The DiSH (Disclosure in Sexual Health) project to develop an identification and support intervention for sexual violence survivors
Funding
Bristol, North Somerset and South Gloucestershire CCG Research Capability Funding (Local development)
What is the research question?
How can sexual health services improve the identification and support for sexual violence (SV) survivors using sexual health services through developing trauma and lived experience informed screening?
What is the problem?
- Sexual abuse and violence are common, rates are increasing and yet criminal justice data shows most survivors (85%) do not report it.
- For many, sexual health services will be their first port of call for seeking help but most do not disclose at this point.
- Recent work with survivors’ groups run by Somerset and Avon Rape and Sexual Abuse Service (SARSAS) has highlighted the gap between what survivors need to be in service in order to be able to tell.
- Existing evidence and practice focused on identification of Domestic Violence (partner or ex-partner) which can miss a range of unwanted sexual experiences with acquaintances or casual intimate partners.
- The way services screen for sexual violence may not allow for people’s own struggle with shame, stigma and blame in order to see what has happened to them as sexual violence (clinical understanding of a trauma informed approach).
- The evidence base and the study team’s own research confirms the need to improve screening to better identify sexual (vs domestic) violence and explore how to ask people about sexual violence.
The negative effects of sexual violence ripple across generations, affecting individuals’ capacities to work, and participate in family and community life. Better screening provides the opportunity to prevent that harm.
What is the aim of the research?
To improve the identification of victims of sexual violence currently using sexual health services to maximise the possibility of early intervention through referral to specialist support services. This has the potential to significantly reduce the physical, psychological and social impact of sexual violence on those affected.
The team will develop and test different ways of asking sexual health service users about sexual violence. The intended impact of this research will be:
- To increase the identification of sexual violence within sexual health services through a co-produced study of how to ask about it.
- To expand the understanding of routinely asking about unwanted sexual experiences to better reflect the range of sexual violence happening that does not fit current domestic violence focused screening (routine asking).
- Test out the impact of being asked about sexual violence patients both positive and negative
- Test out the impact of asking on staff and the wider system such as training needs of staff, what demand this creates on onward referral.
How will this be achieved?
The team intend to run an evaluation study in two places to explore how we ask about sexual violence now, how we can improve it, and how it impacts on the staff, the service and the wider referral network. We will develop an intervention using different approaches to improving screening practice for sexual abuse/violence in sexual health services. The work will be built alongside survivors with the aim of empowering secure and appropriate specialist support on their own terms.
Who is leading the research?
Dr Jane Meyrick, Senior Lecturer in Health Psychology, University of the West of England, Bristol.
Further information
For more information or to get involved in this project, please contact bnssg.research@nhs.net