Sexual assault survivors need community-based, coordinated services with on-call hospital and police accompaniment, counselling, advocacy and clinics.
Changes in the wake of the #MeToo movement have been monumental. Perhaps the most promising outcome is recent research suggesting that survivors themselves are feeling less self-doubt, more supported and more empowered. Furthermore, based on the increases in the number of sexual assaults reported to police, survivors’ belief in their right to access the system is on the rise. Yet in Canada #MeToo has not led to a transformation of public policy and response models, or to an increase public funding, so support services for survivors have not kept pace with our understanding of what is needed.
We know what survivors need immediately after a sexual assault, starting with access to coordinated trauma-informed professionals and community-based emergency sexual assault services. There are well established best practices based on peer-reviewed research, the experience of survivors and the front-line experts who serve them. Major advances have been made in understanding the neurobiology of trauma, survivors’ needs, and what trained responders must do to avoid causing more harm or revictimization.
Community-based responses and emergency services are lifelines for survivors. They include sexual assault response teams (SART), which provide on-call hospital and police accompaniment, emotional support, counselling and advocacy, and integrated sexual assault clinics, where survivors can access medical care, crisis support and police reporting options in a safe and confidential location.
These community-based supports, designed using best practices for sexual assault response in mind, offer a rare policy win-win-win for many reasons.
First – and most importantly – coordinated sexual assault services are survivor-centred and reduce the long-term effects of trauma by providing survivors with early social support and control over their care.
Second, they are inclusive and accessible. Many survivors find entering a medical institution or police station unbearable as a result of current or past trauma, experiences of marginalization, and fear of being blamed. Survivors have felt that there are few pathways to healing, few opportunities to be heard, and even fewer prospects for justice. Perhaps it is not surprising that just 5 percent of survivors who are victimized by sexual assault file a complaint with police. A 2018 report from West Coast LEAF found that survivors who do report to police experience re-traumatization, a lack of trust in the system, and feel they have little control or choice during the process.
Community-based services, including SART teams and integrated sexual assault clinics, open the door to key supports. They are especially critical for members of marginalized communities ─ young women, Indigenous people, sex workers, and trans or gender-diverse individuals ─ who are often most likely to be targeted by sexual predators and face barriers to accessing services. The need for these services is demonstrated by the numbers: in the year after the Victoria Sexual Assault Integrated Clinic opened in British Columbia, emergency responses increased by 124 percent and police-supported interviews rose by 400 percent – not because sexual assault rates had gone up, but because more survivors were able to access the medical care, preventative medication and forensic services they needed.
Better access to health care and justice for more survivors – what more could we ask? In fact, it also turns out that these services are cost-effective. The economic impact of sexual assaults is astronomical – the costs borne by survivors, governments and the economy amount to an astounding $4.6 billion annually. By reducing the long-term emotional and physical impacts of sexual assault, an adequate and trauma-informed response can substantially lower the expenses associated with social services for survivors’ health care, counselling and suicide attempts.
The Victoria centre estimates that providing care at its integrated clinic, instead of in regional hospitals, resulted in an immediate savings of $1,350 per patient/survivor for the health care system and local police. All this while improving services for survivors. Beyond these savings, in the context of missing and murdered Indigenous women and girls, and the profound need for reconciliation, there is a moral obligation to provide these services based on the Calls for Justice (specifically, numbers 3.5 and 5.5.iii).
In the wake of #MeToo, the transformations and conversations in society have not permeated the world of policy and government services for sexual assault survivors.
A policy no-brainer, right? Yet, the reality is that most communities in British Columbia don’t have a community-based sexual assault response program. Where such specialized programs exist, they are almost always at risk of losing their funding. Canada has just one integrated sexual assault clinic, the Victoria Sexual Assault Centre, which opened in 2016 and has been struggling to keep its doors open ever since, due to a lack of predictable and dedicated funding.
Why, in the wake of #MeToo, have the transformations and conversations in society not permeated the world of policy and government services for survivors? There are a few reasons.
First, services in BC are still suffering from the massive funding cuts two decades ago by the Liberal government of the day, which slashed core/operational funding for all sexual assault centres in its 2001-2002 budget. That followed the closing of the provincial Ministry for Women’s Equality. Despite generous and committed donors and the advocacy of organizations like EVA BC, the sector has not recovered, and to this day BC remains the only province in Canada without sustained provincial government funding for sexual assault centres.
Second, sexual assault is still treated as primarily – or solely – a criminal-justice issue. Yet that excludes the 95 percent of survivors who don’t report their attack to police. The physical, sexual, spiritual, and emotional health of these survivors must be taken seriously. Sexual assault nurse examiners are a step in the right direction. Although front-line service providers have managed to collaborate, government ministries have failed to recognize the importance of taking a public health approach with funding and policy changes, despite the evidence that doing so would save lives and money.
Third, in BC the emergency supports that do exist are almost entirely dependent on one-time grant funding; appropriate access to medical care and justice should not rely on bake sales to raise essential financing. When there is not enough grant funding to go around, survivors in one community are pitted against those in another.
Fourth, the stigma of sexual assault, rape myths and victim-blaming persist. Domestic violence units and shelters in BC are now funded through secure resources (as they should be); a recognition, no doubt, of the importance of predictable funding. The fact that sexual assault survivors lack the same suggests a hierarchy of victims; that is, those who are deserving of support versus those who are not.
Finally, much heavy lifting still must be done to end stigma and victim-blaming and to ensure care is available to all survivors. EVA BC has persistently advocated for a provincial sexual assault policy, training for all responders and more funding. In Vancouver, WAVAW was recently recognized for its inclusion work in creating specialized sexual assault response services tailored to trans, nonbinary and two-spirit survivors of sexualized violence. Its work will form a blueprint for other centres across Canada. We can and must trust the expertise of sexual assault and anti-violence organizations and provide security and resources for the services they provide.
These barriers are not insurmountable, and we are optimistic. In 2019, sexual assault centres and other anti-violence organizations joined together to push the BC government to shift its funding model away from a grant-based one and adopt a system of contracted, predictable service agreements. Health ministry resources must be deployed in support of these collaborative and community-based models, working in unison with the Ministry of Public Safety and the Solicitor General.
Given the great potential for significant costs-savings and the long-term benefits, as well as our responsibility to the survivors of sexualized violence, all of our governments must fully meet these challenges and provide survivors with the services they need and deserve.
The authors want to thank Elba Bendo, Director of Legal Reform at West Coast LEAF for her contributions, support, knowledge, and expertise.
This article is part of the Improving Canada’s response to sexualized violence special feature.
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