Supporting sexual assault survivors with disabilities: Tracing disclosure and referral pathways to postassault health care services.

Abstract

National epidemiological data indicate that nearly 4 in 10 victims of recent sexual assaults have physical, cognitive/developmental, or mental health disabilities, which can make navigating postassault help seeking more challenging. To streamline services, many communities have created sexual assault nurse examiner (SANE) programs for comprehensive health care, crisis intervention, medical forensic evidence collection, victim advocacy, and legal referrals. SANE programs are recommended as the national best practice for postassault care, but there is virtually no U.S.-based research on whether survivors with disabilities seek these services. The present study sought to identify the disclosure and referral pathways that successfully connected sexual assault survivors with disabilities to SANE programs for postassault care. Forensic nurses in one midwestem state recorded information about all adult sexual assault patients (N = 755) who sought care during a 9-month window of data collection. Survivors with disabilities were significantly less likely than those who did not have disabilities to disclose to informal support providers (e.g., family, friends) and those individuals were unlikely to suggest to survivors with disabilities that they seek postassault health care. Survivors with disabilities were significantly more likely than survivors who did not have disabilities to disclose to formal help sources and to be referred to SANE programs by other formal community services, typically the police. A strong referral network from law enforcement to SANE programs is important, but survivors who do not wish to pursue criminal investigation need reliable pathways to postassault health care. Strategies for promoting community awareness of SANE services are discussed.