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A light in the darkness

The six Sexual Assault Treatment Units (SATUs) in Ireland provide clinical, forensic, and supportive care for those who have experienced sexual violence. These units are located in Dublin, Cork, Waterford, Mullingar, Galway, and Letterkenny and in 2015, these units provided care for a total of 685 men and women who disclosed rape or sexual assault, according to figures from the recently published National SATU Annual Key Services Activity Report 2015.

In addition to these six SATUs, there is an out-of-hours service at the Mid-Western Regional Hospital in Limerick. This service provided forensic medical examination following referral by An Garda Síochána for a further 22 patients in 2015. “Additional funding would enable provision of the full range of SATU staff and both acute and follow-up services at this location,” notes the Report.

Alcohol and drug use in sexual assault cases

The National SATU Annual Key Services Activity Report 2015 found that 302 patients (44.1 per cent) had consumed more than four units of alcohol in the 12 hours prior to their incident. Some 76 patients (11.1 per cent) were concerned that drugs had been used to facilitate sexual assault.

These figures, particularly the statistics relating to alcohol, generated much media comment on the release of the SATU Report.

Dr Eogan says that it is “standard practice that we collate that information”.

“The reason being is that part of the forensic sampling that we do includes a toxicology assessment, to assess whether it may be a drug-facilitated sexual crime. It is important that we know the drugs or alcohol that a patient has taken in order that the guards can detect whether there is something over and above what a patient knew they had taken.”

However, Dr Eogan added that issues around alcohol’s involvement in sexual assault can be a difficult.

“From every national and international study it is apparent that significant alcohol intake is more likely in people who have been victims of sexual crime and also those who have been perpetrators of sexual crime,” she says.

“So there is definitely a public health message to get out there in terms of safe alcohol use and limiting high-risk behaviour.

“But it’s really important to say that being vulnerable by virtue of high alcohol intake is not the same as being culpable.

“So just because someone is a victim of sexual crime after a significant alcohol intake does not mean they were the cause of that sexual crime – nor does it mean that they themselves are responsible or in any way deserve that sexual crime.

“Nobody deserves to have sexual crime visited upon them, but there are certain factors that may increase someone’s vulnerabilities to sexual crime.”

Dr Eogan says the National SATU Services are aware of some of the concerns over the figures, but maintains “it really is a public health message rather than a blame game in any way”.

“It is a difficult message sometimes to get out there,” acknowledges Dr Eogan.

“When you discuss alcohol in the same breath as sexual crime sometimes people can take that up very sensitively and imply that sexual assault services are saying that people with significant alcohol intake are in someway deserving of having [a sexual assault] visited upon them, but I think it would be remiss of us not to highlight that association.

“The same way that people from a safety perspective know not to walk down a dark street on their own, it is important that link is highlighted and people are aware so they can look out for each other.”

These sentiments were echoed by Ms Noeline Blackwell, CEO of the DRCC.

“We are depending on the anecdotal experience of the centre [DRCC] because there is a lack of objective research out there on the topic,” says Ms Blackwell.

“Drink figures in a lot of sexual assaults in a lot of sexual violence and drugs can figure as well.

“So there is no doubt about that. Drink can happen on both sides. But again if I go back to the analogy – if you are outside a pub blind drunk on a Friday night, that doesn’t give you permission to go and thump anyone outside the pub as well. In the same way being drunk doesn’t give you permission to sexually assault someone else, nor does it mean that you are to blame if you are assaulted.

Ms Blackwell says “there is no circumstance” in which the victim should be blamed or the perpetrator should be excused because of the involvement of alcohol.

While the Report records an increase in attendances to the six units last year (from 628 in 2014), those who work in the field caution against any rush to judgment regarding possible trends shown in these numbers.

“No, I don’t think with one year that we can make any conclusions with this increase,” Dr Maeve Eogan, Medical Director of the National SATU Services, tells the Medical Independent (MI).

In fact the 2014 figure of 628 attendances was a reduction of 49 cases nationally from 2013 (when 677 patients attended),

“On the one hand you could say it’s negative with an increase in sexual crime last year, but we know that universally sexual crime is an under-reported entity, so we are probably only seeing a small proportion of people who experience sexual crime,” says Dr Eogan.

