Sexual Assault: What to do and expect when you go to a crisis center
Sexual Health: What to Know and Expect When Going to a Crisis Center
Editor’s Note: This story is the third part of our Sexual Assault Series, a place where victims, friends and families can learn more about the topic.
It’s important for those impacted by sexual assault, both victims and their loved ones, to know where and how they can get access to medical care and therapy. I sat down with Jasmine Gentry, a medical student, to learn about what crisis centers are and how they can help victims of sexual assault.
What is a crisis center?
“Crisis center is more of an organization where, when certain patients come in with certain complaints, they have a protocol they enact where certain personnel, this includes on-site security… [like] local APD, as well as ER doctors and nurses as well as SANE nurses, respond to and take care of the patient when they come in. Most of the time the crisis center is activated for sexual assault.”
What is a SANE nurse?
“SANE is an acronym that stands for sexual assault nurse examiner. These are forensic nurses; they’ve got special training training to do sexual assault exams… They are trained in medical, psychological and forensic examinations…
Prior to using SANE nurses, most sexual assault victims when they presented to an ER would have their sexual assault exam done by a physician as well as have an interview by both a physician and a member of law enforcement specifically a detective. What a SANE nurse does is they come in and they themselves will actually do a forensic exam as part of their medical assessment and the rape victim. They will also work with a physician and law enforcement to get a lot of those critical details.”
What is a rape kit?
“A rape kit is made up of multiple components” of bags to collect hair, clothing, specimens and other fibers. Gentry states these products “… collect both the victim’s hair as well as any hair they might find on the victim – whether it [is] on her clothing or just on her body.” Collecting the victim’s clothes is important because it can aid “… forensics for analysis that it can help them ID if there’s any DNA or specimens or semen or anything on there.”
Combs are also an important part of rape kits because they can collect fibers, hair and DNA from the victim’s hair that can be analyzed “… if the victim was assaulted in a specific area or a specific place and they may have fibers or carpet, whether it’s from a car or a house, in their hair.” It also includes a nail manicure kit that “… allows the examiner to clean from underneath their nails.”
Fluids will also be collected from “… inside the mouth, the sides, within the genitalia as well. It has devices where blood can be taken… they need to verify that the blood is hers or if it could be someone else’s.”
When is a rape kit most effective?
“As soon as possible. Go immediately to the hospital, go straight to your ER, even immediately call the police. Because really between the first 24-48 hours is a really good time for certain specimens, specifically any fluid like any blood, any semen… is a lot better for our testing techniques to characterize if we need to do analysis… Not to say that if someone comes in after 48 hours, it’s one hundred percent a no go. It’s just that there is a time code of viability in which you can analyze a lot of these things.”
What should and shouldn't be done after an assault?
“Coming in as soon as possible… not showering. You also have to think of the manner which the sexual assault took place… if it were forced oral sex or forced anal sex, you want those patients to not brush their teeth or clean the affected area.”
How are rape kits processed?
“In most of your big cities, the rape kits will go to the local police department that [handles] that jurisdiction. For example, if your rape takes place in Atlanta, and you go to Grady, your rape kit will go to the APD.”
[What can complicate processing a rape kit? How can state jurisdictions affect processing time?]
“Let’s say that your rape took place in a different county like Gwinnett county but you live in Metro Atlanta and you go to Grady. That’s where it gets a little mixed up. [Because] while your exam and specimens may be collected at Grady, oftentimes what puts a drag on it, is that your police report actually has to be filed with the officer in the jurisdiction that your crime took place.”
[What happens after?]
“That can involve the rape kit having to wait until not only do you talk with an APD officer on scene but a Gwinnett county police officer has to travel to Atlanta to talk to you and take your kit back to their jurisdiction. It can get a little backlogged just trying to figure out which jurisdiction it goes to.”
What is mandatory reporting?
“Someone who is a mandated reporter… [is] obligated to tell law enforcement no matter the circumstances… hospitals also have their own interpretations in which they enforce this… [In certain situations] you have to tell an officer that a crime has taken place, but you don’t have to tell an officer which person in your emergency room it happened to…
[In cases of domestic abuse] the patient has the right to decide if they want to involve law enforcement… that doesn’t mean that law enforcement will still file the report… if the patient says I still don’t want to file a report then they don’t have to.”
What are the services provided to victims at a crisis center?
“Nurses are also trained in STI testing. Another reason we want victims to come in as soon as possible as they are is because they may be exposed to sexually transmitted diseases. Grady is a premier hospital that is working against a high population that has HIV/AIDS… they do an excellent job of getting these patients on HIV post-exposure prophylactics which is important…
There’s medication for patients who already have HIV, and there’s medication for patients who want pre-exposure prophylactics [antiretroviral medicines] taken after exposure to HIV that prevent infection or what is known as Truvada. Let’s say they have a partner who they know is HIV positive, and they want to engage in unprotected sex with them; they can be on Truvada. But what about the patient who was raped and has no idea that the person who raped her was HIV positive?
There are medications out there that if that person truly did transmit to her, actually prevent viral replication in her and she will never have a full blown diagnosis of HIV. So that in addition to your other standard STI screening… they have a lot of resources for mental health. The other hospital that I worked with, when the SANE nurses came in, after they left the ER every patient had an appointment with a therapist, which is a psychologist as well as a psychiatrist for a minimum of three months, completely free and [state funded].
And additionally for very high risk patients which typically are patients who are homeless or in foster care or victims of repeated sexual abuse or sexual assault, these patients have the opportunity to be taken in by women’s shelters…”
Awareness is important. Awareness isn’t just understanding and helping to prevent sexual assault. It’s also helping those affected find and get the help they need. Crisis centers provide important services to victims of any background get the care and support they need.