The identification and treatment of mental health and substance misuse problems in sexual assault services: A systematic review

Stefanidou, Theodora; Hughes, Elizabeth; Kester, Katherine; Edmondson, Amanda; Majeed‐Ariss, Rabiya; Smith, Christine; Ariss, Steven; Brooker, Charlie; Gilchrist, Gail; Kendal, Sarah; Lucock, Mike; Maxted, Fay; Perôt, Concetta; Shallcross, Rebekah; Trevillion, Kylee; Lloyd‐Evans, Brynmor

doi:10.1371/journal.pone.0231260

Cited by 17 publications

(26 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, few services seem to tailor interventions to survivors and many of the included studies suggested that referring clients on for needed follow-up was difficult (Brooker & Durmaz, 2015 ; Holly & Horvath, 2012 ; Zweig et al, 2002 ). This finding is in line with other recent reviews of the literature, which identified wide variations in the provision of mental health and substance abuse services at SA centres (Stefanidou et al, 2020 ), and found that pathways from SA services to mental health services are often difficult (Brooker, Hughes, Lloyd-Evans, & Stefanidou, 2019 ). In addition, psychotherapy alone may be insufficient to adequately support survivors with multiple needs as highlighted by Akinsulure-Smith ( 2014 ).…”

Section: Discussionsupporting

confidence: 91%

Underserved survivors of sexual assault: a systematic scoping review

Bach

Hansen

Ahrens

et al. 2021

European Journal of Psychotraumatology

View full text Add to dashboard Cite

Background : Despite knowledge about the extensive and often long-lasting consequences of sexual assault, many survivors remain underserved by formal support systems (e.g. medical, mental health and criminal justice systems). Reasons for underutilizing services are as diverse as the survivors themselves, and little is known about which survivors are most underserved and why they are underserved. Objective : To help organize existing findings on this topic, a systematic scoping review was conducted to identify adult survivors of sexual assault, who may be particularly underserved when attempting to obtain services in Western countries. Method : Five databases (PsycINFO, Embase, MEDLINE, Scopus and CINAHL) were systematically searched for studies published in English from 2000 onwards using terms such as ‘sexual assault’, ‘help seeking’, ‘formal support’, ‘barriers’ and variations thereof. Results : A total of 41 studies were included in the present scoping review, resulting in seven main categories of underserved survivors: Ethnic and cultural minorities, Disabilities, Financial vulnerability, Sexual and gender minorities, Mental health conditions, Problematic substance use, and Older age . Barriers encountered by survivors with these characteristics included limited access to formal supports and insufficient training and awareness among service providers about how to best support survivors. Conclusions : Recommendations include the need for more survivor-centred, culturally appropriate and trauma-informed services and more attention to survivors belonging to underserved groups in policy, practice and research.

show abstract

Section: Discussionsupporting

confidence: 91%

Underserved survivors of sexual assault: a systematic scoping review

Bach

Hansen

Ahrens

et al. 2021

European Journal of Psychotraumatology

View full text Add to dashboard Cite

show abstract

“…These findings highlight a critical need to increase mental health services for survivors of sexual violence, particularly telehealth options, that are accessible both during and following crises. Researchers have advocated for increasing the availability of mental health services delivered through sexual assault service providers (SASPs), possibly through partnerships with local counseling providers ( Stefanidou et al, 2020 ). Specifically, rural SASPs have successfully partnered with university-based mental health programs to provide care, and specifically telehealth counseling, to rural victims of sexual violence who otherwise lacked access ( Gray et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Survivors’ Concerns During the COVID-19 Pandemic: Qualitative Insights From the National Sexual Assault Online Hotline

Elliott

Bardwell

Kamke

et al. 2022

J Interpers Violence

View full text Add to dashboard Cite

With the onset of the COVID-19 pandemic and the implementation of stay-at-home orders in March 2020, experts warned of the possible threat of increased interpersonal violence among individuals isolated with abusers. Researchers have sought to understand how the pandemic impacted victims primarily through the analysis of administrative data sources, such as hospital and police records. However, the preponderance of this data shows a decrease in formal help-seeking among victims during the pandemic, speaking to an impaired access to services but limiting our understanding of other ways in which the pandemic has affected survivors. To overcome these limitations, we examined data collected about users of the National Sexual Assault Online Hotline (NSAOH). Information was collected through staff based on retrospective recall following one-on-one chat sessions with 470 victims of sexual violence who contacted the NSAOH in the first six months of the pandemic and discussed COVID-19-related concerns. We qualitatively examined open-ended descriptions of COVID-19-related concerns and identified the four most common: (1) mental health concerns, (2) creation or exacerbation of an unsafe living situation, (3) not being able to access services, and (4) not having access to a mandatory reporter or trusted adult. These findings demonstrate the myriad ways in which the pandemic affected the lives of victims of sexual violence and can inform practices for services and practitioners to best meet the needs of survivors moving forward. Specifically, these findings highlight the need for more accessible mental health services and funding for sexual assault service providers, as well as the importance of safety planning, particularly in times of crisis.