“On the other hand if it means people are more aware of our services and are therefore more likely to use them when they need them –that is hopefully positive.

“If it means there is an increase in sexual crime, then that is obviously a negative. It will be interesting to review this over time to see if this is a sustained increase or if this is just a blip in a particular year.”

The SATU Report also makes a number of other interesting findings including that 462 (67.4 per cent) of incidents occurred between the hours of 9pm and 9am.

“The round-the-clock service is very important, because DNA evidence deteriorates quickly so the sooner the better that people are seen,” notes Dr Eogan, who is a Consultant Obstetrician and Gynaecologist at the Rotunda Hospital, Dublin.

””

Dr Maeve Eogan

“Also the sooner the better that DNA samples are taken before they wash their clothes, wash themselves, brush their teeth.

“So therefore if you only have a 9 to 5 service and an incident happens to someone at 6pm – well then they are going to have to wait until the following morning and in that time they are going to have to be able to wash or whatever.

“So, it’s better to be able to see people on an around-the-clock basis in order that we can accrue the evidence in as prompt a fashion as possible so that we can give them emergency contraception or any other preventative treatment.”

A new service where forensic evidence can be stored by the SATUs over a longer period of time, allowing patients to make a later decision whether to report the incident to An Garda Síochána, has just been rolled out .

The Report also finds that 631 (92.1 per cent) patients in 2015 were women and 54 (7.9 per cent) were men. The mean age of patients was 25 years, with the youngest patient just 13 years, while the eldest was aged over 80 years.

The National SATU Annual Key Services Activity Report 2015 – key statistics

There were 685 attendances at the six SATUs in the Republic of Ireland in 2015, an increase of 57 cases nationally from 2014 (when 628 patients attended).

462 (67.4 per cent) of incidents occurred between the hours of 21.00 – 08.59, underpinning the need for a round-the-clock service.

The majority of patients reported recent sexual assaults (within seven days).

567 (82.8 per cent) cases involved a single assailant.

631 (92.1 per cent) patients were women and 54 (7.9 per cent) were men.

The mean age of patients was 25 years, the youngest was 13 years, while the eldest over 80 years.

508 (74.2 per cent) cases were referred to the SATU by An Garda Síochána.

540 (78.8 per cent) patients reported the incident to An Garda Síochána and the majority of these attended the SATU within 72 hours of the incident.

DRCC Annual Report 2015 – key statistics

12,615 contacts with DRCC services in 2015.

10,468 counselling calls.

284 victims of recent rape and sexual assault were accompanied by trained DRCC volunteers at the Rotunda SATU.

43 people accompanied to Court or Garda stations

3,536 appointments delivered.

83,478 visits to the DRCC website.

 The Rotunda SATU  faced some challenges in terms of staffing over the last year.

“In 2015 we continued to experience challenges in staffing our assisting nurse/midwife rota,” reads the Report.

“This meant that there were occasions when we were unable to provide an out-of-hours service, which is not ideal, in these instances cover for our patients was provided by the SATU at the Midlands Regional Hospital, Mullingar and we thank them for their support.

“A recruitment drive has been initiated and hopefully this imbalance will be reversed over the course of 2016.”

Earlier this year the Child and Adolescent Sexual Assault Unit (CASATS) in Galway was closed for a period, however, it re-opened its services in April.

Resources

The Dublin Rape Crisis Centre (DRCC) has a dedicated group of volunteers who are available to offer support to women and men who are attending the SATU in the Rotunda Hospital.

The DRCC recently published its latest Annual Report. The headline figures showed a strong demand for its services in 2015, with almost 12,000 people contacting the organisation’s national helpline.

“What strikes me as very important is the number of people who are actually reporting in the first place, people who are disclosing that they are in trouble or that an issue arose,” Ms Noeline Blackwell, CEO, DRCC, tells MI.

However, she says she is worried that resources in the area cannot at the moment keep up with demand – especially when it comes to therapy.

“I am concerned that our resources don’t allow us to see everyone that needs therapy. It is entirely unacceptable that we have waiting lists for people who need therapy,” she warns.

“Because people who need therapy need it now. On the other hand I think it’s important that the helpline is there.

