Sexual Assault Services and the Public Health Model: An Australian Experience

1
Sexual Assault Services and the Public Health
Model An Australian Experience

• Patricia Leahy, PhD

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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

• Multi-disciplinary, evidence-based, holistic
  model
• Sexual violence not just a simplistic two
  dimensional model (SW, and legal) but a
  whole-of-government model
• Education
• Health
• Social Welfare
• Public Policy
• Justice
• Sexual Violence as a Mainstream Issue

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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)
Australian Capital Territory Canberra 1 (308,000)
120 (15m)
Tas 3 (459,000)
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National Association of Services Against Sexual
Violence (NASASV)

• Peak Body (National level lobby group) 1997
  (Resourced, on a project basis by the Office of
  the Status of Women)
• 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

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Canberra Rape Crisis Centre (ACT)

• Grew out of the Womens Movement in the 70s
• 1976 opened
• 1980 government funded
• 1989 funding for after-hours service
• 1994 funding for community education programme
• 1998 funding to auspice mens service (SAMSSA)
• 2001 funding for Aboriginal Support and Education
  Programme

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Feminist Human Rights Model

• Support and Advocacy
• Community based counselling, Crisis support and
  advocacy
• Refer and work with medical, legal, and other
  community resources
• 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
• Collective governance
• power sharing and accountability

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Community Based Counselling

• Housed in a residential Specific workers for
  adult women (2), young women (1), and children
  (1).
• Group support
• Drop in
• Ongoing group for ritual abuse survivors
• School based groups for young women
• Advocacy
• Court support, Victim Impact Statements,
  referrals/applications for social welfare support

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Evidence-based Servicing

• Collaborative Research
• Service effectiveness
• Identifying needs
• women with disabilities,
• lesbian and bisexual women,
• women from non-English speaking backgrounds
• Indigenous women

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Community Education

• Some examples
• Department of Defence
• Police
• Dept of Foreign Affairs
• Dept. of Education
• Family Services (SWD)
• Paramedics
• Hospital staff
• Paramedics
• Schools (students and teachers)

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Publications
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Political and Social

• CRRC membership
• ACT Sexual Assault Advisory Committee
• ACT Council of Social Services (VP)
• NASASV 2 members (Chair)
• Examples of CRCC contributions
• 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,

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Collective Governance

• Management Collective
• Working groups
• 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

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Challenges in Australia

• 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)

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Summary

• Feminist model as it operates in CRCC mirrors the
  public health approach
• Operates effectively across sectors,
• Holistic,
• Evidence based servicing
• What PH can possibly provide
• Mainstreaming
• Access to resources

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Sexual Violence in a Hong Kong Community Sample N
508 (Leahy, Pang, Tang Cheung)


17
Sexual Violence in a Hong Kong University Sample
N 667 (Leahy, Fung, Tang Cheung)



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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.

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Criminal Justice System

• How effective is the criminal justice system in
  communicating to the general public that sexual
  violence is a serious offence?
• Only 4.8 of cases handled by Rain Lilly in 2000
  were successfully convicted (SCMP, Nov 2, 2002)

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(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 Bokharys response to
  these remarks.

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How effective are the health and social welfare
systems in servicing victims of sexual violence?

• How well-resourced are services providing
  specialized services to victims of sexual
  violence?
• How well-trained are front line workers in sexual
  violence issues? (doctors, nurses, social
  workers, psychologists, )

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Doctors Attitudes

• Wong, Wong, Lau Lau, (2002)
• 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

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Social Workers Attitudes

• Tang, Pun Cheung (2002) compared (a) social
  workers, nurses etc. with (b) police, laywers
  etc.
• Which group was more likely to have
  victim-blaming attitudes, (a) or (b)??
• How many of us here today have had any formal
  specialized training (one or more full semester
  courses) as part of our basic training??

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Public Policy?

• 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)
• Role for the Womens Commission?

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Education?

• How effective is the education system in
  promoting a zero tolerance approach to sexual
  violence
• 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
• Including sexual violence issues into the sex
  education curriculum in schools

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Finally..
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Best practice in self-care for individual workers
in each sector.

• McFarlane van der Kolk, 1996
• 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.