show abstract

“…This was because the policies/service specifications used to inform the extraction form (i.e Health and Justice, 2018; NHS England, 2016) contained few recommendations or indicators, which related to mental health or substance use, highlighting a lack of guidance around these issues at the macro-level. To address this, two new core principles and associated indicators were developed by examining and drawing on the results of our systematic review (Stefanidou et al, 2020) around effective mental health and substance use pathways within SARCs. The additional key principles were: (1) ‘ Identification of mental health and substance use needs ’ and (2) ‘ How the service addresses mental health and substance use needs’ .…”

Section: Methodsmentioning

confidence: 99%

“…For example, the SARC process can take several hours, meaning a person prescribed opiate substitution therapy may miss a dose or more and start to experience significant discomfort (Clinical, 2017; Independent Expert Working Group, 2017). When considering how examinations are scheduled for intoxicated or withdrawing service users, a relevant theory from the realist review was identified: ‘ If SARCs don't stock medication for substance use, then service users with withdrawal symptoms can't be managed within the SARC and may have to go to A&E/rearrange Forensic Medical Examination’ (Stefanidou et al, 2020). In order to test this theory, a number of questions were generated to be asked during staff interviews, for example, ‘ do you stock medication for substance use in the SARC?…”

Section: Methodsmentioning

confidence: 99%

“…The study consists of several interconnected work packages (further details can be found on the study website here: https:// mimosstudy.org.uk). Initially, systematic (Stefanidou et al, 2020) and then realist reviews (Stefanidou et al, 2021) were conducted to gain an understanding of the current evidence base (Ariss et al, 2020).…”

Section: Documentary Analysis In a Mixed-methods Realist Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Documentary Analysis Within a Realist Evaluation: Recommendations From a Study of Sexual Assault Referral Centres

Price

Domoney

Ariss

et al. 2021

International Journal of Qualitative Methods

Self Cite

View full text Add to dashboard Cite

Realist approaches are increasingly used in studies of complex health interventions/evaluations to understand how programmes work, for whom and under what circumstances. Mixed-method data sources can be used to generate, refine and test realist programme theories, which explore causal links about the contexts that affect the mechanisms of an intervention and lead to the production of different outcomes. The realist approach provides a framework for a detailed understanding of how a programme functions, aiding with the implementation, refinement or adaptation of interventions. Documentary analysis provides an overview of the theoretical and practical functioning of a service and the ways it is structured to provide interventions. Data are often collected early in the evaluation and can include service specifications, organisational policies and procedures and routine audit data. This paper describes a two-stage process of documentary analysis, where data extraction forms and journey maps are used to explore how Sexual Assault Referral Centres (SARCs) in England respond to the mental health and substance use needs of users. Using documentary analysis as part of a sequential data collection process can be valuable in informing subsequent data sources (e.g qualitative interview schedules can be used to further test and refine theories from a documentary analysis). Considerations for researchers in applying documentary analysis include the value of keeping initial searches broad, to capture documents from a range of sources; the need for clarity about the prioritisation of data sources in the selection process; the benefit in establishing a standardised extraction form that incorporates the wider context within which the intervention functions; taking steps to ensure face validity and transferability during interpretation of data sources; the benefits of transforming information from the data extraction form into a visual journey map.

show abstract

The identification and treatment of mental health and substance misuse problems in sexual assault services: A systematic review

Cited by 17 publications

References 98 publications

Underserved survivors of sexual assault: a systematic scoping review

Underserved survivors of sexual assault: a systematic scoping review

Survivors’ Concerns During the COVID-19 Pandemic: Qualitative Insights From the National Sexual Assault Online Hotline

Documentary Analysis Within a Realist Evaluation: Recommendations From a Study of Sexual Assault Referral Centres

Contact Info

Product

Resources

About