . Collect Data . Create a Strategic Plan . Determine Communication Standards
Hold Team Meetings . Monitor and Evaluate Your Efforts . Sustain Your SART . Know Your Team . Critical Issues

Know Your Team

Health Care Providers

Health care providers understandably are some of the first people victims see in the aftermath of sexual violence. It is important to note, however, that victims may not seek medical care only at hospitals or their regular doctors. Consider promoting public awareness about your SART and expanding collaborations with a broad range of medical practitioners, such as obstetricians, gynecologists, midwives, American Indian healers, campus health service providers, public health professionals, mental health professionals, military medical personnel, administrators of health maintenance organizations, and medical schools.

To ensure consistent and equitable health care responses—

Create and distribute sexual assault medical guidelines to various health care facilities.
Create oversight and accreditation requirements for medical professionals responding to sexual assault.
Establish health care outcome measures. (Also see Monitor and Evaluate Your Efforts, in this toolkit.)

Victims need to know that their health concerns are your priority. They also need to know which services are provided without charge and whether those services require reporting to law enforcement initially or followup medical care. For example, if crime victim compensation pays for the initial medical forensic exam without a report, will followup medical services also be provided without filing a report?

In This Toolkit: Consider Culture and Diversity Discusses the provision of culturally relevant services to specific populations.

Transforming the Face of Health Professions Through Cultural and Linguistic Competence Education: The Role of the HRSA Centers of Excellence Includes a list of cultural and linguistic competency guidelines, curricula, research reports, service organizations, audiovisual tools, and Web sites that may be helpful to health care practitioners on SARTs.

Here are some other considerations to keep in mind:¹³

What services do medical professionals provide?
Is the current medical response as effective as it needs to be? Why or why not?
Are trained medical forensic examiners readily available?
How will you ensure adequate medical followup?
What are the roles of the different medical professionals in your SART (e.g., physician assistants, emergency medical technicians, forensic nurse practitioners)?
Have physicians in private practice established any specific protocols for identifying and responding to sexual assault?
Are there different treatment protocols for working with victims who are also substance abusers?

The Right Tool

In This Toolkit: Health Care

Do hospital personnel receive special training in responding to sexual assault and providing cross-cultural service delivery?
Are there indigenous or native healers in the jurisdiction who work with victims?
How does the forensic evidence collected during a medical forensic exam fit into the larger evidence collection context?

Health Care and Sexual Violence: Statistics

Of adult American women who are raped, 31.5 percent are physically injured, but only 35.6 percent of those who are injured receive medical care.¹
In a study of 226 female acquaintance rape survivors, 72 percent did not report the assault to authorities compared with only 28 percent who did. Of the 72 percent who did not report the assault, none sought medical assistance.²
More than half of spousal rapes, rapes by ex-spouses, and stranger rapes resulted in victim injury. Injuries were the most common among victims age 30 or older and victims of rapists armed with a knife. Nearly 6 in 10 rapes involving a knife resulted in victim injury.³
Of the victims of completed rapes whose victimizations were reported to the police, 59 percent were treated for their injuries, compared with 17 percent of rape victims with unreported victimizations receiving treatment.⁴
Of injured females of a reported attempted rape, 45 percent received medical treatment, compared with 22 percent of injured victims of an unreported rape.⁵
Of all injured sexual assault victims, 37 percent of victims who reported the violence and 18 percent of victims who didn't report received medical treatment.⁶

1 Patricia Tjaden and Nancy Thoennes, Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey, Washington, DC: U.S. Department of Justice, National Institute of Justice, 1998.

2 Wiehe and Richards, Intimate Betrayal: Understanding and Responding to the Trauma of Acquaintance Rape, New York, NY: Sage Publications, 1995.

3 Lawrence Greenfeld, Sex Offenses and Offenders, Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, 1997.

4 Callie Rennison, Rape and Sexual Assault: Reporting to Police and Medical Attention, 1992–2000, Washington DC: U.S. Department of Justice, Bureau of Justice Statistics, 2002.

5 Ibid.

6 Ibid.

This section reviews—