“I think it’s such a vital service to have the helpline day and night. We are a cohort of volunteer counsellors who undergo intensive training who will work through the night and almost 12,000 people contacted the helpline [in 2015]. Of that about 10,000 of them will be looking for counselling support for themselves, because they have had an experience that needs attention. That in my mind is the important figure.”

In terms of funding the sector, Minister for Children and Youth Affairs Katherine Zappone, recently told the Dáil a network of 60 organisations provide services to victims of domestic, sexual, and gender-based violence in Ireland, including 20 services providing emergency refuge accommodation to women and children, 24 community-based domestic violence services, and 16 rape crisis centres providing services to victims of sexual violence.

“The Agency [Tusla] has established a more co-ordinated approach for provision of these services, with a dedicated national budget of €20.6 million in 2016,” the Minister said.

Minister for Justice Francis Fitzgerald also recently told the Dáil of her Department’s plans to develop and implement a coherent national awareness-raising campaign to “achieve attitudinal and societal change to support the prevention of domestic, sexual, and gender-based violence”.

“Funding of €950,000 has been secured for this national primary prevention project in 2016,” she said.

“An EU tendering process is ongoing to recruit the professional expertise to execute this action. The first phase of the campaign will go live in the final quarter of 2016. Subject to funding allocation the campaign will continue over a total six-year period.”

Legislation

There are also a number of significant developments in legislation in the general area of sexual assault and Ms Blackwell says the DRCC wants to see progress on these as soon as possible.

The DRCC has called for the swift passage of the Sexual Offences Bill when politicians return after their summer break.

“We have in Ireland a legal system that is entirely out of date, with the kind of damage that can be done to children by predators through the Internet in particular,” Ms Blackwell tells MI.

“For instance, it is almost unbelievable that we have no offence against the grooming of children over the Internet in Ireland.

“The grooming of children in itself is desperate and it can lead to such awful abuse of children.  That is one of the things that you could actually prosecute better if you have the legislation there.

“This legislation would put in place a better structure for the protection of children. While our job in the Dublin Rape Crisis Centre is to, of course, work with healing the victims of sexual violence, it is also to prevent such sexual violence into the future.

“And part of that is about insuring there is a proper legal framework in place so that children are not subjected to harm wherever possible.

“That is why we are asking as a matter of real urgency that everyone deal with it when they come back in September.  It is particularly urgent in the context that the Government recognises this as a piece of priority legislation. 

“It was past by the Seanad in the last Oireachtas. It was introduced as a priority into this Dáil, but never debated in the couple of months it has been sitting there. So everybody knows it is a good thing and it hasn’t been passed. It is nearing the line, it is tipping the line and we want to push that forward.”

The Sexual Offences Bill is now back in front of the Dáil for its second stage.

“The Bill completed passage through Seanad Éireann in January 2016,” a Department of Justice and Equality spokesperson told MI.

“It is now at second stage in Dáil Éireann. It was evident from the debates in Seanad Éireann and to the extent that the Bill was considered in Dáil Éireann, that the Bill received wide cross-party support.”

The DRCC also wants to see the Criminal Justice (Victims of Crime) Bill passed as soon as possible.

“It is really important that the Victims of Crime Bill be advanced as well. It is at a stage that we have the Heads of the Bill, but we need the actual structured legislation in this case,” Ms Blackwell tells MI.

“This is important in the context of an EU Directive, which we have adopted in Ireland, which should have been transposed into our domestic law in 2015, but which hasn’t been yet. We are in breach of our EU obligations, apart from the extra protection it would give to the victims of crime.”

A spokesperson for the Department of Justice and Equality told MI that “it is intended to publish the Victims of Crime Bill shortly and to secure its adoption as soon as possible thereafter”.

The spokesperson also told MI that there are no plans at the moment for a second Sexual Assault and Violence in Ireland study (SAVI 2) because of funding issues. “However, the Department continues to investigate the financial feasibility, resource implications and approaches to identifying a ring-fenced funding stream for undertaking this body of work at this time and to explore obligations with regard to requisite public procurement arrangements.”

Such a study would show the prevalence of, and attitudes to, sexual violence and elucidate how the experience has changed since SAVI 1.

Minister Fitzgerald told the Dáil in April that “the overall cost of a report is likely to be in the order of €1 million over three years”.

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