Transcript Sexual Assault Services and the Public Health Model: Experiences

Sexual Assault Services and
the Public Health Model: An
Australian Experience
Patricia Leahy, PhD
Outline
Public Health Approach
 Sexual Assault Services in Australia
 The Canberra Rape Crisis Centre
 Challenges in Australia
 Reflective Questions for Best Practice in
Hong Kong
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Public Health
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Multi-disciplinary, evidence-based, holistic model
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Sexual violence not just a simplistic two dimensional
model (SW, and legal) but a “whole-of-government”
model
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Education
Health
Social Welfare
Public Policy
Justice
Sexual Violence as a Mainstream Issue
Sexual Assault
Services in
Australia
(Weeks 2001)
NT
5 (181,900)
Queensland
28 (3.3m)
WA
9 (1.7m)
SA
15 (1.4m)
NSW
57 (6.2m)
VIC
15 (4.5m)
120 (15m)
Australian Capital
Territory
Canberra
Tas
3 (459,000)
1 (308,000)
National Association of Services
Against Sexual Violence (NASASV)
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Peak Body (National level lobby group): 1997
(Resourced, on a project basis by the Office of the
Status of Women)
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Assist Governments in policy development (prevention and service
provision)
Co-ordinate sharing of information, skills and resources
Promote and monitor best practice (1998 national Standards of
Practice Manual)
Undertake research
Promote equity of access
Promote community awareness
Promote understanding of sexual violence against women in the
context of gender and power relations
Canberra Rape Crisis Centre (ACT)
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Grew out of the Women’s Movement in the 70’s
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1976 opened
1980+ government funded
1989 funding for after-hours service
1994 funding for community education programme
1998 funding to auspice men’s service (SAMSSA)
2001 funding for Aboriginal Support and Education
Programme
Feminist Human Rights Model
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Support and Advocacy
– Community based counselling, Crisis support and advocacy
– Refer and work with medical, legal, and other community
resources
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Political Role of Social transformation
– Promote legislative and criminal justice procedure changes
– Community and government education
– Promote a feminist analysis of the political nature of sexual
violence
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Collective governance
– power sharing and accountability
Community Based Counselling
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Housed in a residential Specific workers for adult
women (2), young women (1), and children (1).
Group support
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Drop in
Ongoing group for ritual abuse survivors
School based groups for young women
Advocacy
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Court support, Victim Impact Statements,
referrals/applications for social welfare support
Evidence-based Servicing
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Collaborative Research
 Service
effectiveness
 Identifying needs
– women with disabilities,
– lesbian and bisexual women,
– women from non-English speaking backgrounds
– Indigenous women
Community Education
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Some examples
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Department of Defence
Police
Dept of Foreign Affairs
Dept. of Education
Family Services (SWD)
Paramedics
Hospital staff
Paramedics
Schools (students and teachers)
Publications
Political and Social
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CRRC membership:
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ACT Sexual Assault Advisory Committee
ACT Council of Social Services (VP)
NASASV 2 members (Chair)
Examples of CRCC contributions:
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Legal protection of counsellors’ notes
Sexual Assault law reform
Criminal Injuries Compensation Scheme
Protocols with police, Family services (SWD), Mental
Health Crisis Team, DV services,
Collective Governance
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Management Collective
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Working groups
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Child Services
Adult Services
Young Women services
Community Ed.
Access and Equity
Aboriginal Support and Education (Nguru)
Collective processes
Finance and Funding
Employment Working Group
Challenges in Australia
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Society attitudes
National vs State laws, and policies
Resources
Political will
Lack of co-ordination between service providers
Medicalised model (health not public health)
Insufficient training of front line health workers
Access and equity (90% of victims do not use
crisis, professional, legal or financial services)
Summary
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Feminist model as it operates in CRCC
mirrors the public health approach:
 Operates
effectively across sectors,
 Holistic,
 Evidence
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based servicing
What PH can possibly provide:
 Mainstreaming
 Access
to resources
Sexual Violence in a Hong Kong Community Sample
N = 508 (Leahy, Pang, Tang & Cheung)
20
18
16
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Male
Female
14
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12
10
8
6
4
2
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ChildSA
AdultSA
REVIC
Sexual Violence in a Hong Kong University Sample
N = 667 (Leahy, Fung, Tang & Cheung)
30
25
Male
Female
20
15
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*
10
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5
0
ChildSA
AdultSA
REVIC
Reflective Questioning about
Best Practice in Hong Kong
If we conceptualise the pursuit of best
practice as a continuum, then it becomes
possible to constantly evaluate and
review structures and functions without
the underlying assumption of
dysfunction or failure.
Criminal Justice System
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How effective is the criminal justice system
in communicating to the general public that
sexual violence is a serious offence?
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4.8% of cases handled by Rain Lilly in
2000 were successfully convicted (SCMP, Nov
2, 2002)
(SCMP, April 27, 2002)
 Barrister,
Finny Chan Fei Nai, “a gentlemanly
sort of rape….as soon as one finished he leaves
the room and another takes over”
 “The victim was slightly more vindictive than
hurt”
 Judge, Mrs. Justice Verina Bokhary’s response
to these remarks….
How effective are the health and social
welfare systems in servicing victims of
sexual violence?
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How well-resourced are services providing
specialized services to victims of sexual
violence?
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How well-trained are front line workers in
sexual violence issues? (doctors, nurses,
social workers, psychologists, ……)
Doctors’ Attitudes
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Wong, Wong, Lau & Lau, (2002)
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33% of emergency ward doctors in Hong Kong believe
that women are partly to blame for rape (appearance,
behaviour etc)
36% believe a woman should be responsible for
preventing her own rape
7% believe women secretly desired to be raped
10% believe a woman can successfully resist rape if she
wants to
78% had received no formal training in dealing with
rape victims
Social Workers’ Attitudes
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Tang, Pun & Cheung (2002) compared (a) social
workers, nurses etc. with (b) police, laywers etc.
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Which group was more likely to have victimblaming attitudes, (a) or (b)??
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How many of us here today have had any formal
specialized training (one or more full semester
courses) as part of our basic training??
Public Policy?
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How effective is public policy in
communicating a zero tolerance approach to
sexual violence
 (Mandatory
reporting of CSA, mandatory
criminal background checks of all frontline
workers with children)
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Role for the Women’s Commission?
Education?
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How effective is the education system in
promoting a zero tolerance approach to sexual
violence
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Gender sensitivity education
– countering myths which silence victims
– establishing norms which promote gender and sexual equality
– EOC survey of students (2002) found that boys believed that it
is “unacceptable for girls to take the initiative in courtship and
dating”
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Including sexual violence issues into the sex education
curriculum in schools
Finally…..
Best practice in self-care for
individual workers in each sector.
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McFarlane & van der Kolk, 1996
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As long as people deny the impact of their own
personal trauma and pretend that it did not
matter, that it was so bad, or that excuses can
be made for perpetrators they are likely to
identify with the perpetrators and treat others
with the same lack of empathy and compassion
with which they treat the wounded parts of
themselves.